Pediatric Anomalies Flashcards Preview

► Med Misc 44 > Pediatric Anomalies > Flashcards

Flashcards in Pediatric Anomalies Deck (79)
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1
Q

there is an increase of what with prematurity

A

postop apnea

2
Q

prematurity is defines as a birth before ____weeks gestation

A

37

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

4
Q

what is the calculation to determine post conceptual age?

A

gestational age + post maternal age

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

6
Q

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

A

60 weeks

7
Q

Congenital Diaphragmatic Hernia:

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

A

left

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

9
Q

Congenital Diaphragmatic Hernia:

what lung is the hypo plastic lung

A

ipsilateral

10
Q

Congenital Diaphragmatic Hernia:

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

A

barotrauma

11
Q

Congenital Diaphragmatic Hernia:

there is a high incidence of what with these patients

A

congenital heart dz

12
Q

Congenital Diaphragmatic Hernia:

what do the APGAR scores look like with these pts

A

1st APGAR good/normal

2nd APGAR is decreased

13
Q

Congenital Diaphragmatic Hernia:

what is the hallmark sign

A

profound arterial hypoxia

14
Q

Congenital Diaphragmatic Hernia:

what is the profound arterial hypoxia d/t

A

right to left shunt

15
Q

Congenital Diaphragmatic Hernia:

what do the chest usually look like

A

barrel shaped (b/c bowel in thorax)

16
Q

Congenital Diaphragmatic Hernia:

what do the abdomens look like

A

scophoid (b/c bowels in thorax)

17
Q

Congenital Diaphragmatic Hernia:

what type of accessory breathing is usually seen

A

retractions

18
Q

Congenital Diaphragmatic Hernia:

the goal is to maintain predicate sats above what?

A

85%

19
Q

Congenital Diaphragmatic Hernia:

want to use peak pressures of what?

A

below 20cm/H20

20
Q

Congenital Diaphragmatic Hernia:

allow PaCO2 to rise to what level

A

45-55 mmHg

21
Q

Congenital Diaphragmatic Hernia:

what do you want to do to stomach

A

decompress

22
Q

Congenital Diaphragmatic Hernia:

what is the last resort effort

A

ECHMO

23
Q

Congenital Diaphragmatic Hernia: Anesthesia Concerns

where should pulse ox monitors be placed

A

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

24
Q

Congenital Diaphragmatic Hernia: Anesthesia Concerns

these pts usually have what type of shunt

A

R - L

25
Q

Congenital Diaphragmatic Hernia: Anesthesia Concerns

can you use nitrous

A

nope

26
Q

Congenital Diaphragmatic Hernia: Anesthesia Concerns

what type of ventilation mode is good to use

A

pressure limiting modes

27
Q

Congenital Diaphragmatic Hernia: Anesthesia Concerns

if there is a Left sided herniation what is your concern for the right side

A

Pneumothorax

28
Q

Congenital Diaphragmatic Hernia: Anesthesia Concerns

what is a good anesthesia plan

A

awake intubation
sedation
paralysis
mechanical ventilation

29
Q

Congenital Diaphragmatic Hernia: Anesthesia Concerns

what are 3 things you must avoid

A

hypothermia
hypoxia
acidosis

30
Q

Congenital Diaphragmatic Hernia: Anesthesia Concerns

why must you avoid hypothermia, hypoxia, and acidosis

A

causes increased pulm vascular resistance

31
Q

Plyoric Stenosis:

is this a medical emergency?

A

yes

32
Q

Plyoric Stenosis:

what is it

A

idiopathic hypertrophy of the circular smooth muscle of the pylorus

33
Q

Plyoric Stenosis:

S/S

A

non-bilious projectile vomiting at 2-5 weeks

34
Q

Plyoric Stenosis:

what may occur d/t starvation

A

jaundice

35
Q

Plyoric Stenosis:

what is the most common metabolic presentation

A

hypokalemic

hypochloremic Primary Metabolic Alkolosis w/ secondary respiratory acidosis

36
Q

Plyoric Stenosis:

what 2 electrolyte abnormalities occur

A

HYPOkalemia

HYPOchloremia

37
Q

Plyoric Stenosis:

what must be done prior to going to the OR

A

correct electrolyte disturbances

resp acidosis

38
Q

Plyoric Stenosis:

how should these pt’s be suctioned in the OR

A
3 times
left lateral
right lateral
supine
98% chance of evacuation of all stomach contents
39
Q

