Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery M4 part 2 > Pediatrics 2 > Flashcards

Pediatrics 2 Flashcards

1
Q

What will be formed by failure of obliteration of 2nd brancheal cleft?

A

BRANCHIAL CYST

  • cystic mass in lateral aspect of neck
  • may open with fistula
  • remove by surgical excision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

cystic mass at line of fusion is called?

A

SEQUESTRATION DERMOID CYST

  • usually occurs in external angular in face
  • if in neck -> median
  • treated -> simple excision of cyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

unilateral sternomastoid mass after birth trauma?

A

congenital torticollis

  • diagnosed by neck US
  • head tilt to same side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

coarse lymphangioma presenting with large, translucent cystic mass at the side of the neck is called?

A

CYSTIC HYGROMA

- inject sclerosing agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the types of congenital diaphragmatic hernias?

A

POSTERIOR HERNIA -> foramen of Bockdalek (commonest type)
ANTERIOR HERNIA -> Foramen of Morgagni (opening of IMA)
DIAPHRAGMATIC EVENTRATION -> weakness
CONGENITAL HIATUS HERNIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the clinical presentation of a congenital diaphragmatic hernia?

A

ANTENATAL -> maternal polyhydraminos
AT BIRTH -> neonatal cyanosis & respiratory distress
- scaphoid abdomen
- diminished air entry with audible intestinal sounds on chest
- heart sounds heard better on right side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the complications of a congenital diaphragmatic hernia?

A
  • ipsilateral pulmonary hypoplasia
  • contralateral lung compression
  • strangulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What investigations should be done in order to diagnose a diaphragmatic hernia?

A

CHEST X-RAY

  • bowel in chest
  • shift of mediastinum to contralateral side
  • dextrocardia

GASTROGRAFIN MEAL

ANTENATAL US
- polyhydramanos

BLOOD GASES

  • hypoxia
  • hypercapnia
  • acidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most important step in treatment of congenital diaphragmatic hernia?

A

PRE-OP PROPER PREPARATION

  • NPO
  • NGT & IV FLUIDS -> deflate stomach -> decrease lung compression & mediastinal shift
  • endotracheal intubation -> if failed -> ECMO
  • pulmonary vasodilators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the definitive treatment of a congenital diaphragmatic hernia?

A

OPERATIVE REPAIR AFTER PRE-OP PREP

- open -> subcostal incision OR thoracoscopic -> reduce abdominal contents & fix diaphragmatic defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the cause of esophageal atresia?

A

failure of recanalization of the foregut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the types of esophageal atresia?

A
  • blind upper pouch & fistula of lower pouch -> most common
  • upper fistula & lower atresia
  • atresia without fistula
  • fistula without atresia
  • atresia with upper & lower fistula
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the complications of fistulas?

A
  • lower fistula -> fatal acid pneumonia
  • upper fistula -> aspiration of milk & saliva

cause of death -> pneumonia or VACTREL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the clinical picture of esophageal atresia?

A

antenatal -> maternal polyhydraminos
at birth -> CONTINUOUS POURING OF FROTHY SALIVA SINCE BIRTH
-> regurgitation, chocking, cyanosis & cough
- CATHETER TEST -> stops at 10cm from nostrils
- abdominal distention -> due to air entry
- dehydration
- pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What investigations should be preformed to diagnose esophageal atresia?

A

X-RAY -> fundic air bubbles increase

GASTROGRAFIN -> shows atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is esophageal atresia treated?

A 
SURGICAL EMERGENCY 
PRE-OP PREP
- NPO & IV fluids 
- suction of saliva (sump tube) 
- put baby in prone position to avoid aspiration 
- warm baby

OPEN THORACOTOMY or THORACOSCOPE

  • dissection over TOF & separate it with closure of tracheal defect
  • mobilization of both esophageal ends
  • if gap is long -> circular or spiral esophagomyotomy of upper pouch
  • circular didnt work -> fixation of distal esophageal pouch to paravertebral fascia & marking it with clips -> 2nd set
  • last option -> gastric pull up
17
Q

What is the normal pyloric thickness?

A

4mm

18
Q

When is congenital hypertrophic pyloric stenosis diagnosed?

A

if pyloric thickness is >8mm

19
Q

What is the pathology in CHPS?

A

PYLORUS

  • hypertrophy of circular muscle fibers
  • end abruptly in duodenum
  • fades gradually towards the stomach

STOMACH

  • dilated with hypertrophy of its walls
  • gastritis -> due to stasis

INTESTINE
- collapsed & empty

20
Q

What is the clinical presentation of CHPS?

A 
age of presentation -> peak at 1 month 
VOMITING 
- non-bile stained 
- projectile 
- occurs after feeding 
- does not respond to anti-emetics 
- followed by hunger pain 
CONSTIPATION 
FAILURE TO THRIVE
21
Q

What are the signs of CHPS?

A
  • dehydration
  • recurrent chest infections
  • upper abdominal distention
  • olive-like palpable mass at right hypochondrium
22
Q

What are the complications of CHPS?

A
  • recurrent chest infections
  • dehydration
  • metabolic & electrolyte disturbances
    hypokalemia
    hyponatremia
    hypocalcemia
    metabolic alkalosis
    paradoxical aciduria
23
Q

What is the most diagnostic method of investigation is case of CHPS?

A

ABDOMINAL US -> >8mm pylorus

next is Gastrografin meal

  • dilated stomach
  • delayed emptying
  • string sign
24
Q

What is the main line of treatment in CHPS?

A

PRE-OP PREP

  • NPO
  • NGT & washing of stomach
  • IV fluids
  • correction of dehydration
  • correct metabolic & electrolyte disturbance
  • manage chest infection

RAMSTEDT’S PYLOROMYOTOMY

  • better by laparoscopy
  • incision involves serosa & musculosa till mucosa bulges
25
Q

What are the types of biliary atresia?

A
  • correctable -> portion of extrahepatic tree only is occluded
  • noncorrectable -> intra & extrahepatic atresia

presents as NEONATAL OBSTRUCTIVE JAUNDICE

26
Q

What are the investigations & treatment of biliary atresia?

A

investigations -> US, HIDA scan, ERCP
treatment
- correctable -> KASAI OPERATION (Roux en Y hepatico-jejunostomy)
- non-correctable -> liver transplant

27
Q

What biliary tree anomaly is PRECANCEROUS?

A 
CHOLEDOCAL CYST 
- congenital cystic dilatation of intra/extrahepatic biliary system 
has 5 types 
I -> Fusiform (extra)
II -> saccular (extra)
III -> abnormal fusiform (most distal part of CBD)
IV -> multiple intra&extra hepatic
V -> multiple intrahepatic
28
Q

How does a a choledocal cyst present?

A
  • childhood obstructive jaundice
  • RT hypochondrial swelling
  • +/- pain

predisposition to cholangiocarcinoma

29
Q

How is a choledocal cyst treated?

A
  • EXTRA-HEPATIC -> excision of the cyst with Roux-en-Y choledocho-jejunostomy
  • INTRA-HEPATIC (Caroli’s disease) -> liver transplant
30
Q

What are the indications of circumcision?

A
  • religious indication
  • phimosis (pinpoint opening of foreskin)
  • paraphimosis (obstruction of urethra)
  • recurrent balanitis (recurrent inflammation of smegma)
31
Q

What are the contraindications of circumcision?

A
  • bad general condition
  • hemophilia
  • hypospidius
32
Q

When should circumcision be preformed?

A
  • 1 week of life -> maternal clotting factors

- after 40 days -> neonate developed clotting factors

33
Q

Should anesthesia be used in circumcision?

A
  • < 1 year -> no or local anesthesia

- > 1 year -> general anesthesia

34
Q

What are the complication of circumcision?

A
  • bleeding
  • under correction
  • over correction
  • injury of glans or urethra

Surgery M4 part 2 (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions