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Flashcards in Pediatric Anomalies Deck (79)
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1

there is an increase of what with prematurity

postop apnea

2

prematurity is defines as a birth before ____weeks gestation

37

3

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

small for gestational age

4

what is the calculation to determine post conceptual age?

gestational age + post maternal age

5

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

4 x 6 = 24
30 + 24 = 54 weeks PCA

6

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

60 weeks

7

Congenital Diaphragmatic Hernia:
70 - 90 % of all defects are on what side?

left

8

Congenital Diaphragmatic Hernia:
why are 70-90% of all defects on the left side?

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

9

Congenital Diaphragmatic Hernia:
what lung is the hypo plastic lung

ipsilateral

10

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

barotrauma

11

Congenital Diaphragmatic Hernia:
there is a high incidence of what with these patients

congenital heart dz

12

Congenital Diaphragmatic Hernia:
what do the APGAR scores look like with these pts

1st APGAR good/normal
2nd APGAR is decreased

13

Congenital Diaphragmatic Hernia:
what is the hallmark sign

profound arterial hypoxia

14

Congenital Diaphragmatic Hernia:
what is the profound arterial hypoxia d/t

right to left shunt

15

Congenital Diaphragmatic Hernia:
what do the chest usually look like

barrel shaped (b/c bowel in thorax)

16

Congenital Diaphragmatic Hernia:
what do the abdomens look like

scophoid (b/c bowels in thorax)

17

Congenital Diaphragmatic Hernia:
what type of accessory breathing is usually seen

retractions

18

Congenital Diaphragmatic Hernia:
the goal is to maintain predicate sats above what?

85%

19

Congenital Diaphragmatic Hernia:
want to use peak pressures of what?

below 20cm/H20

20

Congenital Diaphragmatic Hernia:
allow PaCO2 to rise to what level

45-55 mmHg

21

Congenital Diaphragmatic Hernia:
what do you want to do to stomach

decompress

22

Congenital Diaphragmatic Hernia:
what is the last resort effort

ECHMO

23

Congenital Diaphragmatic Hernia: Anesthesia Concerns
where should pulse ox monitors be placed

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

24

Congenital Diaphragmatic Hernia: Anesthesia Concerns
these pts usually have what type of shunt

R - L

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

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