Pediatric Pearls
This idiopathic hypertrophy of the circular smooth muscle of the pylorus is considered a medical, but never a surgical, emergency.
What is Pyloric Stenosis?
This is the primary driver behind the 45–50% increase in minute ventilation during pregnancy.
What is Tidal Volume (TV)?
Cushing’s reflex, the classic triad of elevated ICP, consists of these three cardiovascular/respiratory findings.
What are hypertension, bradycardia, and irregular respirations?
This intraoperative agent is NOT part of the core Apfel score but independently increases the risk of PONV.
What are volatile agents (or Nitrous Oxide/Neostigmine/Opioids)?
This antidepressant class carries the highest risk of precipitating Serotonin Syndrome when mixed with certain opioids.
What are MAOIs?
The classic metabolic derangement seen in pyloric stenosis includes these three abnormalities.
What are metabolic alkalosis, hypokalemia, and hypochloremia?
This condition, caused by a disproportionate increase in plasma volume relative to erythrocyte volume, is a hallmark of pregnancy.
What is physiological (dilutional) anemia of pregnancy?
Autonomic Hyperreflexia (AHR) can occur in patients with spinal cord injuries at or above this level as early as 3 weeks post-injury.
What is T6? (Note: Bradycardia is specific to T1-T4, but AHR risk is general to higher lesions).
This mutation in the sarcoplasmic reticulum is most commonly associated with Malignant Hyperthermia.
What is the ryanodine (RyR1) receptor?
In an infant, separation anxiety typically begins around this age range.
What is 8 to 12 months?
This congenital defect involves a membranous sac covering the herniated bowel and is associated with a higher incidence of cardiac defects.
What is an Omphalocele?
Pregnant patients desaturate rapidly during apnea due to the combination of these two physiological changes.
What are decreased FRC and increased oxygen consumption?
This neurotransmitter is depleted in the basal ganglia of patients with Parkinson’s Disease.
What is Dopamine?
This is the gold-standard diagnostic test for Malignant Hyperthermia.
What is the caffeine-halothane contracture test?
This is the recommended minimum fasting time for breast milk per ASA guidelines.
What is 4 hours?
To achieve any benefit in reducing bronchial hyperactivity after a pediatric URI, surgery should be delayed for this long.
What is 6 weeks?
At term, the uteroplacental blood flow represents approximately this percentage of maternal cardiac output.
What is 10%?
Sudden withdrawal of anti-Parkinsonian medications like Levodopa can lead to a condition resembling this life-threatening syndrome.
What is Neuroleptic Malignant Syndrome?
A normal Dibucaine number falls within this range.
What is 70 to 80?
This specific hematologic adverse effect is associated with chronic phenytoin use.
What is agranulocytosis?
Post-conceptual age (PCA) infants under this threshold require mandatory 12-hour postoperative monitoring due to apnea risk.
What is 46 weeks?
This is the safest trimester to perform non-obstetric surgery in a pregnant patient.
What is the second trimester?
Sedatives are generally avoided in patients with elevated ICP because they cause respiratory depression, leading to this vascular consequence.
What is hypercarbia-induced cerebral vasodilation?
Patients with an abnormally low Dibucaine number (homozygous atypical) will experience this clinical consequence after receiving succinylcholine.
What is prolonged paralysis (extended apnea)?
Unlike legal competency, this clinical determination is made by a physician and is decision-specific.
What is decisional capacity?