Is there are clear evidence of a higher morbidity and mortality in neonates versus older children or adults receiving a general anesthetic?
In the so-called neuroendocrine reflex, stress sends a signal to the brain, and steroids and catecholamines are released. Where is the origin of the outgoing or afferent arc?
What specific hormone is NOT increased with stress?
How many pain receptors (nocioceptors) do neonates have compared to older children?
Endorphins may act through what receptors?
Endorphins and endogenous opioids may be modulators of what in the stress states?
Beta-endorphins and ACTH have been shown to be increased or decreased with neonatal stress (for example the stress of delivery)?
True or false: tumor necrosis factor can directly cause release of pituitary hormones and the stress hormones (ACTH, cortisol)?
Interleukin-6 is increased or decreased after surgery?
What does growth hormone do in adults after stress?
What happens to epinephrine and norepinephrine after an uncomplicated birth?
How long after an uncomplicated operation does it take for epinephrine and norepinephrine to return to normal?
Halothane and fentanyl may lower the normal operative rise in the norepinephrine and epinephrine in neonatal surgery-true or false?
Epinephrine causes an (increase or decrease) in liver glucose production as well as glugcagon production?
Epinephrine causes an increase in the serum lactate and increase in pyruvate through what mechanism?
What is the change in the plasma insulin levels in premature neonates in response to surgical stress?
What is the change in the plasma glucagon levels in premature neonates in response to surgical stress?
Glucagon acts on skeletal muscle causing amino acid mobilization, which in turn (via alanine) stimulates what?
Steroids are felt to have what kind of role in the post traumatic metabolic response?
Cortisol acts on fat to cause release of FFA's via what?
Does cortisol inhibit or stimulate glucagon release?
True or false: dorsal nerve block can abolish the normal 6 hour post operative cortisol surge after circumcision?
True or false: neonates have a normal circadian rhythm of plasma cortisol
Is there a quantitatively lower ACTH stress response with age?
What happens to aldosterone levels in adults after surgical stress?
In adults growth hormone decreases after surgery - T or F?
Adults have an (increase or decrease) in plasma renin levels postoperatively?
What happens to T3 levels and reverse T3 levels after stress?
T or F: endocrine response to stress or surgery in adults is characterized by marked increases in the catabolic hormones and a decrease in the insulin level?
What happens to VO2 (= volume of oxygen utilization) in adults after a surgical stress?
T or F: There is a gradual increase in the VO2 during the first two or three weeks of life.
T or F: VO2 is better correlated with caloric intake than with surgical stress in neonates?
In healthy infants in the newborn period, as much as what percent of their energy requirement is provided by fat?
Soon after birth, there is a significant fall in BLANK, and a fall in glucose?
Depot fat accounts for what percent of the body weight of the normal human neonate?
Is post operative hyperglycemia less persistent because of glycogenolysis in the newborn than it is in adults?
True or false: neonates may be unable to carry out hepatic gluconeogenesis because of their lack of some of the key enzymes involved?
Where does a neonate get glucose production from, gluconeogenesis or glycogenolysis?
Which is NOT a clinical implication of elevated glucose after operation in neonates?
Does fentanyl block or ameliorate the usual increase in pyruvate and lactate seen postoperatively in adults?
Blood lactate levels after stress correlate best with what?
What is the key gluconeogenesis amino acid in adults?
Premature infants have increased muscle protein breakdown (up to 5 % per day) because they have MORE fatty tissue: T or F
What is the ratio of muscle protein degradation to total body protein degradation in premature infants versus adults?
True or false: changes in serum amino acid levels may have an immunomodulatory role?
Several studies have demonstrated what kind of relationship between the amount of stress and quantity of nitrogen losses?
How much nitrogen intake is needed per day to meet demands of infants in the postoperative period?
3 methyl histidine serves as a marker for endogenous actin and myosin breakdown from where?
A markedly increased 3 methyl histidine: creatinine ratio implies markedly increased nitrogen losses or gains?
T or F: The major cause of negative N2 balance after minor trauma in adults is decreased protein synthesis but after major trauma, increased protein breakdown causes negative N2 balance?
Neonatal data indicate a (higher or lower) rate of protein breakdown than for adults?
As much as what percent of postoperative energy requirements are provided by fat?
Lipolysis in fat cells is carried out by what enzyme?
T or F: Increased metabolic rate after burns or stress may be secondary to increased substrate cycling (TCA cycle increased 450 percent)?
ADH may worsen protein breakdown by suppressing what in patients after trauma or stress?
An infant starved for 2 weeks uses up about what percent of its body protein and fat stores?
Ketone bodies stimulate glucose utilization and therefore cause an decrease in the serum glucose - T or F?
Halothane can partially suppress lipolysis? - T or F?
Elevated catecholamines after postoperative stress lead to an increase in all of the following EXCEPT?
In newborns, what percentage of the glycerol turnover enters the gluconeogenesis pathway in the liver?
In adult studies, the concentration of circulating free fatty acids varies with what?
There is a rapid change from CHO metabolism to fat metabolism in normal neonates shortly after birth - T or F?
Which is NOT a major mechanisms by which mobilization of fatty acids occurs?