Ped/OB Exam Review Flashcards
(100 cards)
1
Q
Arnold-Chiari malformation may have what symptoms?
A
Recurrent Aspiration
2
Q
Syndactyly, Cloverleaf Skull, Hypertolerism, and Midface Hyperplasia are characteristics of what syndrome?
A
Apert Syndrome
3
Q
What induction drug should be avoided in Arnold-Chiari malformation surgery?
A
Ketamine (↑ ICP concerns)
4
Q
Which Chiari malformation is most often associated with spinal bifida?
A
Type II (Arnold-Chiari)
5
Q
Most common pediatric craniofacial defect
A
Cleft Palate
6
Q
Anesthesia Intervention for Cleft Palate
A
- Video Laryngoscopy
- Dexemetomidine Infusion
7
Q
Congenital Diaphragmatic Hernia is a defect that involves _________.
A
Hypoplastic Lung Tissue
8
Q
What is the condition?
A
Gastroschisis
9
Q
Indications for Craniofacial Surgery
A
- Psychosocial Reasons
- Severe Exopthalmus
10
Q
Down Syndrome Anesthesia Induction Considerations
A
- Post extubation stridor
- Bradycardia
- Potential Airway Obstruction
11
Q
Intervention for the Following ETCO2
A
- Increase FiO2 to 100%
- Ask the surgeon to stop stimulating the patient
12
Q
Anesthesia Considerations for Encephalocele
A
Challenging airway for the anesthesia provider.
13
Q
Goldenhar Syndrome Characteristic
A
- Cleft Palate
- Mandibular Hypoplasia
14
Q
Gastroschisis and Omphalocele surgical concerns for Anesthesia.
A
- Monitoring signs of impeded venous return
- Hypothermia
- Hypovolemia
15
Q
What is the congenital syndrome?
A
Meningocele
16
Q
Anesthesia concern for bilateral microtia
A
Difficult airway
17
Q
What is this causing?
A
Hypertrophied Pylorus Muscle
18
Q
What does Pyloric Stenosis cause?
A
OUTLET obstruction
19
Q
Crouzon Syndrome features
A
- Midface hypoplasia
- Proptosis
20
Q
Inspiratory stridor and retraction at the suprasternal notch are symptoms associated with what?
A
Laryngospasm
21
Q
If ETT luminal diameter decreases by 2 mm in a pediatric patient, what would be the increase in airway resistance?
A
32x increase in airway resistance
22
Q
What is the syndrome?
A
Pierre Robin Syndrome
23
Q
This syndrome requires a tongue suture to prevent glossoptosis in PACU.
A
Pierre Robin Syndrome
24
Q
What acid-base balance is seen with Pyloric Stenosis?
A
Hypokalemic/ Hypochloremic Metabolic Alkalosis
25
Long-term complications seen from untreated Scoliosis
* Decrease lung compliance
* Recurrent Lung infections
26
What type of scoliosis is associated with cardiac and urological abnormalities along with hemifacial microsomia
Congenital Scoliosis
27
Spinal Bifida is a result of what?
Failure of fusion at the vertebral arches
28
Which Tracheoesophageal Fistula is the most common?
Type C (blind esophageal pouch and TE Fistula coming from the trachea)
29
The most common location for a Congenital Diaphragmatic Hernia
Left Posterior Lateral
30
The primary characteristic of Down Syndrome
* Mandibular hypoplasia
* Hypotonia
* Subglottic Stenosis
31
Primary goal of managing pediatric airway with TE Fistula
Prevent aspiration pneumonitis
32
Three main characteristics involved with the Pierre Robin triad?
* Glossoptosis
* Micrognathia
* Respiratory Distress
33
A higher dose of TXA would be considered for this surgical procedure
Neuromuscular Scoliosis Repair
34
The 3 C's of TE Fistula
* Coughing
* Choking
* Cyanosis
35
Anesthesia intervention for intraoperative bronchospasm
* 100% FiO2
* Deepening Anesthetic
36
Anesthesia consideration for myelomeningocele
* Preservation of function
* Avoidance of further injury
* Proper position for intubation
37
Signs of Bronchospasm
* Expiratory Polyphonic Wheezing
* Slow upslope on the capnography monitor
38
Omphaloceles are associated with these anomalies
* Congenital Heart Defects
* Urologic Defects
39
_________ syndrome becomes more difficult to manage with age
_________ syndrome becomes easier to manage with age
* Treacher Collins is more difficult with age
* Pierre Robin is easier with age
40
Congenital Diaphragmatic Hernia Interventions
Small frequent tidal volumes
41
Calculate the appropriate tube size for a 6-year-old.
5.5 mm ETT
## Footnote
(6/4) + 4 = 5.5
42
Calculate the appropriate tube size for a 10-year-old.
6.5 mm ETT
## Footnote
(10/4) + 4 = 6.5
43
Large tongue, small mouth, and atlantooccipital instability associated with this syndrome
Down Syndrome
44
Determine the ETT depth of a 10-year-old
17 cm
## Footnote
(10/2) + 12 = 17 cm
45
Determine the ETT depth of a 4-year-old
14 cm
## Footnote
(4/2) + 12 = 14 cm
46
The recommended dose of PO versed for pediatric patient
0.5 mg/kg
47
Strabismus correction surgery is associated with these complications
* N/V
* Intraoperative bradycardia
* Malignant Hyperthermia
48
Which of the following is not recommended when securing an airway for epiglottis?
You do not want an IV induction (Keep the patient as calm as possible)
49
The cricoid cartilage is the only ________ cartilage in the tracheal bronchial tree
Complete Ring
50
The narrowest part of a child's airway
Cricoid Ring
51
What does VACTERL stand for?
* Vertebral defects
* Anal atresia
* Cardiac defects
* Tracheal anomalies
* Esophageal fistula
* Renal anomalies
* Limb abnormalities.
52
The 3 C's of TE Fistula (repeat)
* Coughing
* Choking
* Cyanosis
53
Which common condition is associated w/ CDH?
Pulmonary Hypoplasia
54
What would be the appropriate management method for a patient with suspected epiglottitis?
Administration of appropriate cephalosporins
55
Which condition is not commonly associated with Trisomy 21
Hyperthyroidism
56
Hemabate should be used with caution in which of the following comorbidities?
Reactive airway disease
57
The most common cause of postpartum hemorrhage
Uterine atony
58
Define placenta increta
The placenta has invaded the myometrium
59
Which of the following is true of placental abruption?
* Constriction of vessels will be impaired.
* Chronic cocaine use is an increase risk factor
* Uterus and abdomen are hypertonic and tender to the touch
60
C-section patient on Mag. Which medication should be eliminated for general anesthesia?
Defasciculating dose of rocuronium
61
Inverted uterus, what medication will relax the uterus?
Nitroglycerin
62
Hallmark sign of placenta previa
Painless vaginal bleeding
63
What are the benefits of ondansetron for amniotic embolism?
* Mitigation of intense pulmonary vasoconstriction
* Inhibition of initial platelet activation
* Prevention of RV failure
64
Uterine rupture is associated with what?
* FHR < 110
* TOLAC
* Massive maternal hemorrhage
65
The primary risk of placenta abruption.
Hypovolemic Shock
66
The presence of ___________ indicates the patient has preeclampsia and not gestation hypertension
Proteinuria
67
Initial symptoms of amniotic fluid embolism is a result of ___________
Pulmonary vasoconstriction
68
Second-line treatment for boggy uterus after oxytocin
0.2 mg IM Methergine
69
Characteristics of magnesium infusion
* Acts on NMDA receptors to raise the seizure threshold
* Patient will feel warm/flushed
* Inhibits the release of ACh at the NMJ
* Toxicity is treated with Ca Glugonate 1g
70
Repeat C-sections are at risk for
* Placenta previa
* Gestation diabetes
* Wound infection
* Fetal malposition
71
Pt with umbilical prolapse has an in situ epidural running 0.1% ropivacaine + fentanyl 1mcg/mL infusion at 10 mL/hr. The best option for managing this patient's anesthetic for a C-section?
