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Common Peds Surgical Problems Flashcards

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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
Anterior, middle, or posterior mediastinum: thymus
Anterior
26
Anterior, middle, or posterior mediastinum: thyroid
Anterior
27
Anterior, middle, or posterior mediastinum: lymphatic tissue
Anterior
28
Anterior, middle, or posterior mediastinum: Heart and great vessels
Middle
29
Anterior, middle, or posterior mediastinum: Tracheobronchial tree
Middle
30
Anterior, middle, or posterior mediastinum: Lymph nodes, (nodes specifically)
Middle
31
Anterior, middle, or posterior mediastinum: Esophagus
Middle
32
What is a sternal cleft?
Cleft that occurs along the entire length sternum, not just at a single part lik pectus excavatum
33
At what age is it appropriate to surgically repair sternal defects?
14-15 yo
34
What is an omphalocele?
Failure of the umbilicus to come back into the abdomen, causing a Midline defect with the umbilical membrane covering it
35
What is Beckwith-Wiedemann syndrome?
Genetic overgrowth syndrome that predisposes them to malignancies. Macroglossia can occur
36
What is Gastroschisis?
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
What is critical in treating children with gastroschisis or omphalocele?
Keep them warm
38
What should be done with the umbilical cord in children with omphaloceles or gastroschisis?
Keep it long
39
What is the complication with reverse rotation of abdominal contents?
Duodenum is now wrapped around ***
40
In a normal person, where is the ligament of Treitz? Where does this end up in malrotation?
Normally
41
What is the best way to diagnose malrotation or volvulus?
Upper GI series
42
What is the double bubble sign an indication of?
Duodenal atresia
43
What is duodenal atresia associated with?
Down syndrome and heart defects
44
What is the cause of midgut atresia?
Mesenteric vascular accident
45
What is the characteristic deformity of midgut atresia?
Apple-peel
46
What are the rules of twos for Meckel's diverticulum?
2 feet from the ileocecal valve 2% of the pop Ssx before 2 yo
47
What is a Meckel diverticulum? Ssx (3)?
A true congenital diverticulum that is a vestigial remnant of the omphalomesenteric duct, This may cause intussusception, diverticulitis, or massive bleeding
48
What is the cause of Hirschsprung's disease?
Failure of migration of neural crest cells to the end of the gut. This causes aganglionic megacolon
49
What are the presenting ssx of Hirschsprung's?
No meconium within 24 hours. No gas in the rectum Dilated and contracted segments of bowel
50
What is the gold test for Hirschsprung's disease?
Biopsy
51
In Hirschsprung's disease, which segment of the colon is normal, and which is lacking ganglia?
Dilated is normal | Contracted is abnormal
52
What is the most common area of involvement of Hirschsprung's disease?
Rectosigmoid
53
What is the treatment for Hirschsprung's disease?
Colostomy
54
What is an imperforate anus?
Colon that does not connect correctly to the anus
55
Anus ending above the levator muscles usually causes what?
Fistula between UG and GU tract
56
What are cloacal malformations?
Incorrect closure of the cloaca, which is the common opening of the colon and GU tracts embryologically
57
When are umbilical repairs performed? Why not earlier?
5 years. Otherwise increase the chance of recurrence
58
What age range is intussusception most common?
2 months to 2 years
59
What are the ssx of intussusception?
Paroxysmal Crampy pain Currant jelly stools
60
What is the best imaging modality to detect intussusception? What is the classic sign of this?
Ultrasound | Target sign
61
What is the sign that can be seen on xr with intussusception?
Claw sign
62
What is the treatment for intussusception?
Ba enema study is therapeutic Surgery if this does not help
63
What is the age range of pyloric stenosis? Ssx? What gender is more commonly affect?
2 weeks to 2 months Non-bilious, projectile vomiting and palpable olive sign Males
64
Green color of emesis with projectile vomiting means what?
Could be ICP
65
What is the metabolic disturbance that is seen in pyloric stenosis?
Hypochloremic alkalosis
66
What is the ssx and findings of a child with biliary atresia?
High direct bili | Jaundice
67
What is the treatment for biliary atresia? When should this be done?
Develops postnatally | Earlier the better
68
True or false: surgery for a child with biliary atresia is curative
False-- only buys times for a transplant
69
What are type A- C of biliary atresia?
``` A = total fibrosis of duct B = fibrosis of proximal ducts C = fibrosis of distal ducts ```
70
What is the surgery performed to treat biliary atresia?
Kasai Small bowel attached to the porta hepatis, and stomach attached lower down in the duodenum
71
What are choledochal cysts?
Tiny dilations in the biliary stem
72
Which side are inguinal hernias more common on in males? Females?
Right in males Bilateral in females
73
When should you treat an inguinal hernia? Why?
ASAP, since it may compromise the blood supply to the testes, or a BO.
74
When can testes descend at the latest? When should this be fixed? Why?
6 months | Fixed ASAP to prevent damage to the testicle
75
What are retractile testes?
Testes can descend up and down through the inguinal canal.
76
Why is there an increased risk of CA with undescended testes?
Increased metaplasia d/t higher temps
77
How do you tell if it's undescended testes vs atrophic?
If you can feel them in the inguinal canal, or see them with US, then undescended. O/w atrophic.
78
What is hydronephrosis?
Ureteral obstruction causing increased water retention

Gastrointestinal (42 decks)

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