Neonates - correct answer Up to 28 days (extrauterine)
Infants - correct answer 28 days-1 year
Toddlers - correct answer 1-3 years
Fetus - correct answer Developing human inside uterus from 8 weeks until birth (intrauterine0
Child - correct answer One year to 13 years
Adolescents - correct answer 13-18 years
Total Body Water (TBW) percentage in a full-term newborn - correct answer 80%
TBW percentage change from newborn to adult - correct answer Decreases from 80% in
newborns to 60% in adults
Higher loading doses of water-soluble drugs in infants - correct answer Due to larger
extracellular fluid compartments and higher TBW content causing dilutional effects
Plasma proteins responsible for drug binding - correct answer Albumin (acidic drugs) and α1-
acid glycoprotein (basic drugs)
Age plasma protein levels reach adult levels - correct answer 5 to 6 months of age
Primary purpose of Phase I drug metabolism - correct answer To introduce polar groups and
produce water-soluble compounds for excretion
Enzyme system involved in Phase I drug metabolism - correct answer Cytochrome P450
(CYP450) enzyme system
Immature metabolic pathway at birth - correct answer Phase II conjugation pathways
Prolonged effects of drugs in neonates - correct answer Reduced hepatic metabolism and renal
excretion
Preferred route of drug administration for rapid onset in pediatrics - correct answer
Intravenous (IV)
Organ systems receiving greater proportion of cardiac output in infants - correct answer Vessel-
rich organs (brain, heart, liver, lungs)
MAC of sevoflurane for infants up to 6 months of age - correct answer 3%
Reason sevoflurane is preferred for inhalation induction in children - correct answer Low blood-
gas partition coefficient and minimal airway irritation
Side effect of high inspired concentrations of sevoflurane - correct answer Apnea
,MAC of isoflurane in pediatric patients - correct answer 1.6%
Reason isoflurane is less preferred for induction in children - correct answer Causes more
airway irritation and adverse respiratory events
MAC of desflurane for infants - correct answer 9%
Reason desflurane is associated with increased sympathetic stimulation - correct answer Due to
its pungency and rapid changes in inspired concentrations
Postoperative agitation in children - correct answer Emergence delirium
Common behaviors associated with emergence delirium - correct answer Restlessness, crying,
moaning, incoherence, and disorientation
Drugs that help prevent emergence delirium - correct answer Propofol, fentanyl,
dexmedetomidine, and preoperative analgesia
Commonly used premedication that is a benzodiazepine - correct answer Midazolam
Typical IV induction dose of propofol for infants - correct answer 2.5-3.0 mg/kg
Serious complication associated with long-term high-dose propofol infusions - correct answer
Propofol Infusion Syndrome
Physiological effects seen with Propofol Infusion Syndrome - correct answer Lactic acidosis,
rhabdomyolysis, heart failure, and cardiovascular collapse
Reason succinylcholine is contraindicated in children with undiagnosed muscular dystrophy -
correct answer Can cause massive hyperkalemia and cardiac arrest
Reason neonates require higher doses of nondepolarizing neuromuscular blocking agents -
correct answer Due to a larger extracellular fluid compartment and immature acetylcholine
receptors
Risk of residual neuromuscular blockade postoperatively - correct answer Hypoventilation and
inability to maintain a patent airway
Recommended NPO time for clear liquids before surgery in pediatrics - correct answer 2 hours
NPO time for breast milk before surgery - correct answer 4 hours.
NPO time for formula or non-human milk before surgery - correct answer 6 hours.
Age gastric emptying time is equivalent to adults - correct answer By 6 months of age.
Pediatric preoperative fasting times summary rule - correct answer The 2-4-6-8 rule.
Preferred site for neuromuscular monitoring in children - correct answer Adductor pollicis
muscle.
, Negative inspiratory force (NIF) indicating adequate strength for extubation - correct answer At
least −32 cm H₂O.
Common indicator of preoperative anxiety in children - correct answer Difficulty with parental
separation.
Strategies to reduce preoperative anxiety in children without medication - correct answer
Video distraction, handheld games, low sensory stimulation.
Incidence range of emergence delirium in pediatric patients - correct answer 10% to 80%.
Preferred premedication for pediatric patients - correct answer Midazolam, as it provides
anxiolysis, amnesia, and has a rapid onset with minimal side effects.
Typical oral premedication dose of midazolam for children - correct answer 0.25-1.0 mg/kg.
Nonpharmacologic interventions to reduce pediatric preoperative anxiety - correct answer
Parental presence during induction and video distraction.
Goals of pediatric premedication - correct answer Anxiolysis, amnesia, analgesia, antisialagogue
effects, reduced gastric volume, and minimized postoperative nausea.
Recommended IV dose of atropine for children - correct answer 0.02 mg/kg.
Preferred premedication to minimize airway secretions before surgery - correct answer
Glycopyrrolate.
Most common preoperative concern associated with URIs in children - correct answer
Increased risk of laryngospasm and bronchospasm.
Duration of bronchial hyperreactivity after a viral respiratory infection - correct answer 6 to 8
weeks.
Preferred anesthetic approach in children with mild URI symptoms - correct answer Avoid
endotracheal intubation; use facemask or laryngeal mask airway.
Most common cause of pediatric upper airway obstruction postoperatively - correct answer
Residual neuromuscular blockade.
Medication combination used to reverse nondepolarizing neuromuscular blockade - correct
answer Neostigmine with atropine or glycopyrrolate.
Maximum daily dose of acetaminophen for children weighing less than 50 kg - correct answer
75 mg/kg per day.
Typical IV dose of acetaminophen for children over 13 years and over 50 kg - correct answer
1000 mg every 6 hours or 650 mg every 4 hours.
Infants - correct answer 28 days-1 year
Toddlers - correct answer 1-3 years
Fetus - correct answer Developing human inside uterus from 8 weeks until birth (intrauterine0
Child - correct answer One year to 13 years
Adolescents - correct answer 13-18 years
Total Body Water (TBW) percentage in a full-term newborn - correct answer 80%
TBW percentage change from newborn to adult - correct answer Decreases from 80% in
newborns to 60% in adults
Higher loading doses of water-soluble drugs in infants - correct answer Due to larger
extracellular fluid compartments and higher TBW content causing dilutional effects
Plasma proteins responsible for drug binding - correct answer Albumin (acidic drugs) and α1-
acid glycoprotein (basic drugs)
Age plasma protein levels reach adult levels - correct answer 5 to 6 months of age
Primary purpose of Phase I drug metabolism - correct answer To introduce polar groups and
produce water-soluble compounds for excretion
Enzyme system involved in Phase I drug metabolism - correct answer Cytochrome P450
(CYP450) enzyme system
Immature metabolic pathway at birth - correct answer Phase II conjugation pathways
Prolonged effects of drugs in neonates - correct answer Reduced hepatic metabolism and renal
excretion
Preferred route of drug administration for rapid onset in pediatrics - correct answer
Intravenous (IV)
Organ systems receiving greater proportion of cardiac output in infants - correct answer Vessel-
rich organs (brain, heart, liver, lungs)
MAC of sevoflurane for infants up to 6 months of age - correct answer 3%
Reason sevoflurane is preferred for inhalation induction in children - correct answer Low blood-
gas partition coefficient and minimal airway irritation
Side effect of high inspired concentrations of sevoflurane - correct answer Apnea
,MAC of isoflurane in pediatric patients - correct answer 1.6%
Reason isoflurane is less preferred for induction in children - correct answer Causes more
airway irritation and adverse respiratory events
MAC of desflurane for infants - correct answer 9%
Reason desflurane is associated with increased sympathetic stimulation - correct answer Due to
its pungency and rapid changes in inspired concentrations
Postoperative agitation in children - correct answer Emergence delirium
Common behaviors associated with emergence delirium - correct answer Restlessness, crying,
moaning, incoherence, and disorientation
Drugs that help prevent emergence delirium - correct answer Propofol, fentanyl,
dexmedetomidine, and preoperative analgesia
Commonly used premedication that is a benzodiazepine - correct answer Midazolam
Typical IV induction dose of propofol for infants - correct answer 2.5-3.0 mg/kg
Serious complication associated with long-term high-dose propofol infusions - correct answer
Propofol Infusion Syndrome
Physiological effects seen with Propofol Infusion Syndrome - correct answer Lactic acidosis,
rhabdomyolysis, heart failure, and cardiovascular collapse
Reason succinylcholine is contraindicated in children with undiagnosed muscular dystrophy -
correct answer Can cause massive hyperkalemia and cardiac arrest
Reason neonates require higher doses of nondepolarizing neuromuscular blocking agents -
correct answer Due to a larger extracellular fluid compartment and immature acetylcholine
receptors
Risk of residual neuromuscular blockade postoperatively - correct answer Hypoventilation and
inability to maintain a patent airway
Recommended NPO time for clear liquids before surgery in pediatrics - correct answer 2 hours
NPO time for breast milk before surgery - correct answer 4 hours.
NPO time for formula or non-human milk before surgery - correct answer 6 hours.
Age gastric emptying time is equivalent to adults - correct answer By 6 months of age.
Pediatric preoperative fasting times summary rule - correct answer The 2-4-6-8 rule.
Preferred site for neuromuscular monitoring in children - correct answer Adductor pollicis
muscle.
, Negative inspiratory force (NIF) indicating adequate strength for extubation - correct answer At
least −32 cm H₂O.
Common indicator of preoperative anxiety in children - correct answer Difficulty with parental
separation.
Strategies to reduce preoperative anxiety in children without medication - correct answer
Video distraction, handheld games, low sensory stimulation.
Incidence range of emergence delirium in pediatric patients - correct answer 10% to 80%.
Preferred premedication for pediatric patients - correct answer Midazolam, as it provides
anxiolysis, amnesia, and has a rapid onset with minimal side effects.
Typical oral premedication dose of midazolam for children - correct answer 0.25-1.0 mg/kg.
Nonpharmacologic interventions to reduce pediatric preoperative anxiety - correct answer
Parental presence during induction and video distraction.
Goals of pediatric premedication - correct answer Anxiolysis, amnesia, analgesia, antisialagogue
effects, reduced gastric volume, and minimized postoperative nausea.
Recommended IV dose of atropine for children - correct answer 0.02 mg/kg.
Preferred premedication to minimize airway secretions before surgery - correct answer
Glycopyrrolate.
Most common preoperative concern associated with URIs in children - correct answer
Increased risk of laryngospasm and bronchospasm.
Duration of bronchial hyperreactivity after a viral respiratory infection - correct answer 6 to 8
weeks.
Preferred anesthetic approach in children with mild URI symptoms - correct answer Avoid
endotracheal intubation; use facemask or laryngeal mask airway.
Most common cause of pediatric upper airway obstruction postoperatively - correct answer
Residual neuromuscular blockade.
Medication combination used to reverse nondepolarizing neuromuscular blockade - correct
answer Neostigmine with atropine or glycopyrrolate.
Maximum daily dose of acetaminophen for children weighing less than 50 kg - correct answer
75 mg/kg per day.
Typical IV dose of acetaminophen for children over 13 years and over 50 kg - correct answer
1000 mg every 6 hours or 650 mg every 4 hours.
