EXAM #3: PEDIATRIC SURGICAL PROBLEMS Flashcards Preview

Gastrointestinal System > EXAM #3: PEDIATRIC SURGICAL PROBLEMS > Flashcards

Flashcards in EXAM #3: PEDIATRIC SURGICAL PROBLEMS Deck (43):
1

What are the three etiologies of lymphadenopathy?

1) Infectious
2) Reactive
3) Malignancy

2

What is the difference between acute and chronic lymphadenopathy?

- Less than 6 weeks= acute
- Greater than 6 weeks= chronic

3

What is the surgical procedure to diagnose lymphadenopathy?

Biopsy

4

What do you need to do for the proper diagnosis of a thryoglossal duct cyst?

US to ensure there is normal thyroid tissue

5

What is the surgical procedure for a thyroglossal duct cyst?

Sistrunk procedure

A small incision is made over the cyst. The cyst and the entire tract are removed, as well as the middle portion of the hyoid bone

6

When is surgery indicated for congenital torticollis?

Failure to resolve within a year with aggressive conservative therapy

7

How is congenital torticollis treated surgically?

Division of the involved SCM

8

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

Proximal atresia with distal fistula

9

What is the most common presenting symptom of a TE fistula?

Excessive salivation

10

How is a TE fistula managed surgically?

Right toracotomy and exptrapleural repair

*May require gastrostomy

11

What is the VATER association with TE fistula? Why is this important?

Vertebral
Anorectal
Cardiovascular
Tracheal
Esophageal
Renal
Limb

Any kid with a TE fistula will need to be associated for these issues as well.

12

What is the eponym for the most common location of a diaphragmatic hernia?

Foramen of Bochdalek in the left pleuroperitoneal membrane

13

When do you know if a chest wall deformity needs to be repaired?

At least 14 years of age--only intervene earlier if cardiopulmonary compromise

14

What anomalies are associated with omphalocele?

1) Heart
2) Urinary Tract
3) Beckwith-Wiedeman

15

What is the difference between major and minor omphalocele?

Minor= less than 4cm
Major= greater than 4cm

16

What is Bechwith-Wiedeman Syndrome?

This is an overgrowth disorder usually present at birth; it is characterized by an increased risk of childhood cancer and congenital anomalies, including:

1) macroglossia (large tongue),
2) macrosomia (above average birth weight and length),
3) midline abdominal wall defects (omphalocele/exomphalos, umbilical hernia, diastasis recti),
4) ear creases or ear pits, and
5) neonatal hypoglycemia

17

What is Gastrochisis?

Abdominal wall defect right of the umbilicus

18

What is worse, gastrochisis or omphalocele?

Omphalocele

19

What are the complications of gastrochisis and omphalocele?

1) Heat loss-->warm
2) Third space heat loss
3) Infection-->antibiotics

20

At birth, what should you remember about gastrochisis or omphalocele?

Leave the umbilical cord long

21

What is the presentation with malrotation and volvulus?

Forceful often bilious emesis

*Remember, bilious emesis is a red flag*

22

How do you diagnose malrotation/ volvulus?

Upper GI series

23

What is the classic imaging for duodenal atresia?

"Double bubble sign"

24

How is duodenal atresia repaired surgically?

Duodenoduodenostomy

25

What causes midgut atresia?

In utero mesenteric vascular accident

26

What is the rule of two's for Meckel's Diverticumlum?

- 2 feet from ileocecal valve
- 2% population
- Most before age of 2

27

How does Meckel's Diverticulum present?

Massive bleeding

28

What is the first thing you need to do if you suspect Meckel's Diverticulum?

1) Resuscitate
2) Meckel's Scan

29

How do you work-up Hirschsprung's Disease?

1) Barium enema
2) Rectal biopsy* gold-standard

30

On x-ray, what is suggestive of Hirschsprung's Disease?

No gas in the rectum

31

How do you treat Hirschsprung's Disease with surgery?

1) Possible colostomy
2) Remove affected contracted region

32

What is an imperforate anus?

Cloaca that does NOT separate rectum and urogenital sinus

33

What is the typical age that you would repair an umbilical hernia?

3-5 years old

34

What is the classic presentation of Intussception?

- Paroxysmal, crampy abdominal pain
- Currant jelly stool (late sign)

35

How is Intusssception worked up?

1) US--> "target sign"
2) Barium enema

36

What are the buzzwords for pyloric stenosis?

- Projectile non-bilious emesis
- Olive mass
- Hypochloremic hypokalemic alkalosis (emesis contains Cl- and K+)

37

How does biliary atresia present?

Persistent direct hyperbilirubinemia

38

What is the definitive treatment for biliary atresia?

Transplant (initial surgery, "Kasai" only buys time)

39

What type of hernia is more common in kids?

Indirect

40

What increases the risk of indirect hernia?

Premature

41

What should you remember about pediatric inguinal hernias?

Should be fixed ASAP

42

When do undescended testes need to be fixed?

By 1-year (may descend by six months)

43

What is a horseshoe kidney?

Single kidney with fused poles