OnlineMedEd: Surgery: Subspecialty - "Peds: First Day"

Question 1

List two features that can be seen on an x-ray of a baby with tracheoesophageal fistula.

Answer 1

• Air bubble in stomach

* NG tube coiling in blind pouch of esophagus

Question 2

____________ is why you’re not supposed to take the first temperature rectally.

Answer 2

Imperforate anus

Question 3

What kind of imaging is done to evaluate imperforate anus?

Answer 3

Crosstable x-ray

Question 4

How do you manage imperforate anus?

Answer 4

• Mild (i.e., close together): fix immediately

* Severe (i.e., far apart): diverting colostomy now, fix before toilet training

Question 5

True or false: omphalocele is off to the side.

Answer 5

False, it is midline.

Gastroschisis is off to the side (to the schide, hehe).

Question 6

Differentiate omphalocele and gastroschisis.

Answer 6

•Omphalocele:

• Midline
• Has a membrane
• Contains bowel
• Treated with sterile silo that turns bowel in over time

•Gastroschisis:

• Off to right side
• No membrane
• Contains bowel
• Treated with sterile silo that turns bowel in over time

Question 7

Describe exstrophy of the bladder.

Answer 7

• Midline, lower
• Bladder not bowel
• Appears red, wet, and shiny
• Treated with surgical repair

Question 8

There are two kinds of diaphragmatic hernia: ________________.

Answer 8

anterolateral (Morgani) and posterior (Bochdalek)

Question 9

Review diaphragmatic hernia.

Answer 9

• Presents with hypoxia and scaphoid abdomen at birth
• Can hear bowel sounds in lung
• Diagnosable with x-ray
• Treat with cardiorespiratory support and surgery (likely intubation)
• Follow-up with surfactant

Question 10

There are three biliary emesis disorders. Compare and contrast them.

Answer 10

•Malrotation:

• Biliary emesis sometime after birth (may not be on day 1)
• Presents with double-bubble sign with normal gas distally (because some was able to get through)

•Intestinal atresia:

• Biliary emesis at birth
• Intestinal infarcts that may be caused by maternal cocaine
• Double-bubble with air-fluid levels distally

•Duodenal atresia or annular pancreas:

• Biliary emesis at birth
• Double-bubble with nothing distally

Question 11

A contrast enema can be diagnostic and therapeutic for _______________.

Answer 11

intussusception and malrotation