Pediatrics

Question 1

Croup (laryngotracheobronchitis):

Answer 1

-Viral
-Affects ages < 2 years
-Gradual onset
-mild fever, stridor, barking cough
-treat with O2, racemic epi, humidification, fluids

-intubation rare

Question 2

Epiglottitis:

Answer 2

-Bacterial
-affects ages 2-6 years
-rapid onset
-drooling, dyspnea, dysphagia HIGH FEVER
-treat with O2, urgent airway, abx
-ENT present for induction

Question 3

Most common cause of postintubation laryngeal edema?

Answer 3

ETT too large

Question 4

Main way to prevent post-intubation laryngeal edema

Answer 4

maintain air leak < 25 cm H20
use manometer to measure cuff pressures

Question 5

Racemic epi doses: 2.25%
0-20 kg:
20-40 kg:
> 40 kg:

Answer 5

0-20 kg: 0.25 mL
20-40 kg: 0.5 mL
> 40 kg: 0.75 mL

Volume of NS dilutent for all = 2.5ml

Question 6

Most to Least favorable to minimize risk of airway reactivity?

Answer 6

Facemask > LMA»_space;> ETT

Question 7

How long to postpone procedure for kid with upper respiratory tract infection?

Answer 7

2-4 weeks

Question 8

Best volatile agent for kids with URI?

Answer 8

sevo

Question 9

URI: what atenuates airway reactivity and reduces risk of bronchospasm?

Answer 9

Propopfol

Question 10

Foreign body aspiration triad:

Answer 10

cough, wheezing, decreased breath sounds on the affected side (usually right)

Question 11

FBA: supraglottic obstruction –>
subclotting obstruction –>

Answer 11

stridor
wheezing

Question 12

What is the gold standard procedure for Foreign body removal?

Answer 12

Rigid Bronchoscopy

Question 13

Best induction method for foreign body removal?

Answer 13

sevoflurane induction with spontaneous ventilation

TIVA best maintenane technique

Question 14

Conditons with Large Tongues

Answer 14

-Beckwith syndrome
-Trisomy 21

“Big Tongue”

Question 15

Conditions with Small/underdeveloped mandible:

Answer 15

-Pierre Robin
-Goldenhar
-Treacher Collins
-Cri du Chat

“Please Get That Chin”

Question 16

Conditions with Cervical Spine anomaly:

Answer 16

-Klippel-Feil
-Trisomy 21
-Goldenhar

“Kids Try Gold”

Question 17

Most common cardiac anomaly associated with Down syndrome?

Answer 17

Atrioventricular sepatal defect

Question 18

Trisomy 21 (Down syndrome) risk for difficult intubation:

Answer 18

-small mouth
-big tongue
-palate is narrow with a high arch
-mdface hypoplasia
-atlantoacial instability
-subglottic stenosis
-OSA

Question 19

_____ is the most common coagulation disorder in patients undergoing T&As

Answer 19

von Willebrand disease

Question 20

Dose of dexamethasone for T&A in kids:

Answer 20

1mg/kg up to 25mg

Question 21

What med should kids not get after a T&A for pain and why?

Answer 21

codeine –> incresed risk of death d/t respiratory depression

Question 22

Primary bleeding post-tonsillectomy occurs when?
75% of bleeds occur when?

Answer 22

first 24 hours
first 6 hours after surgery

Question 23

Hypocalcemia is common in patients with ______ syndrome. This can cause ___.

Answer 23

DiGeorge syndrome
QT prolongation