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57 Cards in this Set
- Front
- Back
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"Not ALL major structures of the brain and cranial nerves are developed at birth" True or False?
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False; All the major structures of the brain and cranial nerves are developed at birth
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How does the brain size change during the first year of life?
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During the first year of life the brain triples in size
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When do the cranial sutures fuse?
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They fuse at 16-18 months of age
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How is the Blood Brain Barrier in neonates and infants different from adults?
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Neonates and Infants have an immature BBB and enhanced CNS receptivity
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When does Myelination of the nerves occur?
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During the 1st year of life
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"Neonates and Infants are more sensitive to Neurotoxins and Poisons" True or False?
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TRUE
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What are the developmental motor function milestones?
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Gross Motor Skills (Walking, Sitting, Crawling) and Fine Motor Skills (Writing, Picking Up, Feeding Themselves)
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What are the developmental speech milestones?
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Able to produce basic sounds at around 6months and to start full words at 1 year of age
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When do Neonates and Infants begin understanding commands?
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Around a year
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What limits the children's ability to increase their tidal volume?
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Because there is a different Rib Position (Rib movement on Inspiration
[Up in children versus Up and Out in Adults] |
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How do the respiratory muscles differ in children compared to adults?
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There are fewer Type 1 Fibres and so they get more tired faster.
Also the small airway muscles are not completely developed. |
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"The work of breathing in neonates is equal to adults" True or False?
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False; Work of breathing is 3 times more in neonates than in Adults
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How are infants, "Obligate Nasal Breathers"?
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They are able to breathe while they are eating/feeding
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What is the normal HR, SBP and RR in Neonates?
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HR: 120-150bpm
SBP: 60-70mmHg RR: 30-60 |
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What is the normal HR, SBP and RR in 6 month olds?
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HR: 120-140bpm
SBP: 65-120mmHg RR: 25-35 |
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What is the normal HR, SBP and RR in 1 year olds?
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HR: 120-140bpm
SBP: 70-120mmHg RR: 20-30 |
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What is the normal HR, SBP and RR in 5 year olds?
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HR: 90-110bpm
SBP: 80-125mmHg RR: 20-25 |
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What is the normal HR, SBP and RR in 15 year olds?
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HR: 60-90bpm
SBP: 110-130mmHg RR: 12-16 |
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Why do Children have a much higher elevated normal HR compared to Adults?
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Because it is the most efficient means of increasing cardiac output, since there is limited ability to stretch ventricles of the Heart (to increase stroke volume)
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What are the common cardiac dysrhythmias in Children?
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SupraVentricular Tachyarrythmias commonly due to Congenital Heart Disease & Asphyxia
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Why is the cardiac contraction in Neonates with less force?
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Because they have immature sarcomeres hence they are calcium dependent
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How does Cardiac output compare in Neonates to Adults?
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Neonate: CO is HR dependent
Adult: CO is SV & HR dependent |
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How does Contractility compare in Neonates to Adults?
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Neonates have reduced contractility
Adults have normal contractility |
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How does Starling Response compare in Neonates to Adults?
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Neonates have limited starling response.
Adults have normal starling response |
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How does Heart Compliance compare in Neonates to Adults?
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Neonates have reduced heart compliance.
Adults have normal heart compliance. |
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How does Afterload Compensation compare in Neonates to Adults?
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Neonates have limited afterload compensation.
Adults have effective afterload compensation. |
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How does Ventricular Interdependence compare in Neonates to Adults?
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Neonates have high ventricular interdependnece.
Adults have relatively low ventricular interdependence. |
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How does Blood Volume in infants compare to Adults?
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Infants: 80-90 mL/kg
Adults: 65-70 mL/kg |
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Why are infants more prone to Anemia from bleeding and lab tests?
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Due to the relatively small volumes of blood in their bodies
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How does gastric acid production change during the first years of life?
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At birth; 6-8 and
24 hours after birth: 1-2 and eventually to 4-7. Then begins dropping to normal (2-3) over the next 2-3 years. |
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How does gastric motility and activity change during the first years of life?
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Motility is irregular and different peristaltic pattern than adults, with gastric emptying irregular & erratic.
They normalize at around 6-8 months of age. |
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How are CYP1A2 Enzymes affected by age?
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Fetus: has minimal activity and it reaches adult levels 3-6 months of age
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How are CYP2C9 Enzymes affected by age?
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Fetus: not detectable
1 year of age: 30% of adult activity Child: Exceeds adult activity. Adolescent decreases to adult activity |
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How are CYP2D6 Enzymes affected by age?
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Fetus: minimal activity.
Neonates: Increasing activity. By 10 years of age Adult activity is attained. |
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How are CYP3A_ Enzymes affected by age?
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Fetus: 30-75% of adult activity.
Infant by 1 year: exceeds adult activity. Adolescence: CYP3A4 decreases to adult activity by the end of puberty |
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How is the rate of Glucorinadation affected by age?
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Fetus: Very low activity
Neonate: 10% of adult activity. Infant/Child reaches adult activity levels between 2 months and 3 years of age |
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How is the rate of Sulfation affected by age?
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Fetus: Active in-vitro.
Neonates: 66% of adult activity |
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How is the rate of Acetylation affected by age?
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Fetus: Limited activity.
Neonate: Poor Activity. Infants/Children: Reaches adult maturity levels between 15 months & 4 years |
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How is the rate of Methylation affected by age?
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Fetus: 2nd Trimester, 33% of adult levels.
Neonate: 150% of adult activity |
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"All Nephrons are present at birth" True or False?
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TRUE
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"All of the Renal Cortex is present at birth" True or False?
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False; only 50% of the renal cortex is present at birth
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How does GFR change in the first few weeks of life?
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GFR increases in first 2 weeks of life
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How does Tubular Secretion develop in the first few years of life?
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At birth 20-30% of adult values and matures by 6-8 months of age
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How does Tubular Reabsorption develop in the first few years of life?
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Decreased at birth and matures by 1-2 years of age
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How does the normal urine output compare in Neonates, Infants and Adolescents?
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Neonates: 2-4mL/Kg/h
Infants & Children: 1-2mL/Kg/h Adolescents & Adults: 0.5-1mL/kg/h |
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How does Normal Serum Creatinine change with age?
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Lowest is with Infant age.
Increases with age untill Adolescent |
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How does Normal Urea production change with age?
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Increased with age until Adolescence
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How does the GFR change with age?
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Increases with age and peaks at 12-24 months
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Why shouldn't the Cockroft Gloft equation be used in pediatric patients?
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Because it overestimates the renal clearance, we use Schwartz equation instead.
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What equation should we use to determine CrCl in Children >2 years old?
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Modified Schwartz Equation
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What equation should we use to determine CrCl in Children <2 years old?
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Schwartz Equation
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When should dose adjustment be done in pedriatric patients with renal failure?
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Adjust only when >50% in reduction of GFR
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How is the concentration of Albumin change with age?
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Generally there is lower concentration in younger age groups and with reduced binding capacity & affinity with younger age groups
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Why is there increased Bilirubin in neonates?
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Because of there being more breakdown of RBCs
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What is the danger with drugs that can displace Biliruben from Albumin?
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The excess Billiruben will pass the BBB and cause serious defects in the CNS: Kernicterus
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Why do Neonates have a poor ability to thermoregulate?
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1) Large Body Surface Area
2) Low Fat Stores 3) Infants cannot shiver to generate heat --> need warmers, bundling |
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Why do Neonates have a predisposition to Hypoglycemia?
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1) Decreased Glycogen Stores
2) Decreased body fat 3) High metabolic needs |
