Pediatric General Surgery 5 (Exam 1) Flashcards by Kaitlyn McDow

Cleft lip and palate has an occurance rate of __________ and is more common in______
A. 1 in 500 ;males
B. 1 in 10000; females
C. 1 in 100; females
D. 1 in 600 ;males

D. 1 in 600; males

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Cleft lip and palate is more common in (select 2)
A. Asians
B. Africans
C. Latin Americans
D. White

A. Asians
C. Latin Americans

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Cleft lip and palate is least common in
A. Asians
B. Africans
C. Latin Americans
D. White

B. Africans

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Cleft lip and palate is often caused by and associated with (select 3)
A. syndromes
B. Viruses
C. enviromental causes
D. genetic causes

A. syndromes (more than 400 syndromes)
C. enviromental causes
D. genetic causes

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When does cleft lip and palate formation begin?
A. third trimester
B. second trimester
C. conception
D. first trimester

D. first trimester

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When is cleft lip usually repaired?
A. 6-10 months
B. 4-6 months
C. 2-3 months
D. 1-3 months

C. 2-3 months

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When is cleft palate usually repaired?
A. 6-10 months
B. 4-6 months
C. 2-3 months
D. 1-3 months

A. 6-10 months

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________ and ______ occur around 10 years of age.
A. palatal bone transformations
B. palatal revision
C. alveloar bone grafts
D. alveloar transplants

B. palatal revision
C. alveloar bone grafts

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True or false

If you have a cleft palate you will always have a cleft lip

False. You can have one without the other

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Difficult airway varies from about 3-23% and more difficult in _________ vs_________Cleft
A. bilateral vs unilateral
B. unilaterial vs bilateral

A. bilateral vs unilateral

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____________ is an independent predictor of a difficult airway but will _____ with age
A. Macrognathism increase
B. micrognathia; increase
C. Macrognathism; decrease
D. Micrognathia; decrease

D. Micrognathia; decrease

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Through Preop assessment we should assess if there is ____ present specifically mentioned in lecture
A. smoking in the home
B. 2 parents
C. normal vital signs
D. associated abnormalites and syndromes

D. associated abnormalites and syndromes
mictotia, hemifacial microsomia, treacher collins

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What should pre op HCT be at to avoid transfusion
A. >50
B. >30
C. >20
D. >40

B. >30

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What type of induction is used for cleft lip and palate repair?
A. awake
B. rapid sequence
C. IV
D. mask

D. mask induction in usually uncomplicated

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What are ways that will help facilitate intubation for cleft lip and palate repair (select 3)
A. cricoid pressure
B. laryngoscopy
C. Fiberoptic
D. nasal intubation

A. cricoid pressure
B. laryngoscopy
C. Fiberoptic

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What type of ETT is most often used
A. Nasal RAE tube
B. standard oral ET tube
C. uncuffed ETT
D. oral RAE tube

D. oral RAE tube and secured midline to the chin

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What blade should be used to intubate a patient with cleft lip/palate
A. Mac
B. miller
C. no blade
D. LMA

B.miller straight blade

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How should you approach intubation for a patient with cleft lip and palate
A. right postglossal approach
B. midline approach
C. right paraglossal approach
D. left paraglossa approach

C. right paraglossal approach

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What is the dose of fentanyl for induction of cleft lip/palate repair
A. 0.5-1mcg/kg
B. 1-2mcg/kg
C. 3-4 mcg/kg
D. 10mcg

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B. 1-2mcg/kg

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What is the dose of propofol for cleft lip and palate repair
A. 2mg/kg
B. 4mg/kg
C. 1mg/kg
D. 5mg/kg

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A. 2mg/kg

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For cleft lip and palate repair, what maintenance drug will be used most often
A. ketamine
B. propofol
C. precedex
D. sevoflurane

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D. sevoflurane

slide 168

true or false

For cleft lip and palate repair it is essential to keep the patient spontaneously breathing

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False
Controlled ventilation

What drug and dose is appropriate for cleft lip and palate
A. dexamethasone 4mg/kg
B. zofran 0.1mg/kg
C. tylenol 15mg/kg
D. dexmethasone 0.5mg/kg

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D. dexmethasone 0.5mg/kg

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What dose of tylenol is acceptable for cleft lip and palate repair (select 2)
A. IV 10-15mg/kg
B. rectal 30-40mg/kg
C. IM 3mg/kg
D. oral 1000mg

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A. IV 10-15mg/kg
B. rectal 30-40mg/kg

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Dexmedetomidine can be used to reduce emergence agitation with a dose intraop of A. 0.1-0.2mcg/kg/hr B. 0.6-0.7 mcg/kg/hr C. 0.3-0.5mcg/kg/hr D. 0.2-1mcg/kg/hr

C. 0.3-0.5mcg/kg/hr ## Footnote slide 168

# True or false An infraorbital, external nasal nerve, palatal, bilateral suprazygomatic maxillary block can be done by the surgeon or anesthesia provider to help with post op pain

true ## Footnote slide 168

What is a primary reason for the potential use of post-operative nasal trumpets after cleft lip and palate repair? a) To prevent infection b) To maintain airway patency and allow suctioning c) To deliver oxygen d) To support the nasal structure

b) To maintain airway patency and allow suctioning placed by surgeon ## Footnote slide 169

