Pediatrics

Question 1

Patient (peds) outcomes affected by

Answer 1

immaturity of organ systems

psychological

physical stress of surgery

effects of anesthetics

related pathology

Question 2

Immaturity of ograns mostly significant until what age

Answer 2

2 yo

per therman

Question 3

age of neonates

Answer 3

<30 days

Question 4

infant age

Answer 4

1-12 months

Question 5

preterm infant

Answer 5

born before 37 weeks

Question 6

»Term infant:

Answer 6

born after 37 wks & before 42 wks

Question 7

»Post term infant:

Answer 7

born after 42 wks

Question 8

»Low birth weight:

Answer 8

< 2500 gms

•Regardless of gestational age

Question 9

»Extremely low birth weight:

Answer 9

< 1000 gms

Question 10

•Children: ___years of age

»Toddler: ___ years of age

»Preschool: ___ years of age

»School age: ___ years of age

Answer 10

•Children: 1-12 years of age

»Toddler: 1-3 years of age

»Preschool: 3-6 years of age

»School age: 6-13 years of age

Question 11

•Adolescent: ___ years of age

Answer 11

•Adolescent: 13-18 years of age

Question 12

contractile components of myocardium

Answer 12

sacroplasmic reticulum

t-tubule system

Question 13

•Myocardium pepends on what for contractility

Answer 13

free ionized Ca++

Question 14

•Capable of limited ↑ in SV

up to LA pressures of ___ mmHg
when afterload remains low

Answer 14

10-12

Question 15

things that can increase afterload which leads to further decrease in cardiac output

Answer 15

acidosis

hypothermia

pain

Question 16

CO depends on what

Answer 16

HR

Question 17

2 things that cause

dec CO & organ perfusion threatened

Answer 17

hypovolemia + bradycardia

Question 18

drug that increase contractility + inc HR

Answer 18

epi

Question 19

HR

1st day of life:

1st month of age:

Adolescence:

Answer 19

1st day of life: 120

1st month of age: 160

Adolescence: 75-100

Question 20

sleep HR lower than

Answer 20

100

Question 21

HR inc up to __ with pain

Answer 21

200

Question 22

predominant driver producing bradycardia with even minor clinical interventions (eg suctioning, laryngoscopy)

Answer 22

ANS causes HR variation

parasympathetic dominance

Question 23

T wave upright due to

Answer 23

Right ventricular (RV) dominance

Question 24

considered Hypotension in asnethetized

newborn

1 year old

other child

Answer 24

1. newborn <60 mmHg
2. 1 year old < 70
3. other child SBP 70 + age(yrs)x2

Question 25

calculation for child \> 1 to determine if hypotension

Answer 25

70 + age\*2

Question 26

lowest BP "according to Barash chart" 1. 0-3 mo 2. 3-6 mo 3. 6-12 mo 4. 1-3 years 5. 3-6 years 6. 6-12 years 7. \>12 years

Answer 26

1. 0-3 mo **65** 2. 3-6 mo **70** 3. 6-12 mo **80** 4. 1-3 years 90 5. 3-6 years 95 6. 6-12 years 100 7. \>12 years 110

Question 27

Lowest BP "according to Nagelhout chart" neonate 12 mo 3 years 12 years

Answer 27

neonate **70** 12 mo **95** 3 years 100 12 years 110

Question 28

predominant hemoglobin species in neborn contributing to 70-90% of total

Answer 28

Fetal Hg

Question 29

explain how/why the fetus is able to "exist" in such a low PaO2 environment in utero

Answer 29

**O2 affinity** fetal Hg \> Adult Hg fascillitates O2 uptake thru placental circ.

Question 30

lowest Hg during this age

Answer 30

3 months nadir bc of dec erythropoesis and dec life span of of newborns RBC

Question 31

Review 1. O2 rich environment p birth 2. decreased erythroid activity, dec hematopoesis 3. dec erythroposis + dec lifespan of newborn RBC 4. --\> lowest Hg by 3 months 5. Physiologic Anemia of Infancy 6. Does NOT compromise fetus bc RIGHT O2/hg/diss curve 7. More released to tissue 8. inc 2,3 DPG and inc Hemaglobin A (adult) replacing fetal 3-6 mo

Answer 31

Review 1. O2 rich environment p birth 2. decreased erythroid activity, dec hematopoesis 3. dec erythroposis + dec lifespan of newborn RBC 4. --\> lowest Hg by 3 months 5. Physiologic Anemia of Infancy 6. Does NOT compromise fetus bc RIGHT O2/hg/diss curve 7. More released to tissue 8. inc 2,3 DPG and inc Hemaglobin A (adult) replacing fetal 3-6 mo

Question 32

Vitamin K dependent clotting factors which are 20-50% of adult levels even lower in premature

Answer 32

II, VII, IX, X ## Footnote **2, 7, 9, 10**

Question 33

newborn's blood volume depends on what

Answer 33

**time of cord clamping** **blood volume** immediate clamping **\<** if clamping after placenta out

Question 34

newborn EBV

Answer 34

80 - 90 ml/kg

Question 35

% loss of IVF immediately/postnatal period

Answer 35

dec 25% inc over next 2 months peaks 2 months of age

Question 36

EBV by age 1. premature 2. newborn 3. infant 3 mo - 3 yo 4. \> 6 yo children 5. adults

Answer 36

1. premature **90-100** 2. newborn **80-90** 3. infant 3 mo - 3 yo **75 -80** 4. \> 6 yo children **65-70** 5. adults **65-70**

Question 37

fetus able to sustain life what weeks of gestational age

Answer 37

24-26 weeks

Question 38

•\_\_\_\_\_ million terminal sacs develop into alveoli after birth

Answer 38

10-20 mil

Question 39

alveolar formation accelorates what age

Answer 39

12-18 mo postnatally

Question 40

alveoli increase in # and SIZE until what age

Answer 40

8 yo

Question 41

alveoli # btw 8-10 yo

Answer 41

200-300 million

Question 42

•\_\_\_\_\_\_ __ \_\_\_\_\_\_\_ - production & secretion of surfactant

Answer 42

Type II pneumocytes

Question 43

surfactant (type II pneumocytes) **begins** at what wks and **peaks**

Answer 43

* Type II pneumocytes - production & secretion of surfactant * Begins ~ 22-26 wk; Peaks ~ 35-36 wk gestation

Question 44

explains relationship btw dec surface tension within the alveoli to decrease alveolar collapse

Answer 44

Law of Laplace

Question 45

control of breathing depend on what 3 things

Answer 45

1. PaO2 2. PaCO2 3. Ph - central chemoreceptors

Question 46

* Inspiratory pause lasting 10 seconds followed by ↑ ventilation * More common in premature * Occurs more often during REM

Answer 46

•Periodic breathing: