Principles Of Anesthesia Ii; Pediatrics

Front 1

1. Preop interview includes all except:
a. YOUR EXPERIENCE/TRAINING
b. system review
c. parent interview/concerns,
d. ?)

Back 1

a. YOUR EXPERIENCE/TRAINING

Front 2

2. Preop interview concerned with all of the following except:
a. Surgical History of Mother Prior to Pregnancy
b. Prenatal
c. Postnatal
d. NICU/PICU

Back 2

a. Surgical History of Mother Prior to Pregnancy

Front 3

3. URI you will see all of the following except:
a. Cough
b. Laryngospasm
c. Bronchospasm
d. Vomiting

Back 3

d. Vomiting

Front 4

5. Pathologic murmur characteristics
a. Pansystolic
b. Loud
c. Late systole
d. All of the above

Back 4

d. All of the above

Front 5

6. What system is dominant in the neonate?
Sympathetic
Parasympathetic
Autonomic

Back 5

Parasympathetic

Front 6

7. What is not responsible for hypotension?
a. Increased resistance to sympathomimetics
b. Parasympathetic dominant
c. Decrease catecholamine stores
d. Nonactivation of sympathetic nervous system

Back 6

a. Increased resistance to sympathomimetics

Front 7

8. All are physiological difference of neonates :
a. Increased HR
b. Decreased BP
c. Decreased LV compliance
d. Strong respiratory muscles

Back 7

d. Strong respiratory muscles

Front 8

9. Pharmacological differences of neonates except:
a. Decrease VD
b. Immature hepatic
c. Decreased protein binding
d. ?

Back 8

a. Decrease VD

Front 9

Cardiac output is dependent upon ___________?

Back 9

heart rate

Front 10

11. All of the following are shunts except:
a. Foramen ovale
b. Ductus arteriosis
c. Ductus venosis
d. Foramen of Morgani

Back 10

d. Foramen of Morgani

Front 11

Pulmonary circulation:

Back 11

5-10%

Front 12

All are difference between adults and neonates except:
a. Short epiglottis
b. Short trachea/neck
c. Large head
d. Anterior larynx

Back 12

a. Short epiglottis

Front 13

14. Functional closure of DA

Back 13

1-8

Front 14

15. Causes of transitional circulation except
a. Decrease PVR
b. Increase SVR
c. Increase aortic pressure
d. Thrombosis of 2 umbilical veins

Back 14

d. Thrombosis of 2 umbilical veins

Front 15

16. Fetal circulation (in regards to pulmonary vascular resistance [PVR] and SVR)

Back 15

increase PVR with decrease SVR

Front 16

17. All cause hypothermia except:
a. Brown fat
b. Thin skin
c. High BSA
d. Low fat ratio

Back 16

a. Brown fat

Front 17

18. All of the following will prevent hypothermia except
a. Keep >25 celcius
b. Warm IV fluid
c. Blankets
d. Increase fresh gas flows

Back 17

d. Increase fresh gas flows

Front 18

19. Clear liquids NPO requirement

Back 18

2 hours

Front 19

20. An awake intubation is indicated in all of the following except
a. Vomiting
b. Critically ill
c. Inguinal hernia
d. Full stomach

Back 19

c. Inguinal hernia

Front 20

21. The patient meets extubation criteria with all of the following except
a. Reversal agent given
b. Eyes open
c. Purposeful movement
d. Crying

Back 20

a. Reversal agent given

Front 21

22. Fluid maintenance calculations

Back 21

421 rule
Over 20kg use (kg + 40)

Front 22

Succ is indicated in all of the following situations except:
a. Emergencies
b. Rapid sequence
c. Difficult airway
d. ?

Back 22

d. ?

Front 23

25. The IM dose of Succ –

Back 23

4-5 mg/kg

Front 24

26. ROP is:

Back 24

fibrovascular proliferation overlying the retina

Front 25

27. ROP Sat?

Back 25

SpO2 90-95% (too high O2 is bad)

Front 26

Apnea of prematurity is:

Back 26

conception to 55 weeks (we learned to 60 weeks)

Front 27

29. Caudal block does all of the following except?

Back 27

poor postop pain relief

Front 28

30. All of the following are surgeries performed during the first week of life except:
a. TEF
b. Inguinal hernia
c. CDH
d. Omphalocele

Back 28

b. Inguinal hernia

Front 29

31. All of the following are obvious at birth except:
a. TEF
b. Omphalocele
c. Gastroschisis
d. Meningomyelocele

Back 29

a. TEF

Front 30

32. CDH incidence

Back 30

1:5000

Front 31

33. CDH mortality

Back 31

40-50%

Front 32

34. Hallmark signs of CDH except:
a. Hypoxia at birth
b. Scaphoid abdomen
c. Bowel sounds in chest
d. ?

Back 32

d. ?

Front 33

35. PPHN – fetal circulation:

Back 33

right to left shunt

Front 34

36. All of the following are characteristics of Omphalocele except:
a. At the base of the umbilicus
b. Herniated sac of lateral abdominal wall
c. Many other congenital abnormalities
d. Hypoxia at birth

Back 34

d. Hypoxia at birth

Front 35

37. Gastroschisis has all of the characteristics except:
a. Lateral abdominal wall defect
b. Snake like intestines – no sac
c. Isolated finding not assoc with other abnormalities
d. Hypoxia at birth

Back 35

d. Hypoxia at birth

Front 36

38. All of the following are the 3 “C’s” of TEF except:
a. Cough
b. Crying
c. Cyanosis
d. Choking

Back 36

b. Crying

Front 37

Which condition will surgery take place within the first month?
a. NEC
b. PDA
c. Pyloric Stenosis
d. All of the above

Back 37

d. All of the above

Front 38

42. NEC caused by all of the following except:
a. Intenstinal ischemia
b. Bacteria colonization
c. Excessive protein substrate
d. Poor feeding techniques

Back 38

d. Poor feeding techniques

Front 39

43. NEC associated with all of the following except:
a. Metabolic alkalosis
b. Peritonitis
c. Necrosis/gangrene
d. Hypovolemia

Back 39

a. Metabolic alkalosis

Front 40

44. PS is characterized by:

Back 40

persistant vomiting at 3-5 week

Front 41

PDA results in:

Back 41

large left to right shunt w/RV failure

Front 42

46. Hydrocephalus preanesthesia assessment would include all of the following except:
a. Bowel sounds
b. Gag
c. LOC
d. NPO

Back 42

a. Bowel sounds

Front 43

Incidence that PDA is found on autopsy of adults:

Back 43

25%

Front 44

1. Cyanotic disorders, pick 3:

Back 44

TOF, transposition of great arteries, TAPVR

Front 45

2. VSD is what type of shunt

Back 45

L to R

Front 46

3. Acyanotic is what type of shunt

Back 46

R to L

Front 47

4. TOF has what 2 characteristics

Back 47

…..RVH & VSD

Front 48

8. Atropine dose for Bradycardia

Back 48

0.02 mg/kg

Front 49

9. Epi dose

Back 49

0.01 mg/kg

Front 50

Surgeon requests torodol for the patient, what is the dose?

Back 50

0.5 mg/kg

Front 51

11. Decadron dose for 10 kg pt

Back 51

1.5 mg

Front 52

12. OR nurse wants to give rectal Acetaminophen 120 mg, what do you do?

Back 52

Give it, within dose range

Front 53

13. Dose of versed for 20 kg pt

Back 53

0.5 mg/kg=10 mg PO

Front 54

14. Zofran dose for pt 10 kg

Back 54

2.0 mg (use lower dose range per linda)

Front 55

15. Pt has recent URI but no fever, no wheeze w/clear nasal drainage

Back 55

proceed w/case

Front 56

16. Active URI, pt susceptible to:
a. laryngospasm
b. stridor
c. croup
d. wheezes
e. all of the above

Back 56

all of the above (laryngospasm, stridor, croup, wheezes, etc)

Front 57

17. Why is an adult semi-closed system not good for a pediatric patient <10kg?
a. Increase dead space
b. I:E valve=increase WOB
c. Absorber too big for TV
d. All of the above

Back 57

All of the above (increase dead space, I:E valve=increase WOB, absorber too big for TV)

Front 58

18. Tube diameter formula?
Age 6 size?

Back 58

age + 16 / 4 = mm ETT size
5.5

Front 59

19. IV fluid maintenance for pt weighing 35 kg

Back 59

75 ml/hr

Front 60

20. Induction w/inhalation ratio

Back 60

N2O 70% and O2 30%

Front 61

Emergence Criteria:

Back 61

Opens mouth to oral stim, tries to take out tube, moves legs/arms purposefully….not irregular breathing pattern

Front 62

22. Deep extubation

Back 62

not on pts <2 years old

Front 63

23. Asthma

Back 63

reversible, airway inflammation, increase airway responsiveness….not decreased alveolar size

Front 64

24. Agents that release histamine except

Back 64

Ketamine

Front 65

25. All are susceptible to MH except

Back 65

CP

Front 66

26. CP = rhonchi in lower airways r/t:

Back 66

…..chronic aspiration and problems mobilizing secretions

Front 67

27. Low FRC in infants leads to:

Back 67

rapid desaturation

Front 68

28. Why do we give less NMBA to infants

Back 68

….immature NMJ

Front 69

29. The patient that you just gave SUX to arrests, you should suspect

Back 69

hyperkalemia

Front 70

30. Most pedi arrests are r/t

Back 70

medications

Front 71

31. Trisomy 21 characteristics except:

Back 71

….absent adenotonillar

Front 72

32. Muscular dystrophy is characterized by….

Back 72

….progressive weakness and loss of striated muscle

Front 73

35. Sickle cell patients you want to avoid:

Back 73

hypovolemia, hypothermia & hypoxemia (hypotension too)

Front 74

36. All of the following are true re: sickle cell except:

Back 74

except: do not give narcotics

Front 75

37. All of the following make you suspect increased bleeding tendencies except…

Back 75

quick clotting

Front 76

38. Appendectomy…

Back 76

RSI

Front 77

40. Peritonsilar abscess in pt w/patent airway and working IV

Back 77

RSI

Front 78

41. Pt extubated and develops laryngospasm

Back 78

give small dose SUX

Front 79

42. Emergence delirium want to rule out other causes such as

Back 79

all of the above or all except Bradycardia

Front 80

43. All of the following are appropriate to give for PONV except:

Back 80

Fentanyl

Front 81

44. Epiglottitis Induction?

Back 81

inhalation induction w/ENT present

Front 82

45. Stridor

Back 82

….(leak 10-25 cm, occurs 1-4 year olds) NOT uncuffed ETT moving up and down trachea

Front 83

46. Advantages of IV induction over inhalation induction except:

Back 83

maximizing Stage II

Front 84

47. Pt is on steroids and uses a MDI at home. What do you do

Back 84

….give a pre-op breathing tx

Front 85

48. All of the following contribute to PONV except

Back 85

….Propofol

Front 86

49. Dose for 2 year old Fentanyl

Back 86

1-2 mcg/kg