Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

DH: Adv Principles A > Peds (Part 1) > Flashcards

Peds (Part 1) Flashcards

1
Q

Differentiate the different pediatric “life stages” based on these ages:

Birth - 1 month:
1 month - 12 months:
12 months - 3 years:
4 - 6 years:
6 - 13 years:
13 - 18 years:

A

Birth - 1 month: Neonate
1 month - 12 months: Infants
12 months - 3 years: Toddlers
4 - 6 years: Preschool
6 - 13 years: School age
13 - 18 years: Adolescents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What would make a baby “ post term”?

A

Delivered at > 42 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the corresponding birth weights for the following terms:

LBW:
VLBW:
ELBW:
Micropremie:

A

LBW: < 2500 gm
VLBW: < 1500 gm
ELBW: < 1000 gm
Micropremie: < 750 gm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where should we measure an infant’s pulse ox with a PDA?

A

“Pre ductal” extremity = The right hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If a patien’t PDA needs to stay open, what can be given?

A

Prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The fetus relies on the ___ for gas exchange, not the ___.

A

Placenta

Not Lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why is the neonates heart thought to be significantly less developed compared to an adult Heart?

A
  • Fewer myofibrils
  • Sarcoplasmic reticulum and T-Tubules are much more immature
  • Cellular disorganization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Is tachycardia or bradycardia more poorly tolerated in neotaes?

What do we use to treat the issue?

A

Bradycardia!

Epi/Atropine = increases CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why is the neonates SV relatively fixed, making the CO heavily reliant on HR?

A

The neonates heart is very dependent on exogenous calcium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Autonomic innervation is predominately ___.

A

Parasympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

With increased stimulus to a neonate (suctioning/laryngoscopy), we would likely see ___.

A

Bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Normal HR for a Neonate, 12 month old, 3 year old, 12 year old:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Basedon the lecture notes, which of the following patients would be considered hypotensive?

A. 11 year old w/ SBP of 94 mmHg
B. 7 month old w/ SBP of 77 mmHg
C. 2 month old w/ SBP of 62 mmHg
D. 8 year old w/ SBP of 72 mmHg
E. 22 day old w/ SBP of 65 mmHg

A

C. 2 month old w/ SBP of 62 mmHg
D. 8 year old w/ SBP of 72 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Normal Hgb at birth:

A

18-20 g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why do infants experience a physiological anemia at around 3-4 months?

A

Decrease in erythropoietin activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the structural differences between Hgb F and Hgb A:

A

Hgb F: 2 alpha and 2 gamma chains

Hgb A: 2 alpha and 2 beta chains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where does 2,3 - DPG bind to?

A

The beta chains only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Alveolar Ductal development begins around ___ weeks gestation.

A

24 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The neonatal alveolar surface area is roughly how big compared to an adult?

A

About 1/3rd the size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When does surfactant start to get produced?

A

22-26 wks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe anatomical things that may alter a neontates breathing mechanics:

A
  1. Horizontal Ribs: Collapse inward causing a paradoxical breathing pattern
  2. Less Type 1 mucle fibers: tire out quicker
  3. Pliable Chest wall
  4. Flat diapragm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Is the metabolic rate and consumption of oxygen different for a neonate than an adult?

A

YES!

2x greater than adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Is Minute ventilation for a neonate more dependent on RR or TV?

A

Respiratory Rate!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Anatomical components of a neonate’s airway:

A
  1. Large tongue
  2. Superior Larynx
  3. Omega-Shaped epiglottis
  4. Vocal cords are angled
  5. Short, funnel shaped trachea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Most narrow portion of the neonates airway is the:
Cricoid "Ring"/ Cricoid cartilage | We can use uncuffed tubes
26
Angle in which each bronchi takes off from the trachea?
55 degrees
27
Neonates have a short neck and large occiput, this can lead to what issue?
Obstruction when they lie flat (for intubation)
28
Where are the vocal cords positioned in a neonate in terms of vertebrae level?
C3-C4
29
How is the CNS mentioned to be different in neonates?
- Incomplete myelination (until 3 yrs) - Immature NMJ (greater affinity for NDMB) - Immature BBB (until 1 yr)
30
True or False: There is no CBF/Autoregulation in neonates:
FALSE: Just isnt fully developed yet
31
The cerebral vessels are more ___, especially in ___ infants. Making them more prone to ___.
Fragile LBW infants intracerebral hemorrhage
32
What may precipitate an intracerebral hemmorrhage? 6
1. Hypercarbia 2. Hypoxemia 3. Hyperglycemia 4. Hypoglycemia 5. Hypernatremia 6. Wide swings in BP
33
Termination of spinal cord, dural sac, and conus medullaris in neonates:
Spinal Cord: L1 Dural Sac: S2-S3 Conus Medullaris: L2-L3
34
When does GFR reach normal adult level?
6-12 months
35
GFR for preterm: GFR for Full term:
0.55 ml/kg/min 1.6 ml/kg/min
36
An immature renal medulla can lead to diminished...
ADH
37
Fluid requirements per day:
150 ml/kg per day
38
Hepatic System Alterations in neonates:
- Immature glycogen stores (hypoglycemia) - Decreased liver function - Low Albumin/AAG = more free drug floating --> toxicity - Decreased clotting factors (Need Vit. K)
39
Gastric pH is more ___ at birth.
Alkalotic (comes back to normal by day 2)
40
How will upper and lower intestinal anomalies manifest?
Upper: Vomiting Lower: Abd distention/failure to pass meconium
41
Why do neonates have such a difficult time with thermoregulation?
They don't have the ability to shiver
42
How do neonates stimulate heat production?
NST: Non-shivering thermogenesis 1. SNS stimulation releases Norepi 2. The norepi acts on brown fat, increases body tmep 3. Metabolic acidosis can also occur here
43
Hypothermia in a neonate can lead to:
- Bradycardia - Acidosis - Coagulopathies
44
Examples of sensible and insensible evaporative heat loss:
Sensible: Sweating Insensible: Water through the skin
45
Which method is responsible for the majority of heat loss?
Radiant (environment)
46
What type of heat loss occurs through direct contact?
Conductive
47
Increasing the OR temp will help decrease this method of heat loss
Convective
48
Pharmacokinetics for infant/neonate:
- Increased absorption and Distribution (higher CO) - Decreased elimination - Decreased metabolism (Underdeveloped CYP-450)
49
What is the average CO for the following age ranges: Neonate: Infant: Adolescent:
Neonate: 440 ml/kg/min Infant: 200 ml/kg/min Adolescent: 100 ml/kg/min
50
Pharmacodynamic differences for infants/neonates:
- Nicotinic Ach Receptors (open for longer) - More opioid receptors (mu/kappa = more resp. depression) - 1/3rd the normal amount of GABA recetors (higher benzo binding though)
51
Are there usually more or less CV side effects for inhalation agents in infants/neonates? What about emergence delirium?
- MORE for BOTH!
52
With which shunt would it take much longer to induce?
Right to left = decrease in uptake
53
Besides sevo, when is MAC the highest?
2-3 months specifically is the peak (Sevo is birth to 1 month)
54
MAC of Sevo for: Neonates: Infants 1-6 months: Children > 6 months:
Neonates: 3.3% Infants 1-6 months: 3.2% Children > 6 months: 2.5%
55
Benefit of using Nitrous Oxide along with Sevo for inhalational induction?
2nd gas effect --> may decrease stage II time
56
Propofol drug profile for infants/neonates:
- Requires larger dose becasue of increased metabolic rate - Reduced clearance in preterm - Monitor for propofol infusion syndrome
57
ED-50 for Propofol (loss of eyelid reflex) in 1-6 month old:
3mg/kg
58
Do we need more or less Ketamine in children? Dose?
MORE 1-3mg/kg | Neonates might need smaller dose
59
Precedex drug profile:
- 1-2 mcg/kg - Takes 30-40 min for peak effect - Decreased incidence of emergence delirium
60
Morphine dose:
0.05 - 0.1 mg/kg (might need to decrease in neonates)
61
What surgery specifically is codeine contraindicated in?
Tonsillectomy
62
Fentanyl dose:
0.5 - 2 mcg/kg
63
Most frequently used opioid intraop:
Fentanyl
64
Traditionally neonates do not clear drugs faster than older children, with the exception of this drug:
Remifentanil
65
Remi can cause ___ in peds.
Bradycardia
66
Is succs more water or lipid soluble?
Water = rapid redistribution to ECF
67
IV Dose and IM Dose of Succs for Children and for neonates/infants
Neonate/Infant: - 2mg/kg IV - 5mg/kg IM Children: - 1 mg/kg IV - 4 mg/kg IM
68
___ is common with succs administration in children < 5yrs. Therefore we give ___.
Bradycardia Atropine/glyco
69
Only NDMR that can be given IM:
Roc
70
Dose for Neostigmine and Edrophonium:
Neostigmine: 0.04 - 0.07 mg/kg Edrophonium: 0.5 - 1 mg/kg
71
Sugammadex is FDA approved for patients aged...
2 years or older
72
When do the 2 main fontanels close?
Anterior: closes by 2 years Posterior: closes by 4 months

DH: Adv Principles A (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions