Pediatric Anesthesia Considerations Flashcards
7 cards from real BCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Pediatric Anesthesia Considerations flashcards as text
Which congenital heart defect most commonly causes right-to-left shunting (cyanotic lesion) and is known as a 'tet spell'?
Answer: Tetralogy of Fallot
Tetralogy of Fallot causes episodic hypercyanotic 'tet spells' due to dynamic right ventricular outflow obstruction increasing right-to-left shunting.
In a child with a right-to-left intracardiac shunt undergoing inhalation induction, what happens to the speed of induction?
Answer: Slower than normal
Right-to-left shunting dilutes alveolar agent with unoxygenated blood, slowing the rise in arterial partial pressure and prolonging inhalation induction.
A 5-year-old with Down syndrome presents for tonsillectomy. What is the most important preoperative airway concern?
Answer: Atlanto-axial instability
Atlanto-axial instability occurs in 10–20% of children with Down syndrome and can cause spinal cord injury with extreme neck flexion or extension during airway management.
What is the primary pharmacokinetic reason neonates require lower weight-based doses of opioids compared to older infants?
Answer: Immature blood-brain barrier with greater CNS penetration
The neonatal blood-brain barrier is immature, allowing greater opioid penetration into the CNS, increasing sensitivity to respiratory depression.
Emergence agitation in children is MOST commonly associated with which anesthetic agent?
Answer: Sevoflurane
Sevoflurane is the most common volatile agent associated with emergence agitation (delirium) in preschool-aged children, with an incidence up to 80%.
Which regional technique provides optimal perioperative analgesia for a child undergoing open inguinal hernia repair?
Answer: Caudal epidural with bupivacaine
Caudal epidural block provides reliable, effective multidermatome analgesia covering the inguinal region and is technically easy in small children.
When performing a caudal epidural in a child, which anatomical landmark identifies the sacral hiatus?
Answer: Posterior superior iliac spines forming an equilateral triangle with the sacral hiatus
The sacral hiatus sits at the apex of an equilateral triangle formed by the two posterior superior iliac spines (PSIS), a key landmark for caudal block placement.