Podcast
Questions and Answers
What is the most significant factor for ductal closure in a full-term neonate?
What is the most significant factor for ductal closure in a full-term neonate?
Which structure closes functionally within the first hour of a newborn's life? select 2
Which structure closes functionally within the first hour of a newborn's life? select 2
What does a score of 7 or higher on the APGAR scale indicate?
What does a score of 7 or higher on the APGAR scale indicate?
What technique regarding meconium aspiration is no longer recommended for newborns?
What technique regarding meconium aspiration is no longer recommended for newborns?
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What does functional closure of the fetal openings indicate in newborns?
What does functional closure of the fetal openings indicate in newborns?
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What physiological change may occur if there is inadequate ductal closure after birth?
What physiological change may occur if there is inadequate ductal closure after birth?
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Which characteristic of the neonatal airway poses challenges to ventilation?
Which characteristic of the neonatal airway poses challenges to ventilation?
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What is the main indicator of a potential shunt in a neonate?
What is the main indicator of a potential shunt in a neonate?
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What physiological condition is identified as the most common cause of neonatal depression?
What physiological condition is identified as the most common cause of neonatal depression?
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What are the three fetal shunts? (Select all that apply)
What are the three fetal shunts? (Select all that apply)
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What is anatomical closure in relation to shunts?
What is anatomical closure in relation to shunts?
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What causes persistent pulmonary hypertension in the neonate? (Select all that apply)
What causes persistent pulmonary hypertension in the neonate? (Select all that apply)
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What is the response to hypercapnia in neonates with pulmonary hypertension?
What is the response to hypercapnia in neonates with pulmonary hypertension?
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Parasympathetic NS is more developed than the sympathetic nervous system in the neonate
Parasympathetic NS is more developed than the sympathetic nervous system in the neonate
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What is the benefit of the parasympathetic nervous system (PSNS) being more developed than the sympathetic nervous system (SNS) in neonates? select 3
What is the benefit of the parasympathetic nervous system (PSNS) being more developed than the sympathetic nervous system (SNS) in neonates? select 3
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What should be used to intubate a micropremie?
What should be used to intubate a micropremie?
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What should be used to intubate a newborn?
What should be used to intubate a newborn?
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When should ventilatory support be given to a neonate?
When should ventilatory support be given to a neonate?
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When should CPR be started in a neonate?
When should CPR be started in a neonate?
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What is the dosage of atropine in pediatrics? select 2
What is the dosage of atropine in pediatrics? select 2
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What medication can cause neurodegenerative changes in pediatric patients?
What medication can cause neurodegenerative changes in pediatric patients?
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What drug is a mainstay for sedation and analgesia in pediatric patients?
What drug is a mainstay for sedation and analgesia in pediatric patients?
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Which medication is not FDA approved for pediatric patients and has less clearance in neonates?
Which medication is not FDA approved for pediatric patients and has less clearance in neonates?
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Which neuromuscular blocking drug (NMBD) requires increased doses because of those listed below, it has the largest volume of distribution (Vd) due to its water solubility?
Which neuromuscular blocking drug (NMBD) requires increased doses because of those listed below, it has the largest volume of distribution (Vd) due to its water solubility?
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Which medication requires serial EKGs due to its association with prolonged QT interval?
Which medication requires serial EKGs due to its association with prolonged QT interval?
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The second dose of ______ is associated with bradycardia and sinus arrest.
The second dose of ______ is associated with bradycardia and sinus arrest.
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Which neuromuscular blocking drug (NMBD) is characterized by hepatic metabolism with active metabolites, requiring decreased doses in neonates?
Which neuromuscular blocking drug (NMBD) is characterized by hepatic metabolism with active metabolites, requiring decreased doses in neonates?
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Sugammadex is not approved for use in pediatric patients
Sugammadex is not approved for use in pediatric patients
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What reversal agents are used to reverse the effects of neuromuscular blocking drugs (NMBDs) in pediatrics?
What reversal agents are used to reverse the effects of neuromuscular blocking drugs (NMBDs) in pediatrics?
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What is involved in the transition to newborn circulation after birth? (Select all that apply)
What is involved in the transition to newborn circulation after birth? (Select all that apply)
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At what gestational age is the neonate's pulmonary system mature enough for gas exchange?
At what gestational age is the neonate's pulmonary system mature enough for gas exchange?
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The neonate's neuromuscular junction (NMJ) is more sensitive to the effects of ______
The neonate's neuromuscular junction (NMJ) is more sensitive to the effects of ______
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What is an expected finding in the complete blood count (CBC) of a neonate?
What is an expected finding in the complete blood count (CBC) of a neonate?
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Neonates do not respond well to inotropes due to their poorly developed SNS
Neonates do not respond well to inotropes due to their poorly developed SNS
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What does preductal SpO2 measure?
What does preductal SpO2 measure?
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When does functional closure of the ductus arteriosus occur?
When does functional closure of the ductus arteriosus occur?
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When does functional closure of the foramen ovale and ductus venosus occur?
When does functional closure of the foramen ovale and ductus venosus occur?
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Study Notes
Neonatal Anesthesia
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Transition to Newborn Circulation: Critical 72-hour period after birth.
- Immediate first breath triggers closure of 3 fetal openings:
- Ductus arteriosus
- Ductus venosus
- Foramen ovale (closes within the first hour).
- Functional closure differs from anatomic closure:
- Functional closure is largely closed, but not completely.
- Anatomic closure is fully closed (occurs within the first year for most).
- Immediate first breath triggers closure of 3 fetal openings:
-
APGAR Score: A measure of newborn health.
- A score of 7 or greater is considered normal.
- Scored at 1 and 5 minutes after birth.
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Persistent Pulmonary Hypertension (PPHN): A complication where shunts (PDA and PFO) do not close immediately.
- Characterized by rapid desaturation and decreased responsiveness to increased carbon dioxide.
Neonatal Airway
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Structure: Airway is more anterior and funnel-shaped than in adults.
- Larger tongue and occiput (back of head) are present.
- Cricoid cartilage is the narrowest part of the pediatric airway.
Meconium Aspiration
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Cause: A stressed fetus may pass meconium (first stool) into the amniotic fluid.
- This can occur in utero or at birth.
- Complications: Meconium can obstruct the airway (tracheobronchial system), requiring respiratory support.
- Current Practice: Routine suctioning of newborns is no longer recommended.
Neonatal Cardiovascular System
- Oxygen's Role: In full-term newborns, oxygen levels are key for ductal closure.
- Nervous System: Parasympathetic nervous system (PSNS) is more developed than the sympathetic nervous system (SNS)
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Monitoring: Pulse oximetry (SPO2) should be measured pre-ductally (in right hand) and compared to the foot.
- Differences indicate a shunt.
- Common Cause of Depression: Intrauterine asphyxia (lack of oxygen).
- Interventions: Ventilation support may be required based on Heart Rate.
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Description
This quiz covers critical aspects of neonatal anesthesia, including the transition to newborn circulation, APGAR scoring, and persistent pulmonary hypertension. Additionally, it explores the structure of the neonatal airway, focusing on its unique characteristics compared to adults. Test your understanding of these vital concepts in neonatal care.