Give 2-chloroprocaine 3% (15 mL) + morphine preservative 2mg through the epidural
72
Twin-to-twin transfusion syndrome is commonly associated with this type of placentation.
Dichoriontic Diamniotic
73
The placenta attaching and invading the myometrium and adjacent organs is referred to as
Placenta Percreta
74
A positive fetal fibronectin level is associated with
preterm labor
75
Anesthesia conditions for external cephalic version
* Admin Nitroglycerin
* Prep OR for RSI
* Preform analgesic spinal
76
Preeclamptic patients is more likely to have
* Thrombocytopenia
* Increase SVR
* Low oncotic pressure
* Decrease fibrinogen levels
77
Patient on propranolol, during epidural test dose, aspiration has blood. Explain failure for IV test dose.
* Pre-existing adrenergic blockade blunted tachycardia of IV epinephrine
* Pain of labor mask the change seen with the test dose
78
HELLP syndrome, what is the rationale for the administration of corticosteroids?
* Increase parturient plt count for C-section
* Decrease intraventricular hemorrhage of the fetus after birth
79
Maternal physiological change during preeclampsia
* Decrease renal blood flow
* Decrease hepatic blood flow
* Increase cerebral blood flow
80
The most common symptoms before eclamptic seizure
* Headache
* Visual disturbancess
81
Mag Toxicity: what drug should be administered to treat this?
Calcium Gluconate
82
Mag infusion, pt develops 3rd degree heart block. What is the best intervention for immediate resolution of the conduction defect?
IV Calcium Chloride
83
Patient is 10cm dilated, baby is breeched, what drugs will relax the uterus to optimize delivery
* Sevoflurane
* Epidural Opioids
* Pudendal Nerve Blocks
* Nitrous Oxide Inhalation
84
A woman undergoes general anesthesia C-section for preeclampsia. 2 hours post-op, the patient is still intubated, requiring mechanical ventilation, and cannot be aroused.
Deep Tendon Reflex 1+
MV, FiO2 0.4,
PaO2 130 mmHg
PaCO2 32 mmHg
pH = 7.45
BE = -0.6
What is the most likely cause?
Intercerebral Hemorrhage
85
Amniotic Fluid Embolism: What is the least likely clinical finding?
Increase end-tidal CO2 tension
86
TOLAC wants to try vaginal birth after 1 C-section, during delivery, experience a ruptured uterus. What is the likely cause of the uterine rupture?
Classic Uteral Incision
87
Hypotension associated with Pitocin administration following C-section delivery of the fetus occurs from
* The release of nitric oxide
* The release of atrial natriuretic peptide
88
Pt needs Methergine after a repeat C-section. Which receptor is the medication a partial agonist at?
Partial alpha-adrenergic receptor
89
Maximum dose of Methergine
0.8 mg IM
90
Epidural running 0.1 ropivacaine + fentanyl at 1 mcg/mL at 10 mL/hr. What is the best local anesthetic to use to convert this labor epidural to a surgery anesthetic?
Lidocaine 2%
91
Which drug will relax the uterus for the doc to remove the placenta?
Nitroglycerin 50 mcg IV
92
A 6-year-old (20 kg) girl develops pulseless v-tach after induction. What do you charge the defibrillator to?
40 J
## Footnote
2 J/kg
93
Neonate presents with 3 days of vomiting; what electrolytes need to be corrected before surgery?
* Chloride (hypochloremia)
* Potassium (hypokalemia)
94
A baby with gastroschisis is more likely than a baby with omphalocele to have this condition
Prematurity
95
17 yr old develops pulmonary edema after post-op laryngospasm; while breathing at 100%, SpO2 is 80%. Which of the following is the most appropriate management?
PPV
96
Sux does a comparison between infant/neonate and adult
The pediatric dose is increase to 2-3 mg/kg
97
Goals of urine output to monitor volume status intra-operatively
0.5-1 mL/kg/hour
98
What is the cardiac output increase in a mom delivering twins compared to a mom delivering one baby?
20% increase compared to a mom delivering a single baby
99
Which pediatric patient is at risk for hypoglycemia?
Neonates
100
The initial symptoms of umbilical cord prolapse is
Fetal bradycardia
