Why is the Sat 75%?
The Kid is Crashing
Why won't they go to sleep?!
The Brain is Mad
Pediatric ARDS
Hormones are mad & the pH is judging you
Don't break my heart
100
The most common cause for desats immediately post-intubation
What is ETT malposition, right mainstem intubation?
100
Capnography is a measure of CO2 during which phase of the breathing cycle?
End-expiration
100
Kid is feral, which tool lets you know it's delirium and NOT vibes?
Cornell Assessment of Pediatric Delirium (CAPD) score
100
Triad of impending doom
Hypertension, bradycardia, decreased respiratory drive
100
Measure of lung distensibility.
Compliance
Daily Double: calculation
100
True or False: Peds patients with T2DM can present in DKA
True
100
Signs of Cardiogenic Shock
Cold, clammy
Delayed cap refill
Weak pulses
Hypotension
200
Name 3 strategies for the use of HFNC in acute respiratory failure
1) Comfort + increased secretion clearance 2/2 heated & humidified air
2) Elimination of dead space in upper airways
3) Decreases nasal resistance to air flow
4) decreased caloric expenditure/insensible losses 2/2 high rates of compressed air
5) Increased oxygenation 2/2 decreased entrainment of ambient air
200
Hypotension. CVP through the roof. Yet the heart is begging for more fluid.
Cardiac Tamponade
200
Name two amnestic agents
Propofol
Dexmedatomidine (Precedex)
Benzodiazepines
Ketamine
200
Most common type of pediatric stroke
Intracerebral Hemorrhage (ICH) Strokes
200
Most objective marker of the degree of lung injury
Oxygen Index
Double Jeopardy! How do you calculate?
200
Glucose has normalized. Gap has closed. Metabolic acidosis persists - who's the culprit?
Chloride
200
You hear “Tet spell” - your heart rate goes up.
What’s actually happening physiologically?
Increased RV outflow obstruction → ↓ pulmonary blood flow
300
ABG: 7.31/60/85/28/+4
Vent: Tv 8mL/kg, PEEP 5, FiO2 0.35
What is the diagnosis & next vent change?
Hypercapneic Respiratory Failure
At upper end of Tv range, oxygenation stableThus: must optimize minute ventilation - Decrease Tv and increase RR
300
Most common code rhythm in pediatrics & why
Pulseless Electrical Activity (PEA)
Hypoxic arrests
300
Difference between moderate vs. deep sedation
Moderate: responds to light stimuli, maintains airway
Deep: responds only to noxious/painful stimuli, may need assistance keeping airway patent, spontaneous ventilation may be impaired
300
Name 3 primary measures to treat acute ICP spike
Hyperventilation
HOB elevated
Head midline
Hypertonic saline bolus
Mannitol
Sedation
300
Name PARD's sacrificial lamb
Carbon Dioxide
Double Jeopardy: what is this called?
300
Gap is 8. pH is low. My favorite H+/K+ pump is mad at you. What's the diagnosis?
Renal Tubular Acidosis Type 1
300
Baby improves when you make them squishy (knees to chest). Why does this work?
↑ SVR → ↓ right-to-left shunt
daily double: if "knees to chest" doesn't work, what else can you do?
400
Name the West Zone with LOWEST PAO2
Zone 3
400
Sudden hypotension. Vent is alarming. Absent breath sounds unilaterally. What is the diagnosis and the "don't wait for imaging" move?
Tension Pneumothorax
400
Name the drug with the LOWEST delirium profile
Dexmedatomidine (Precedex)
400
Name 3 etiologies for Ischemic Strokes & no I dont mean Sickle Cell Disease
Cardiac: PFO, endocarditis, valvular disease
Arteriopathies: moya moya, vasculitis, dissection
Thrombophilia/Clotting disorders: Antiphospholipid syndrome, cancer
Infection: meningitis
Trauma - head/neck injuries
400
Most common ventilator strategy
Protective lung strategy: High PEEP, Low tidal vol
400
Name a genetic condition associated with Metabolic Alkalosis
Liddle's
Bartter's
Gittelman's
400
Preload dependent cardiomyopathy
hypertrophic
500
High Peak Pressures (PIPs) + low tidal volumes - What's the problem?
High airway resistance (bronchospasm, secretions, kinked ETT)
500
End-tidal CO2 is 7 during CPR. Monitor is unimpressed. What does this mean?
Poor quality chest compressions.
500
Which agents are relatively contraindicated in septic patients & those with adrenal insufficiency?
Etomidate, Ketamine
500
Most recent pharmacologic addition to Status Epilepticus guidelines
Ketamine
500
Physiologic limit in ARDS with rising PaCO2 despite increasing RR and represented in red below:
Dynamic Hyperinflation +/- dead space ventilation
500
Urine is salty. Blood is not. Name the diagnosis
SIADH
500
Profound cyanosis at birth. Oxygen doesnt help. RELIES on ASD, VSD, and PDA for survival.
