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► Med Misc 44 > Pediatric Anomalies > Flashcards

Pediatric Anomalies Flashcards

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1
Q

there is an increase of what with prematurity

A

postop apnea

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2
Q

prematurity is defines as a birth before ____weeks gestation

A

37

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3
Q

what is the term for an infant (full or preterm) whose age adjusted weight is less than the 5th percentile

A

small for gestational age

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4
Q

what is the calculation to determine post conceptual age?

A

gestational age + post maternal age

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5
Q

what is the post conceptual age of a baby who is 6 months old and born at 30 weeks

A

4 x 6 = 24

30 + 24 = 54 weeks PCA

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6
Q

less than ____ weeks PCA have the greatest risk of experiencing puostanesthestic complications

A

60 weeks

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7
Q

Congenital Diaphragmatic Hernia:

70 - 90 % of all defects are on what side?

A

left

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8
Q

Congenital Diaphragmatic Hernia:

why are 70-90% of all defects on the left side?

A

bc the opening ( left foramen of bochdalek) closes last during development

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9
Q

Congenital Diaphragmatic Hernia:

what lung is the hypo plastic lung

A

ipsilateral

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10
Q

Congenital Diaphragmatic Hernia:

anytime this occurs d/t the hypo plastic ipsilateral lung there is a risk of what?

A

barotrauma

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11
Q

Congenital Diaphragmatic Hernia:

there is a high incidence of what with these patients

A

congenital heart dz

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12
Q

Congenital Diaphragmatic Hernia:

what do the APGAR scores look like with these pts

A

1st APGAR good/normal

2nd APGAR is decreased

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13
Q

Congenital Diaphragmatic Hernia:

what is the hallmark sign

A

profound arterial hypoxia

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14
Q

Congenital Diaphragmatic Hernia:

what is the profound arterial hypoxia d/t

A

right to left shunt

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15
Q

Congenital Diaphragmatic Hernia:

what do the chest usually look like

A

barrel shaped (b/c bowel in thorax)

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16
Q

Congenital Diaphragmatic Hernia:

what do the abdomens look like

A

scophoid (b/c bowels in thorax)

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17
Q

Congenital Diaphragmatic Hernia:

what type of accessory breathing is usually seen

A

retractions

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18
Q

Congenital Diaphragmatic Hernia:

the goal is to maintain predicate sats above what?

A

85%

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19
Q

Congenital Diaphragmatic Hernia:

want to use peak pressures of what?

A

below 20cm/H20

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20
Q

Congenital Diaphragmatic Hernia:

allow PaCO2 to rise to what level

A

45-55 mmHg

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21
Q

Congenital Diaphragmatic Hernia:

what do you want to do to stomach

A

decompress

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22
Q

Congenital Diaphragmatic Hernia:

what is the last resort effort

A

ECHMO

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23
Q

Congenital Diaphragmatic Hernia: Anesthesia Concerns

where should pulse ox monitors be placed

A

Preductally ( Right upper extremity)
and
Postductally ( lower extremity)

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24
Q

Congenital Diaphragmatic Hernia: Anesthesia Concerns

these pts usually have what type of shunt

A

R - L

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25
Congenital Diaphragmatic Hernia: Anesthesia Concerns | can you use nitrous
nope
26
Congenital Diaphragmatic Hernia: Anesthesia Concerns | what type of ventilation mode is good to use
pressure limiting modes
27
Congenital Diaphragmatic Hernia: Anesthesia Concerns | if there is a Left sided herniation what is your concern for the right side
Pneumothorax
28
Congenital Diaphragmatic Hernia: Anesthesia Concerns | what is a good anesthesia plan
awake intubation sedation paralysis mechanical ventilation
29
Congenital Diaphragmatic Hernia: Anesthesia Concerns | what are 3 things you must avoid
hypothermia hypoxia acidosis
30
Congenital Diaphragmatic Hernia: Anesthesia Concerns | why must you avoid hypothermia, hypoxia, and acidosis
causes increased pulm vascular resistance
31
Plyoric Stenosis: | is this a medical emergency?
yes
32
Plyoric Stenosis: | what is it
idiopathic hypertrophy of the circular smooth muscle of the pylorus
33
Plyoric Stenosis: | S/S
non-bilious projectile vomiting at 2-5 weeks
34
Plyoric Stenosis: | what may occur d/t starvation
jaundice
35
Plyoric Stenosis: | what is the most common metabolic presentation
hypokalemic | hypochloremic Primary Metabolic Alkolosis w/ secondary respiratory acidosis
36
Plyoric Stenosis: | what 2 electrolyte abnormalities occur
HYPOkalemia | HYPOchloremia
37
Plyoric Stenosis: | what must be done prior to going to the OR
correct electrolyte disturbances | resp acidosis
38
Plyoric Stenosis: | how should these pt's be suctioned in the OR
``` 3 times left lateral right lateral supine 98% chance of evacuation of all stomach contents ```
39
Plyoric Stenosis: | should these pt's get LR
no
40
Plyoric Stenosis: | what may occur 2-3 hours after sx d/t inadequate liver glycogen stores and no dextrose infusions
hypoglycemia
41
Actue epiglottitis: | age if onset
2-7 yo | older than other one
42
Actue epiglottitis: | do they have a high fever
yes >39C
43
Actue epiglottitis: | why is there difficulty swallowing
edema of the supraglottic structures
44
Actue epiglottitis: | is there inspiratory stridor
yes
45
Actue epiglottitis: | what may happen in the struggling pt?
they may cause the airway to collapse
46
Actue epiglottitis: | how do the usually present
sitting forward and upright, chin up, mouth open, drooling
47
Actue epiglottitis: | etiology?
hemophilus influenza B, S aureus
48
Actue epiglottitis: | treatment?
vaccination against Homophilus influenza B, S aureus
49
Actue epiglottitis: Anesthesia concerns | what dos the epiglottis look like
cherry-red
50
Actue epiglottitis: Anesthesia concerns | does it require immediate intubation
yes
51
Actue epiglottitis: Anesthesia concerns | should you attempt to visualize the epiglottis
no
52
Actue epiglottitis: Anesthesia concerns | best position for sedation
sitting
53
Actue epiglottitis: Anesthesia concerns | muscle relaxants?
not for intubation
54
Actue epiglottitis: Anesthesia concerns | what about the ETT you use
smaller (1-3mm smaller) with leak
55
Actue epiglottitis: Anesthesia concerns | what is overall treatment goals
secure airway abx blood and throat cultures extubation in 2-3 days
56
Laryngotracheal bronchitits: | what is another name?
Croup
57
Laryngotracheal bronchitits: Croup | age of onset
6mths -6 yo | slightly younger than acute epiglottis
58
Laryngotracheal bronchitits: Croup | high grades fever?
no (low grade fever at best)
59
Laryngotracheal bronchitits: Croup | where is the narrowing of the airway?
Subglottic
60
Laryngotracheal bronchitits: Croup | hallmark sign on prsentation
croupy cough " barking"
61
Laryngotracheal bronchitits: Croup | is the most common cause of what in healthy kids?
airway obstruction
62
Laryngotracheal bronchitits: Croup | etiology
common cold
63
Laryngotracheal bronchitits: Croup | treatment
cool humidity oxygen recemic epi
64
Laryngotracheal bronchitits: (Croup) Anesthesia: | is there a need to emergently intubate
no (not most of the time)
65
Laryngotracheal bronchitits: (Croup) Anesthesia: | how do you prepare epi to give in a nebulizer and when can you repeat the treatment
a 2.25% epi in 3 mL NS is given @ 0.05 mL/kg up to 0.5 mL/kg | repeat Q1-4 hours
66
State Acute epiglottitis or Laryngotracheal bronchitits: | ange 2-7
AE
67
State Acute epiglottitis or Laryngotracheal bronchitits: | age 6 mths to 6 yo
LB
68
State Acute epiglottitis or Laryngotracheal bronchitits: | low grade fever
LB
69
State Acute epiglottitis or Laryngotracheal bronchitits: | high grade fever
AE
70
State Acute epiglottitis or Laryngotracheal bronchitits: | Inspiratory stridor
AE
71
State Acute epiglottitis or Laryngotracheal bronchitits: | croupy cough
LB
72
State Acute epiglottitis or Laryngotracheal bronchitits: | Subglottic narrowing
LB
73
State Acute epiglottitis or Laryngotracheal bronchitits: | supraglottic narrowing
AE
74
State Acute epiglottitis or Laryngotracheal bronchitits: | caused via common cold
LB
75
State Acute epiglottitis or Laryngotracheal bronchitits: | Caused Via homophilus influenza B
AE
76
State Acute epiglottitis or Laryngotracheal bronchitits: | Needs emergent intubation
AE
77
State Acute epiglottitis or Laryngotracheal bronchitits: | needs small ett
AE
78
State Acute epiglottitis or Laryngotracheal bronchitits: | correct w/ racemic epi
LB
79
State Acute epiglottitis or Laryngotracheal bronchitits: | cherry red epiglottitis
AE

► Med Misc 44 (72 decks)

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