What does not change in the newborn?
-Stroke volume
The hallmark of intravascular fluid depletion in neonates and infants is:
-Hypotension without tachycardia
The major cause of perioperative morbidity and mortality in pediatric patient is:
Hypoxia from indequate ventilation
The pediatric patient’s major mechanism for heat production is:
Nonshivering thermogenesis
A concern for paradoxical air embolism may occur in the neonate because of:
Patent foramen ovale
Up to what age is the cricoid cartilage the narrowest point of the pediatric airway
5 years
Correct pediatric endotracheal tube placement is confirmed by:
Bilateral breath sounds
The most common type of T-E fistula is:
Type IIIB
In a patient with congenital diaphragmatic hernia what should the peak inspiratory airway pressure be:
20 cm/H20
An appropriate blood pressure for a neonate should be:
65/40
If the MAC for agent A is 3% for the newborn, what MAC value would represent the one-year-old?
3 percent
Which is NOT a manifestation of congenital diaphragmatic hernia?
Lab tests
The pediatric patient with scoliosis secondary to muscular dystrophy has been given succinycholine for rapid sequence induction. All of the following may result AND which one will not result:
RESULT:
- Myoglobinuria
- malignant hyperthermia
- cardiac dysrhythmias
Will NOT result:
-Hypokalemia
Which inhalational agent has the same MAC for neonates and infants?
Sevoflurane
Your pediatric patient has had a recent viral infection. What time should pass before general anesthesia and endotracheal intubation would be considered reasonable
2-4 weeks
During the perioperative period your pediatric patient develops sudden profound bradycardia and sinus node arrest. What drug(s) were given
Succinylcholine without atropine pretreatment
An 18 month old female is brought to the emergency room with inspiratory stridor, a barking cough, hoarseness and substernal retractions. The child’s parents report that she had developed a temperature of 38.3 degrees Celsius and a runny nose and cough for which she was treated symptomatically three days agoe. There were no significant problems unit three hours ago, when she became agitated and short of breath. The most likely diagnosis is?
CROUP
The anterior fontanelle usually closes by what age:
Eighteen months
A 6 year old boy has a cardiac arrest following administration of succinylcholine. What is the most likely reason?
Hyperkalemia
The following patient was admitted for cleft lip repair: A six month old 7 kg male infant. The surgery will last three hours from 8 to 11 A.M. The infant was given a clear liquid feeding at 5 A.M. Hemoglobin 11; hematocrit 33.
During surgery, replacing deficit and maintenance requirements of fluids for this child (not including blood loss or third-space loss) would mean infusing fluids for the first hour of approximately:
75 cc (4:2:1 rule)
The following patient was admitted for cleft lip repair: A six month old 7 kg male infant. The surgery will last three hours from 8 to 11 A.M. The infant was given a clear liquid feeding at 5 A.M. Hemoglobin 11; hematocrit 33.
The infant’s tidal volume would be approximately:
45-50 cc
The following patient was admitted for cleft lip repair: A six month old 7 kg male infant. The surgery will last three hours from 8 to 11 A.M. The infant was given a clear liquid feeding at 5 A.M. Hemoglobin 11; hematocrit 33.
Normal repiratory rate would be approximately:
30-35 breaths per minute
The following patient was admitted for cleft lip repair: A six month old 7 kg male infant. The surgery will last three hours from 8 to 11 A.M. The infant was given a clear liquid feeding at 5 A.M. Hemoglobin 11; hematocrit 33.
Midway through surgery, a month old infant’s vital signs were BP 75/50, P 122, and temp 37 degree Celsius. Which of the following would you do?
Maintain same level of anesthesia and temperature
The following patient was admitted for cleft lip repair: A six month old 7 kg male infant. The surgery will last three hours from 8 to 11 A.M. The infant was given a clear liquid feeding at 5 A.M. Hemoglobin 11; hematocrit 33.
O2 consumption for this infant would be approximately:
7 cc/kg
The following patient was admitted for cleft lip repair: A six month old 7 kg male infant. The surgery will last three hours from 8 to 11 A.M. The infant was given a clear liquid feeding at 5 A.M. Hemoglobin 11; hematocrit 33.
If this infant were allowed to cool, his O2 consumption would :
INCREASE
Which of the following would help decrease R to L shunt the most in a condition such as tetralogy of Fallot?
Increase systemic vascular resistance
What Electrolyte abnormalities are present in the infant with pyloric stenosis.
- Hypochloremia,
- Hypokalemia,
- Metabolic Allkalosis
Administration of resuscitation fluids containing glucose in a child with thermal burns may result in
hypertonic-nonketotic coma
What is the average blood volume of a 6 month old infant?
80 cc/kg
At what gestational age is surfactant deposited on the surface of the lung in sufficient quantities to allow easier expansion of lungs?
35 weeks
At what post conception age does the risk of R.O.P become negligible?
44 weeks
In an infant with severe diarrhea the electrolyte and acid base status is likely to be:
- Hypokalemic
- Acidosis
During fetal circulation, blood passes from the right atrium to the left atrium by way of:
Foramen ovale
A ridge in the fetal inferior vena cava directs blood in two streams. This ridge is termed the:
Crista terminalis
What are you most concerned with intraoperatively in a child when you discontinue TPN prior to surgery?