Immediately following extubation, what is a significant risk for patients who have undergone cleft lip and palate repair? a) Lower extremity weakness b) Cardiac arrhythmias c) Upper airway obstruction d) Hypothermia

c) Upper airway obstruction ## Footnote slide 169

Which of the following describes the typical state of the patient during extubation after cleft lip and palate repair? a) Sedated b) Asleep c) Paralyzed d) awake

d) awake ## Footnote slide 169

What type of restraints are commonly used post-operatively for patients after cleft lip and palate repair? a) Ankle restraints b) Wrist restraints c) Arm restraints or "no-no's" d) Chest restraints

c) Arm restraints or "no-no's" ## Footnote slide 169

When is extubation typically performed following cleft lip and palate repair? a)In the operating room while the patient is awake b) In the PACU while the patient is asleep c) In the PICU once the patient is fully recovered d) Before the surgical procedure begins

a)In the operating room while the patient is awake ## Footnote slide 169

What is the most common chromosomal abnormality, occurring in approximately 1 out of 800 live births? a) Turner Syndrome b) Klinefelter Syndrome c) Down Syndrome d) Edward's Syndrome

c) Down Syndrome ## Footnote slide 170

The most frequent chromosomal cause of Down Syndrome is: a) Monosomy X b) Trisomy 18 c) Deletion on chromosome 5 d) Trisomy 21

d) Trisomy 21 ## Footnote slide 170

Besides Trisomy 21, what other genetic mechanisms can lead to Down Syndrome? a) Balanced translocations and gene mutations b) Unbalanced translocations or chromosomal mosaicism c) Aneuploidy and polyploidy d) Duplication and inversion

b) Unbalanced translocations or chromosomal mosaicism ## Footnote slide 170

Which of the following physical characteristics is often associated with Down Syndrome? (select 3) a) small/low set ears b) Prominent nose c) Epicanthal folds d) short neck

a) small/low set ears c) Epicanthal folds d) short neck ## Footnote slide 170

Which of these features is commonly observed in individuals with Down Syndrome? a) Short stature b) Large head circumference c) High-set ears d) Abnormally long fingers

a) Short stature ## Footnote slide 170

Which gastrointestinal problem is commonly observed in individuals with Down Syndrome? a) Pyloric stenosis b) Appendicitis c) Duodenal atresia d) Crohn's disease

c) Duodenal atresia ## Footnote slide 171

Approximately what percentage of individuals with Down Syndrome are affected by congenital heart defects? a) 40-50% b) 25-35% c) 10-20% d) 60-70%

a) 40-50% ## Footnote slide 171

All of the following are congenital heart defects commonly seen in Down Syndrome EXCEPT: a) Atrioventricular (AV) Canal defect b) Ventricular Septal Defect (VSD) c) Patent Ductus Arteriosus (PDA) d) Aortic Stenosis e)TOF

d) Aortic Stenosis ## Footnote slide 171

Which of the following is a common muscular characteristic seen in individuals with Down Syndrome? a) Hypertonia b) Spasticity c) Hypotonia d) Rigidity

c) Hypotonia ## Footnote slide 171

What endocrine disorder is frequently observed in individuals with Down Syndrome? a) Hyperthyroidism b) Diabetes mellitus c) Adrenal insufficiency d) Hypothyroidism

d) Hypothyroidism ## Footnote slide 171

Which of the following are associated with down syndrome (select 4) A. long neck B. macroglossia C. tachycardia under anesthesia D. mandibular hypoplasia E. atlantoaxial instability F. ligamentous instability

B. macroglossia D. mandibular hypoplasia E. atlantoaxial instability (C1 C2) F. ligamentous instability ## Footnote slide 172

Down syndrome is associated with all the following except A. subglottic stenosis B. upper airway obstruction C. large radial vessels D. post extubation stridor E. bradycardia under anesthesia

C. large radial vessels Small/abnormal radial vessels ## Footnote slide 173

What is common for down syndrome patients regarding anesthesia (select 2) A. tachycardia B. airway obstruction C. subglotting narrowing D. neuroaxial stability

B. airway obstruction C. subglotting narrowing ## Footnote slide 176

What should be considered preoperatively specifically for down syndrome A. neuro exam B. BMP C. hemoglobin D. cervical x rays

A. neuro exam D. cervical x rays ## Footnote slide 176

# True or false cervical x rays for down syndrome are done under general anesthesia and the radiologist with flex and extend head to assess instability

False cervical x rays for down syndrome are done AWAKE and the radiologist with flex and extend head to assess instability ## Footnote what she mentioned in lecture

What 2 drugs should you have ready for anesthesia induction on down syndrome patients A. Atenelol 1mg B. atropine 0.01-0.02mg/kg C. Fentanyl 2mcg/kg D. Robinul 0.01mg/kg

B. atropine 0.01-0.02mg/kg D. Robinul 0.01mg/kg Bradycarida on induction Need to give before HR actually decreases to ensure prompt onset allowing cardiac output to be maintained

Pediatric General Surgery 5 (Exam 1) Flashcards

(47 cards)