Multiprofessional Critical Care Review: Pediatric 2024 (MCCRCP24ON)-Bonus Practice_MCCRCPeds

Bonus Practice_MCCRCPeds_BoardReviewQuestionsandAnswers

Pdf Summary

The provided text consists of clinical scenarios, questions, and rationales focused on various medical conditions and treatments, particularly in pediatric critical care and emergency medicine settings. Here are summaries of a few key cases:<br /><br />1. **10-Year-Old Boy with Leukemia in Septic Shock**: This patient, displaying symptoms of septic shock with neutropenia and shock refractory to fluids and dopamine, is best treated with norepinephrine according to evidence-based guidelines.<br /><br />2. **18-Month-Old with Postoperative Cardiac Complications**: Post-surgery for atrioventricular canal defect, the patient exhibits hypotension, tachycardia, and hypoxia. The recommended treatment is normalization of CO2 levels and provision of 100% oxygen over other options, addressing the respiratory acidosis and improving oxygenation.<br /><br />3. **15-Year-Old Girl with TPN-Dependent Cerebral Palsy**: Presented with pneumonia and requiring advanced ventilatory support, her echocardiographic findings include organized clots and likely elevated right ventricular pressures, indicative of complications from chronic thromboembolic pulmonary hypertension.<br /><br />4. **6-Month-Old with Severe Respiratory Distress and Cardiac Issues**: Demonstrates a rapid heart rate unresponsive to typical maneuvers. The immediate and appropriate step in this setting is synchronized cardioversion due to hemodynamic instability suggesting supraventricular tachycardia (SVT).<br /><br />5. **Hyperleukocytosis in Infant with Acute Respiratory Distress**: The response to this critical condition, characterized by extremely high white blood cell counts and respiratory distress, focuses on urgent cytoreduction therapy with hydroxyurea or initiation of induction chemotherapy.<br /><br />6. **15-Year-Old Boy with Head Trauma and Elevated ICP**: Administering hypertonic saline to manage intracranial pressure in this context is crucial. Continuous infusion rates should be carefully managed to avoid complications associated with high serum sodium levels.<br /><br />Each case is intricately crafted to provide educational insights and depict real-world decision-making processes, focusing on the importance of evidence-based practices and prompt interventions.

Keywords

pediatric critical care

emergency medicine

septic shock

cardiac complications

cerebral palsy

respiratory distress

hyperleukocytosis

intracranial pressure

evidence-based guidelines

synchronized cardioversion

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