Rebound hypoglycemia
The rate of pre-op hydration for continued bleeding post tonsillectomy is recommended to be:
15-20 cc/kg
Overinflation of the lungs may produce apnea by which of the following reflexes:
Hering-Breuer
A 7 year old 25 kg child comes to the OR for a tonsillectomy what size endo tube would most likely be used?
5.5
Regarding the above mentioned child what would his hourly maintenance fluids be?
(A 7 year old 25 kg child comes to the OR for a tonsillectomy what size endo tube would most likely be used? )
65
Of the following congenital heart defects, which one would result in a decreased pulmonary blood flow?
Tetrology of fallot
In patients with a diagnosis of coarctation of the aorta, where would youplace the arterial line?
Right radial artery
For a premature infant, estimated blood volume is:
100 cc/Kg
All of the following are true of the management of a patient with Necrotizing Enterocolitis and the one that is not?
Right management:
- Do an awake intubation
- Decreased platelet, prolonged PT PTT administer fresh frozen plasma and platelets
- Come to OR with NG tube
NOT right managment:
-Usually present with hypervolemia
At what post conception age does post op apnea cecome less of a risk factor in the preterm infant?
50 to 60 weeks
What % of BSA is an infants head?
19%
The average tidal volume in a newborn infant weighing 2.5 kg is approximately:
20 mL
A 3 month old child for non emergent surgery has a preoperative hemoglobin of 11. What is the proper course of action?
Proceed with the surgery
Hypoglycemia in neonates is a serum gluscose of less then ____ mg/dl.
30
Blood loss in an infant not requiring replacement by blood is typically replaced with?
3 cc of LR per cc of blood loss
If a child experiences a cardiac arrest after succinylcholine which of the following is recommended?
Immediate treatment for hyperkalemia should be institute
Which of the factors predispose the neonate to respiratory problems?
Paradoxical response to hypoxia
Which of the following statements is true when comparing gastroschisis and omphalocele?
More associated congenital anomalies with omphalocele
At what age is renal function almost normal in the healthy infants?
6 months
Which is the only abnormality present in the normal fetal heart?
Foramen ovale
Neonates produce heat by
brown fat metabolism
Presence of a patent Foramen Ovale will increase the risk of
Paradoxical air emboli
Post extubation laryngospasm is caused by stimulation of which nerve?
Superior laryngeal
In a congenital diaphragmatic hernia a sign of a contralateral pneumothora is:
Sudden decrease in pulmonary compliance
Which of th efollowing is true of the patient with muscular dystrophy?
Increased incidence of malignant hyperthermia
In the patient with Trisomy 21 syndromewhich of the following is true
Neck flexion during intubation may lead to atlanto occipital dislocation
All of the following are true of Cystic Fibrosis except?
Decreased residual volume
Hypothermia in infants has been associated with all of the following except:
Decreased pulmonary vascular resistance
Anatomic differences in infants when compared to adults include all except:
Compliant left ventricle
Pharmacologic differences in infants when compared to adults include all except:
Increased protein binding
Which of the following is a true statement regarding the infants response to hypovolemia?
Hypotension with minimal or no change in heart rate
Which of the following would be an anesthetic concern in the patient with progeria
Difficult intubation
Which of the following statements is true regarding anesthesia management of the patient with Verebral Plasy?
Increased risk of aspiration
Calculate the minute volume of a 4 kg infant with a respiratory rate of 30
850-950
What is the anatomic deadspace in a 30 kg child
65-80
Coarctation of the aorta primarily presents which of the following insults to the pediatric heart?
Increased afterload
In a pediatric patient iwth congestive heart failure which of the following drugs would be best for induction?
Ketamine
During neonatal resuscitation the initial dose of epinephrine is:
0.01 kg/ kg
What is the most common type of tracheoesophageal fistula?
IIIB
What is the most frequent electrolyte disorder postoperative in the pediatric patient?
hyponatremia
With regardis to post op care of the patient who has had a reapair of a TEF which of the following should be avoided?
Gastric or esophageal suctioning
Which of the following IV drugs is currently recommended for RSI in a pediatric patient?
Rocuronium
At what age is the MAC of Forane the highest?
1 year
Which of the following drugs is utilized in the pediatric patient with a PDA to help cause closure?
Indomethacin
In a patient with TOF which of the followin drugs would be most likely to cause a decrease in PaO2?
Nipride
All of the following are classical defects of TOF and the one that is not?
Signs of TOF:
- Ventral septal defect
- Right ventral obstruction
- overiding aorta
NOT a sign of TOF:
Patent ductus
Where do you check for a pulse in an infant when doing CPR?
Brachil/femoral
What is the most common type of congenital heart disease?
ventral septal defect (VSD)
At what age does the pediatric larynx descend to the adult level with the cricoid cartilage being opposite C5
6
At what age does the FRC of the pediatric patient reach adult levels (cc/kg)?
4 days
The diagnosis of persistent fetal circulation can be confirmed by?
Simultaneous comparison of PaO2 between preductal and postductal arteries
Which of the following is true of renal function in the 3 to 5 week old infant compared to the neonate?
GFR is increased nearly fourfold
Which of the following is the most common congenital heart defect
Ventral septal defect (VSD)
Which of the following is not a concern in the pediatric patient for strabismus surgery?
Increased IOP
