EDAIC Pediatric and Neonatal Anesthesia 2 — Questions and Answers
Question 1: What is the primary mechanism of heat loss in neonates during anesthesia?
- Radiation (Correct answer)
- Conduction
- Convection
- Evaporation
Correct answer: Radiation
Radiation accounts for the largest proportion of heat loss in neonates due to their high surface-area-to-volume ratio.
Question 2: Which volatile anesthetic is associated with the highest risk of laryngospasm in pediatric patients?
- Sevoflurane
- Desflurane (Correct answer)
- Isoflurane
- Halothane
Correct answer: Desflurane
Desflurane is the most pungent volatile agent and is associated with the highest incidence of airway reactivity, coughing, and laryngospasm in children.
Question 3: A term neonate requires emergency laparotomy. What is the most appropriate ETT size?
- 2.5 mm uncuffed
- 3.0–3.5 mm uncuffed (Correct answer)
- 3.5 mm cuffed
- 4.0 mm uncuffed
Correct answer: 3.0–3.5 mm uncuffed
A term neonate typically requires a 3.0–3.5 mm uncuffed (or microcuffed) endotracheal tube.
Question 4: At what postconceptional age is it generally safe to perform elective surgery without overnight monitoring for apnea in a premature infant?
- 44 weeks
- 50 weeks
- 56 weeks (Correct answer)
- 60 weeks
Correct answer: 56 weeks
Most guidelines recommend 56–60 weeks postconceptional age before elective surgery without mandatory overnight apnea monitoring, though thresholds vary by institution.
Question 5: Which induction technique is preferred for a child with a suspected difficult airway and a full stomach?
- Inhalation induction with sevoflurane
- Rapid sequence induction with propofol and succinylcholine
- Awake fiberoptic intubation (Correct answer)
- Ketamine IM followed by direct laryngoscopy
Correct answer: Awake fiberoptic intubation
Awake fiberoptic intubation preserves spontaneous ventilation and airway reflexes, making it the safest choice when both airway difficulty and aspiration risk coexist.
Question 6: What is the correct formula for estimating blood volume in a preterm neonate?
- 60 mL/kg
- 80 mL/kg
- 90–100 mL/kg (Correct answer)
- 110–120 mL/kg
Correct answer: 90–100 mL/kg
Preterm neonates have a blood volume of approximately 90–100 mL/kg, compared to 80–90 mL/kg in term neonates.
Question 7: Which physiological feature of the neonate makes them particularly vulnerable to opioid-induced respiratory depression?
- Increased protein binding of opioids
- Immature blood-brain barrier with higher CNS penetration (Correct answer)
- Faster hepatic metabolism
- Greater renal clearance of morphine
Correct answer: Immature blood-brain barrier with higher CNS penetration
The immature blood-brain barrier in neonates allows greater CNS penetration of opioids, increasing sensitivity to respiratory depression.
EDAIC Pediatric and Neonatal Anesthesia 2
What is the primary mechanism of heat loss in neonates during anesthesia?