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68 Cards in this Set
- Front
- Back
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Which of the following factors influence pharmacokinetics?
A. half life B. renal blood flow C. volume of distribution D. clearance |
A, C, D
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Pediatric pts have (larger or smaller) Vd for water soluble drugs?
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larger
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Pediatric pts have (larger or smaller) Vd for lipophilic drugs?
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smaller
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Ability ot eliminate a drug?
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clearance
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Definition of Vd?
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dose of drug/plasma concentration
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definition of extraction ratio?
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amount of drug entering the liver that gets eliminated on first pass
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Who has higher total body water?
A. preemie B. infant C. Child D. adult |
A
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Which fluid compartment is fixed across all ages-ICF or ECF?
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ICF
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Definition of pharmacokinetics?
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What the body does to a drug-how does drug move through body
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Definition of pharmacodynamics?
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biological effect of the drug-what the drug does to the body
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Which of the folloowing components of renal function is decreased in neonates?
A. GFR B. RBF C. tubular function D. concentrating ability |
All are correct
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Neonates are prone to what electrolyte disturbance?
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hyponatremia (tubules have decreased concentrating ability)
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When does renal function reach adult status?
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3 years
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2 Major determinants of hepatic clearance?
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1. hepatic blood flow
2. hepatic extraction ratio |
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Albumin bind which kind of drug: acid or basic?
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acid
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Alpha 1 glycoprotein ( AAG) binds which of the following?
1. acid drugs 2. basic drugs |
2
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Which route of administration is most relaible under any circumstances?
A. oral B. PR C. IV D. intranasal |
C
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A drug bound to plasma protein is (active or inactive)?
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inactive
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What is the most important enzyme in the metabolism of anesthesia drugs?
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CYP3A
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Which of the following drugs are hydrophilic?
A. volatile agents B. NMB's C. Heparin D. glycopyrrolate |
B, C, D
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Which of the following are lipophilic?
A. NMBs B. propofol C. opiates D. ketamine |
B, C, D
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which is more lipophilic: morphine or fentanyl?
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fentanyl
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When is MAC the highest?
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6 mo of age
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What can be doen to ameliorate emrgence delirium seen with ketamine?
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Treat with versed
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Dose of propfol in peds?
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2.5-3.5 mg/kg
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Is sux approved for ped use?
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No
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Why might sux have longer DOA in peds pts?
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they have less cholinesterase
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Dose of sux for peds pt?
IV and IM |
2-2.5 infant IV
1.5-2.0 child IV 4 mg/kg IM |
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Pavulon dose for kids?
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0.1 mg/kg
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why is pavulon used in peds?
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it is vagolytic-providers are taking advantasge of fact that it increases HR and BP
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Does pavulon have an active metabolite?
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Yes- and it can prolong NMB
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Dose of atopine?
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.02 mg/kg
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Dose of glyco?
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.02 mg/kg
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What is the active metabolite of demerol? Why is this important?
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normeperidine. It has longer 1/2 life and can cause sz
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PO dose of versed in peds?
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.5-0.75 mg/kg
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Dose of tylenol?
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5-10 mg/kg
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What is the single biggest advancemetn in ped., anes?
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pulseox
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Father of peds anesthesia?
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Dr Robert Smith
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Are ETT sized by internal or external diameter?
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internal
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Which of the following can be used to prolong neuraxial blockade?
A. tramadol B. clonidine C. neostigmine D. ketamine E. versed |
All are correct
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The larynx of a child is at what vertebral level?
Adult? |
C3-4 in peds
C5-6 adult |
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How is the epiglottis different in peds?
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short, stiff and "omega shaped" (U shaped)
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The difference between infant and adult cricoid cartilage?
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infants are funnel shaped
adults are cylindrical |
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smallest part of pediatric airway?
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cricoid cartilage
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What is the difference in teh pediatric mainstem?
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R mainstem is less vertical in kids
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what is the most intense fear of infants and young children?
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separation from parents
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What is major fear of older children in regards to anesthesia?
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pain and loss of control
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example of open breathing systems include:
A. mapleson circuits B. nasal cannula C. face mask D. open drop ether |
B, C, D
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What is the order Mapleson circuits are less likely to cause rebreathing during SPONTANEOUS breathing?
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All Dogs Can Bite
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Order in which Mapleson circuits are less likely to cause rebreathing during
controlled ventilation |
Dog Bites Can Ache
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Which is better fore calculating fluid and nutritional reqs: BSA or age/wt?
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BSA
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Is the foramen ovale presdsure sensitive or oxygen sensitive?
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pressure sensitive
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Is the ductus arteriosius pressure or oxygen sensitive?
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oxygen sensitive
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When does the foramen ovale close functionally? Anatomically?
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functional: immediately after birth
anatomically: 5-7 days (20 % of adults have probe-patent PFO's) |
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When does the ductus arteriosus close functionally? Anatomically?
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functionally: hours after birth
anatomically: 2 weeks after birth |
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When does production of surfactant start?
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24-32 weeks
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What type of cells produce surfactant?
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type II pneumocytes
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Infants have predominantly which kind of muscle fibers in their diaphragms: type i or type II?
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Mostly type II-which are fast twitch and more likely to fatigue.
"why they crap out so fast" |
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are infant chest walls more or less compliant than an adults?
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Much more compliant: still have lots of cartilage, so more flexible
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General aneshtesia does what to FRC?
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abolishes muscle tension and FRC collapses. (this = airway closure)
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When does formation of adult type alveoli start?
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36 weeks PCA (post conceptual age)
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What is the effect of hypoxia on newborn control of breathing?
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in a newborn, hypoxemia depresses respiration, while in an adult, hypoxemia stimulates resp.
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Where does the spinal cord end in an adult?" Infant?
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L1 in adult, L3 in infant
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Which is better developed at birth: the parasympathetic system or the sympathetic system?
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PSNS
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laryngeal reflex is activated by what?
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stimulation of receptors on face, nose, upper airways
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When is formation of renal tubules complete?
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36 weeks gestation
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Newborns are prone to what electrolyte disturbance? Why?
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hyponatremia. Immature tubular fxn causes poor reabsortion of Na.
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Which of the following are airway concerns in Down's syndrome pts?
A. atlantoaxial instability B. macroglossia C. poor muscle tone D. CSF reabsorption problems |
A, B, C
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