EDAIC Pediatric and Neonatal Anesthesia 5

Question 1

A preterm neonate undergoing laser treatment for retinopathy of prematurity (ROP) requires anesthesia. Which anesthetic concern is MOST specific to this procedure?

Accepted Answer

Hyperoxia worsening ROP progression

Answer

Excessive supplemental oxygen (hyperoxia) during anesthesia can worsen ROP; oxygen saturation targets of 90–95% are typically maintained to minimize retinal injury.

Question 2

Which of the following best describes the hepatic clearance of drugs in neonates compared to older children?

Accepted Answer

Neonates have reduced clearance due to immature cytochrome P450 enzyme activity

Answer

Cytochrome P450 enzyme systems (especially CYP3A4) are markedly immature at birth, significantly reducing hepatic drug clearance in neonates.

Question 3

During tracheoesophageal fistula (TEF) repair in a neonate, which intraoperative event should prompt the anesthesiologist to check for a right-sided intubation?

Accepted Answer

Sudden deterioration of SpO2 with decreased chest rise on the left

Answer

Surgical manipulation can advance the ETT into the right mainstem bronchus; left-sided decreased breath sounds with falling SpO2 indicates endobronchial intubation.

Question 4

What is the most appropriate initial management of laryngospasm in a pediatric patient?

Accepted Answer

Positive pressure via tight-fitting mask with jaw thrust (Larson's maneuver)

Answer

Immediate application of CPAP with jaw thrust (Larson's maneuver targeting the laryngospasm notch) is the first-line treatment for laryngospasm, breaking the reflex before resorting to medications.

Question 5

In a child with pulmonary hypertension undergoing cardiac catheterization, which intraoperative trigger should be MOST aggressively avoided?

Accepted Answer

Hypercapnia and acidosis

Answer

Hypercapnia and acidosis are potent pulmonary vasoconstrictors that can precipitate acute right ventricular failure in children with pulmonary hypertension.

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC Pediatric and Neonatal Anesthesia 5