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Gastrointestinal > Common Peds Surgical Problems > Flashcards

Common Peds Surgical Problems Flashcards

1
Q

How do you define acute LAD?

A

Less than 2 weeks duration

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2
Q

How do you define subacute LAD?

A

2-6 weeks

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3
Q

How do you define chronic LAD?

A

> 6 weeks

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4
Q

What is the treatment for reactive LAD?

A

observation and f/u

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5
Q

What are the presenting ssx of thyroglossal duct cyst?

A

midline neck mass that is near the hyoid bone

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6
Q

What are the characteristics of thyroglossal duct cyst movement? When do these present? Where?

A

Move with the tongue
around 2 years
Near the hyoid bone

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7
Q

What are the complications with a thyroglossal duct cyst?

A

infection

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8
Q

Why is it important to get an ultrasound prior to surgically repairing a thyroglossal duct cyst?

A

To see if there is a normal thyroid tissue

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9
Q

What causes congenital torticollis? Treatment?

A

birthing process shortens the SCM

Usually physiotherapy

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10
Q

Why does reflux appear to cause torticollis?

A

Baby will try to stop gastric juices from coming up

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11
Q

What does the lung develop from?

A

Primitive foregut

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12
Q

Who usually gets pulmonary sequestration? Which lung side?

A

Males

Lower left

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13
Q

What is the most common associated abnormality of pulmonary sequestration?

A

Diaphragmatic hernia

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14
Q

What are the two types of pulmonary sequestration? Which is more common?

A

Intralobar and extralobar

Extralobar more common

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15
Q

What is the best imaging modality for diagnosing pulmonary sequestration?

A

CT, but US can diagnose before birth

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16
Q

What is the most common type of tracheo-esophageal fistula?

A

proximal Esophageal atresia, with tracheo-esophageal fistula (type C)

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17
Q

What is the 2nd most common type of esophageal atresia?

A

Total atresia of both esophagus and trachea

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18
Q

How do babies with tracheo-esophageal fistulas present?

A

Excessive drooling

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19
Q

What is the simple test for atresia?

A

Feed an NG tube in, and see if it comes back.

Gas in the abdomen

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20
Q

What is the treatment for TE fistula?

A

Gastrostomy

Right thoracotomy

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21
Q

What is the common congenital defect that occurs with TE fistula?

A

Cardiac defects

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22
Q

What is the VACTREL association?

A 
Vertebral
Anorectal
Cardio
Tracheal
Esophageal
Renal
Limb
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23
Q

What is the foramen bochdalek?

A

Left posterolateral diaphragmatic hernia

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24
Q

What are the complications of diaphragmatic hernias at birth?

A

Pulmonary HTN

Hypoplastic lung

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25
Q

Anterior, middle, or posterior mediastinum: thymus

A

Anterior

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26
Q

Anterior, middle, or posterior mediastinum: thyroid

A

Anterior

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27
Q

Anterior, middle, or posterior mediastinum: lymphatic tissue

A

Anterior

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28
Q

Anterior, middle, or posterior mediastinum: Heart and great vessels

A

Middle

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29
Q

Anterior, middle, or posterior mediastinum: Tracheobronchial tree

A

Middle

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30
Q

Anterior, middle, or posterior mediastinum: Lymph nodes, (nodes specifically)

A

Middle

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31
Q

Anterior, middle, or posterior mediastinum: Esophagus

A

Middle

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32
Q

What is a sternal cleft?

A

Cleft that occurs along the entire length sternum, not just at a single part lik pectus excavatum

33
Q

At what age is it appropriate to surgically repair sternal defects?

A

14-15 yo

34
Q

What is an omphalocele?

A

Failure of the umbilicus to come back into the abdomen, causing a Midline defect with the umbilical membrane covering it

35
Q

What is Beckwith-Wiedemann syndrome?

A

Genetic overgrowth syndrome that predisposes them to malignancies. Macroglossia can occur

36
Q

What is Gastroschisis?

A

Abdominal wall defect causing a protrusion of abdominal contents, caused by a disruption of the blood supply to the developing abdominal wall from the omphalomesenteric duct artery by the eighth week of gestation

37
Q

What is critical in treating children with gastroschisis or omphalocele?

A

Keep them warm

38
Q

What should be done with the umbilical cord in children with omphaloceles or gastroschisis?

A

Keep it long

39
Q

What is the complication with reverse rotation of abdominal contents?

A

Duodenum is now wrapped around ***

40
Q

In a normal person, where is the ligament of Treitz? Where does this end up in malrotation?