Plyoric Stenosis:

should these pt’s get LR

A

no

40
Q

Plyoric Stenosis:

what may occur 2-3 hours after sx d/t inadequate liver glycogen stores and no dextrose infusions

A

hypoglycemia

41
Q

Actue epiglottitis:

age if onset

A

2-7 yo

older than other one

42
Q

Actue epiglottitis:

do they have a high fever

A

yes >39C

43
Q

Actue epiglottitis:

why is there difficulty swallowing

A

edema of the supraglottic structures

44
Q

Actue epiglottitis:

is there inspiratory stridor

A

yes

45
Q

Actue epiglottitis:

what may happen in the struggling pt?

A

they may cause the airway to collapse

46
Q

Actue epiglottitis:

how do the usually present

A

sitting forward and upright, chin up, mouth open, drooling

47
Q

Actue epiglottitis:

etiology?

A

hemophilus influenza B, S aureus

48
Q

Actue epiglottitis:

treatment?

A

vaccination against Homophilus influenza B, S aureus

49
Q

Actue epiglottitis: Anesthesia concerns

what dos the epiglottis look like

A

cherry-red

50
Q

Actue epiglottitis: Anesthesia concerns

does it require immediate intubation

A

yes

51
Q

Actue epiglottitis: Anesthesia concerns

should you attempt to visualize the epiglottis

A

no

52
Q

Actue epiglottitis: Anesthesia concerns

best position for sedation

A

sitting

53
Q

Actue epiglottitis: Anesthesia concerns

muscle relaxants?

A

not for intubation

54
Q

Actue epiglottitis: Anesthesia concerns

what about the ETT you use

A

smaller (1-3mm smaller) with leak

55
Q

Actue epiglottitis: Anesthesia concerns

what is overall treatment goals

A

secure airway
abx
blood and throat cultures
extubation in 2-3 days

56
Q

Laryngotracheal bronchitits:

what is another name?

A

Croup

57
Q

Laryngotracheal bronchitits: Croup

age of onset

A

6mths -6 yo

slightly younger than acute epiglottis

58
Q

Laryngotracheal bronchitits: Croup

high grades fever?

A

no (low grade fever at best)

59
Q

Laryngotracheal bronchitits: Croup

where is the narrowing of the airway?

A

Subglottic

60
Q

Laryngotracheal bronchitits: Croup

hallmark sign on prsentation

A

croupy cough “ barking”

61
Q

Laryngotracheal bronchitits: Croup

is the most common cause of what in healthy kids?

A

airway obstruction

62
Q

Laryngotracheal bronchitits: Croup

etiology

A

common cold

63
Q

Laryngotracheal bronchitits: Croup

treatment

A

cool humidity
oxygen
recemic epi

64
Q

Laryngotracheal bronchitits: (Croup) Anesthesia:

is there a need to emergently intubate

A

no (not most of the time)

65
Q

Laryngotracheal bronchitits: (Croup) Anesthesia:

how do you prepare epi to give in a nebulizer and when can you repeat the treatment

A

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
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

ange 2-7

A

AE

67
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

age 6 mths to 6 yo

A

LB

68
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

low grade fever

A

LB

69
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

high grade fever

A

AE

70
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

Inspiratory stridor

A

AE

71
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

croupy cough

A

LB

72
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

Subglottic narrowing

A

LB

73
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

supraglottic narrowing

A

AE

74
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

caused via common cold

A

LB

75
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

Caused Via homophilus influenza B

A

AE

76
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

Needs emergent intubation

A

AE

77
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

needs small ett

A

AE

78
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

correct w/ racemic epi

A

LB

79
Q

State Acute epiglottitis or Laryngotracheal bronchitits:

cherry red epiglottitis

A

AE

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