Pediatric Anesthesiology Review: Clinical Cases for Self-Assessment PDF
Preview Pediatric Anesthesiology Review: Clinical Cases for Self-Assessment
Pediatric Anesthesiology Review Clinical Cases for Self-Assessment Second Edition Robert S. Holzman Thomas J. Mancuso Joseph P. Cravero James A. DiNardo Editors 123 Pediatric Anesthesiology Review Robert S. Holzman • Thomas J. Mancuso Joseph P. Cravero • James A. DiNardo Editors Pediatric Anesthesiology Review Clinical Cases for Self-Assessment Second Edition Editors Robert S. Holzman Joseph P. Cravero Senior Associate in Perioperative Anesthesia Senior Associate in Perioperative Boston Children’s Hospital Anesthesia and Pain Medicine Boston, MA Boston Children’s Hospital USA Boston, MA USA Professor of Anaesthesia Harvard Medical School Associate Professor of Anaesthesia Boston, MA Harvard Medical School USA Boston, MA USA Thomas J. Mancuso Senior Associate in Perioperative James A. DiNardo Anesthesia Critical Care Medicine Senior Associate in Cardiac Anesthesia and Pain Medicine Chief Division of Cardiac Anesthesia Boston Children’s Hospital Boston Children’s Hospital Boston, MA Boston, MA USA USA Associate Professor of Anaesthesia Professor of Anaesthesia Harvard Medical School Harvard Medical School Boston, MA Boston, MA USA USA ISBN 978-3-319-48447-1 ISBN 978-3-319-48448-8 (eBook) DOI 10.1007/978-3-319-48448-8 Library of Congress Control Number: 2017938117 © Springer International Publishing AG 2017 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface This text is designed for those who would become consultants in pediatric anesthe- sia. It is based on a curriculum developed in our department since 1992 to illustrate the breadth and depth of the practice of pediatric anesthesia. Weekly meetings are held with our fellows and many of our faculty who are or who have been associate examiners of the American Board of Anesthesiology. The program is an integral part of the didactic series in the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children’s Hospital. An ability to explain why various data are required before or during the care of a patient or why a certain anesthesia care plan was chosen was critical to us in our philosophy of the course, and we have tried to preserve that ideal during the crafting of this text. Although the interactive aspect of a dialog between examiner and exam- inee cannot be effectively recreated through a textbook, the reader is encouraged – strongly so – to use this book in creative ways to mimic the spontaneity achievable through conversation. First of all, a “buddy” system is advisable. Recording your answers is extremely useful when using the questions as prompts; the contemplative reader will listen critically to the responses he or she has offered into the recorder and then hopefully improve with time and practice. When all else fails, you can find the closest 4-year-old, who will gleefully ask you “why” after every response, uncannily similar to a board exam. Using materiality as the best endpoint for ade- quate answers, the discerning reader should attempt to answer the question to the satisfaction of an imaginary partner – whether the patient her- or himself, a parent, a surgeon, a pediatrician, or another anesthesiology colleague calling for help. With practice and introspection, it is amazing how similar, rather than different, the answers are to those diverse audiences. The written examinations, seen at the beginning of the text as a baseline in pedi- atric medicine, are primarily knowledge-based, reflecting factual medical informa- tion necessary for the subspecialty practice of pediatric anesthesiology. This second edition has the same purpose as the first – to accompany the reader’s journey in attaining proficiency, expertise, and, finally, mastery in pediatric anesthe- siology. The formatting of the book is designed to encourage the reader’s free flow of ideas. One should begin with looking at both facing pages, then progress to v vi Preface covering the answers on the right, and eventually cover the questions on the left, so that probing questions become self-generated. In this very simple, programmed text manner, practice at generating the appropriate breadth and depth of answers, and then questions, can be encouraged. With this basic guidance, the reader is encouraged to be creative throughout this book, to use imagination as well as a fund of knowledge in bringing yourself “into the operating room” and managing the patient in an expert fashion, one that would, in the eyes of peers as well as patients and their families, merit the awarding of “consultant in pediatric anesthesiology.” Boston, MA, USA Robert S. Holzman Thomas J. Mancuso Joseph P. Cravero James A. DiNardo Contents Part I Pediatric Medicine for Pediatric Anesthesiologists 1 Newborn Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Thomas J. Mancuso 2 Respiratory System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Thomas J. Mancuso 3 Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Thomas J. Mancuso 4 Hematology/Oncology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Thomas J. Mancuso 5 Cardiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Thomas J. Mancuso 6 The Musculoskeletal System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Thomas J. Mancuso 7 General Pediatrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Thomas J. Mancuso Part II Consultations in Pediatric Anesthesia 8 Prematurity/Extreme Prematurity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Thomas J. Mancuso 9 Newborn Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 Thomas J. Mancuso 10 Fetal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 Joseph P. Cravero 11 Neuroanesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 Thomas J. Mancuso vii viii Contents 12 Central Nervous System/Orthopedics . . . . . . . . . . . . . . . . . . . . . . . . . . 191 Robert S. Holzman 13 Orthopedics: Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 Joseph P. Cravero 14 Otolaryngology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 Robert S. Holzman 15 Head and Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 Robert S. Holzman 16 Ophthalmology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249 Robert S. Holzman 17 Respiratory System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265 Robert S. Holzman 18 Cardiac I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279 James A. DiNardo 19 Cardiac II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 James A. DiNardo 20 Cardiac III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307 James A. DiNardo 21 Thoracic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323 Robert S. Holzman 22 Conjoined Twins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335 Joseph P. Cravero 23 Gastrointestinal Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 343 Joseph P. Cravero 24 Bariatric Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357 Robert S. Holzman 25 Renal Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373 Joseph P. Cravero 26 Acid/Base Disturbances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 383 Joseph P. Cravero 27 Genitourinary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393 Joseph P. Cravero 28 Bone and Connective Tissue Disorders . . . . . . . . . . . . . . . . . . . . . . . . . 403 Joseph P. Cravero 29 Skin Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417 Robert S. Holzman Contents ix 30 Inborn Errors of Metabolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435 Robert S. Holzman 31 Allergy/Immunology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 447 Robert S. Holzman 32 Infectious Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 459 Thomas J. Mancuso 33 Neuromuscular Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 473 Joseph P. Cravero 34 Endocrinopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489 Thomas J. Mancuso 35 Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 505 Thomas J. Mancuso 36 Minimally Invasive Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 525 Robert S. Holzman 37 Trauma I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 537 Robert S. Holzman 38 Trauma II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 549 Thomas J. Mancuso 39 Regional Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 565 Joseph P. Cravero 40 Pain Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 577 Joseph P. Cravero 41 Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 591 Joseph P. Cravero 42 Anesthesia Outside the Operating Room . . . . . . . . . . . . . . . . . . . . . . . 603 Robert S. Holzman 43 Vascular Anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 615 Robert S. Holzman 44 Dental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 625 Joseph P. Cravero 45 Ambulatory Surgery Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 637 Joseph P. Cravero 46 Equipment and Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 649 Robert S. Holzman 47 Thermoregulation: Hypothermia and Hyperthermia . . . . . . . . . . . . . 667 Joseph P. Cravero x Contents 48 Adolescence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 681 Robert S. Holzman 49 Postanesthesia Care Unit (PACU) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 693 Joseph P. Cravero 50 Behavioral Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 715 Thomas J. Mancuso 51 Critical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 727 Thomas J. Mancuso 52 Resuscitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 749 Joseph P. Cravero Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 761
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