A

Normally

41
Q

What is the best way to diagnose malrotation or volvulus?

A

Upper GI series

42
Q

What is the double bubble sign an indication of?

A

Duodenal atresia

43
Q

What is duodenal atresia associated with?

A

Down syndrome and heart defects

44
Q

What is the cause of midgut atresia?

A

Mesenteric vascular accident

45
Q

What is the characteristic deformity of midgut atresia?

A

Apple-peel

46
Q

What are the rules of twos for Meckel’s diverticulum?

A

2 feet from the ileocecal valve
2% of the pop
Ssx before 2 yo

47
Q

What is a Meckel diverticulum? Ssx (3)?

A

A true congenital diverticulum that is a vestigial remnant of the omphalomesenteric duct,

This may cause intussusception, diverticulitis, or massive bleeding

48
Q

What is the cause of Hirschsprung’s disease?

A

Failure of migration of neural crest cells to the end of the gut. This causes aganglionic megacolon

49
Q

What are the presenting ssx of Hirschsprung’s?

A

No meconium within 24 hours.

No gas in the rectum
Dilated and contracted segments of bowel

50
Q

What is the gold test for Hirschsprung’s disease?

A

Biopsy

51
Q

In Hirschsprung’s disease, which segment of the colon is normal, and which is lacking ganglia?

A

Dilated is normal

Contracted is abnormal

52
Q

What is the most common area of involvement of Hirschsprung’s disease?

A

Rectosigmoid

53
Q

What is the treatment for Hirschsprung’s disease?

A

Colostomy

54
Q

What is an imperforate anus?

A

Colon that does not connect correctly to the anus

55
Q

Anus ending above the levator muscles usually causes what?

A

Fistula between UG and GU tract

56
Q

What are cloacal malformations?

A

Incorrect closure of the cloaca, which is the common opening of the colon and GU tracts embryologically

57
Q

When are umbilical repairs performed? Why not earlier?

A

5 years. Otherwise increase the chance of recurrence

58
Q

What age range is intussusception most common?

A

2 months to 2 years

59
Q

What are the ssx of intussusception?

A

Paroxysmal
Crampy pain

Currant jelly stools

60
Q

What is the best imaging modality to detect intussusception? What is the classic sign of this?

A

Ultrasound

Target sign

61
Q

What is the sign that can be seen on xr with intussusception?

A

Claw sign

62
Q

What is the treatment for intussusception?

A

Ba enema study is therapeutic

Surgery if this does not help

63
Q

What is the age range of pyloric stenosis? Ssx? What gender is more commonly affect?

A

2 weeks to 2 months

Non-bilious, projectile vomiting and palpable olive sign

Males

64
Q

Green color of emesis with projectile vomiting means what?

A

Could be ICP

65
Q

What is the metabolic disturbance that is seen in pyloric stenosis?

A

Hypochloremic alkalosis

66
Q

What is the ssx and findings of a child with biliary atresia?

A

High direct bili

Jaundice

67
Q

What is the treatment for biliary atresia? When should this be done?

A

Develops postnatally

Earlier the better

68
Q

True or false: surgery for a child with biliary atresia is curative

A

False– only buys times for a transplant

69
Q

What are type A- C of biliary atresia?

A 
A = total fibrosis of duct
B = fibrosis of proximal ducts
C = fibrosis of distal ducts
70
Q

What is the surgery performed to treat biliary atresia?

A

Kasai

Small bowel attached to the porta hepatis, and stomach attached lower down in the duodenum

71
Q

What are choledochal cysts?

A

Tiny dilations in the biliary stem

72
Q

Which side are inguinal hernias more common on in males? Females?

A

Right in males

Bilateral in females

73
Q

When should you treat an inguinal hernia? Why?

A

ASAP, since it may compromise the blood supply to the testes, or a BO.

74
Q

When can testes descend at the latest? When should this be fixed? Why?

A

6 months

Fixed ASAP to prevent damage to the testicle

75
Q

What are retractile testes?

A

Testes can descend up and down through the inguinal canal.

76
Q

Why is there an increased risk of CA with undescended testes?

A

Increased metaplasia d/t higher temps

77
Q

How do you tell if it’s undescended testes vs atrophic?

A

If you can feel them in the inguinal canal, or see them with US, then undescended. O/w atrophic.

78
Q

What is hydronephrosis?

A

Ureteral obstruction causing increased water retention

Gastrointestinal (42 decks)

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