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Flashcards in Pediatric Surgery Deck (19):
1

A NG tube passed on a newborn with feeding difficulty is shown to be coiling in the upper chest. This is likely?

Esophageal atresia

2

Prior to operating on a newborn with esophageal atresia, what should be done?

VACTER anomaly rule out

3

What is the most important factor in a patient with congenital diaphragmatic hernia?

Their immature hypoplastic lung. Allow 3-4 for maturation before surgery.

4

Explain the gross differences between gastrochisis and omphalocele.

Gastrochisis has a normal cord, the defect is to the right of the cord, no protective membrane

Omphalocele has the cord to the defect and a thin protective covering

5

How long does it take for the bowel to begin to function in a baby with gastrochisis?

1 month

6

What three congenital anomalies have bilious vomiting and a "double bubble" X-ray?

Duodenal atresia, annular pancreas, malrotation

7

Malrotation can be diagnosed via?

Double bubble plus normal gas pattern distally

Contrast enema

8

Intestinal atresia has this characteristic finding on X-ray?

Double bubble with multiple air bubbles distally

9

A newborn developed abdominal distention and a rapid drop in platelets following his first feed. He was transferred to the NICU and started on IV nutrition. Imaging should be looking for these findings, which indicate surgery is needed?

An infant with necrotizing enterocolitis needs surgery when they have pneumatosis, portal vein air, pneumoperitoneum

10

This disease is common in newborns with CF who have a "ground glass" appearing bowel? How is it diagnosed?

Meconium ileus

Gastrograffin enema

11

What are the common H&P findings in a baby with hypertrophic pyloric stenosis?

-firstborn boys
-nonbilious vomiting
-eager for food
- visible gastric peristalsis
-palpable "olive" mass

12

Patients with hypertrophic pyloric stenosis will need this electrolyte abnormality corrected before surgery?

Hypocholremic, hypokalemic metabolic alkalosis

13

How is the diagnosis of Hirschaprung disease made?

A child with chronic constipation. Full thickness biopsy of rectal mucosa is diagnostic

14

What will a child with intussusception look like?

Extreme abdominal pain one second and normal the next. Usually 6-12 months old. Current jelly stools.

15

How is intussusception treated in a child? Adult?

Child: barium enema

Adult: surgery

16

A radioisotope scan for meckel diverticulum, looks for this?

Ectopic gastric mucosa

17

At what age does an undescended testicle need surgically fixed?

1 year

18

A testicle that can be easily pulled down into the scrotum is...

Normal testicle with an overactive cremasteric reflex

19

A malignant liver tumor in a child will have this clinical exam finding? This lab finding?

-moves with respiration
-elevated alpha fetaprotein