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Pediatric Surgery Flashcards

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1
Q

Insensible water losses in premature infant less than 1.5kg

  1. 10-20mL/kg
  2. 20-30 mL/kg
  3. 30-35 mL/kg
  4. 45-60 mL/kg
A

Premature infants have greater insensible fluid loss - 45-60mL/kg

30-35mL/kg - insensible water loss in term infant

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2
Q

Most common esophageal atresia

  1. Type A - pure esophageal atresia
  2. Type B - atresia + proximal TEF
  3. Type C - atresia + distal TEF
  4. Type D - atresia + distal and proximal TEF
    Type E - no atresia, only TEF (H like deformity)
A 
Answer 
Type A 7%
Type B 2%
Type C 86%
Type D 1%
Type E 4%
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3
Q

Sausage shaped mass seen in intussusception in children is seen in

  1. RUQ
  2. RLQ
  3. Upper midline
  4. Lower midline
A

RUQ

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4
Q

Indication of fundoplication in GER in children

  1. Failure to thrive
  2. Stricture
  3. Near miss SIDS episode
  4. Failure of medical management
  5. Recurrent pneumonia or asthma
A

All

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5
Q

Medical management of GER in children

Thickened feeds + decreased volume of feeds + postural manoeuvres + acid supression

A

All

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6
Q

Important points regarding gerd in children

  1. Delayed emptying improves with fundoplication
  2. Severity does not correlate with les dysfunction
  3. 24 hr pH probe is gold standard
  4. Gastric emptying scan done with Tc 99 - 50% emptying in 1h and 80% emptying in 90min is normal.
  5. Gerd in children usually resolves spontaneously since it is due to incompetent les at birth
  6. Vomiting is common symptom
  7. Vagal reflex causes asthma like bronchospasm
A

All

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7
Q

Structures divided in ramstedt pyloromoyotomy

  1. Serosa
  2. Submucosa
  3. Mucosa
  4. Both 1&2
  5. All of the above
A

Serosa only

Submucosa remains intact

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8
Q

Which of the following is not an indication for circumcision

  1. Spina bifida
  2. Single episode of balanoposthitis
  3. Balanitis xerotica obliterans
  4. Recurrent UTI
  5. Preventing HIV transmission
A

Single episode of balanoposthitis

Circumcision for hiv transmission is a controversial but emerging insication since circumscision prevents transmission

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9
Q

Which of the following is not true regarding esophageal atresia

  1. Type C is the most common type
  2. Associated with hereditary VACTERL deformities
  3. Type E is often diagnosed beyond the neonatal period
  4. Isotonic contrast should not be used to demonstrate presence of fistula
  5. Replogle tune is used for decompression of proximal pouch
A

Answer is VACTERL are non hereditary and non random

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10
Q

Which of the following is not true in esophageal atresia

  1. Routine endotracheal intubation should be avoided
  2. Gastronomy should be avoided
  3. Type E is usually repaired via cervical incision
  4. Circular esophagomyotomy on upper end can be done in case of long gap
  5. Type A is repaired within 1-2 days
A

Type A is repaired at 1 year. Initially - cervical esophagomyotomy + gastrotomy is done for feeding.

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11
Q

Apple peel deformity, Christmas tree deformity are both seen in

  1. Extra hepatic biliary atresia
  2. Jejuno-ileal atresia
  3. Duodenal atresia
  4. Annular pancreas
A

Jejuno-ideal atresia type III b

Type I mucosal web
Type II atretic cord between two ends
Type IIIa V shaped defect of mesentry with complete separation of ends
Type IIIb - apple peel or Christmas tree deformity - with large msesentric gap - distal bowel recieves retrograde supply from R colic artery - tenuous - risk of anastomotic failure
Type IV - multiple atresia - Sausage string appearance

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12
Q

Which of the following is true

  1. Jejunal atresia is not associated with Cystic fibrosis
  2. Meconium ileus has absence of air fluid levels in x Ray
  3. Investigation of choice for meconium ileus is water contrast upper gi series
  4. Pilocarpine iontophoresis sweat test with chloride more than 20 mEq/L is confirmatory for cystic fibrosis
A

Jejunal atresia is associated with cystic fibrosis in 10%

Air fluid levels are absent in meconium ileus

IOC is water soluble contrast enema

Pilocarpine sweat test - cl >60 mEq/L is confirmatory

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13
Q

Which of the following is not done in Ladd procedure

  1. Evisceration of twisted bowel
  2. Derotation of bowel in clockwise direction
  3. Base of mesentry widened
  4. Appendectomy
A

Derotation in counterclockwise direction

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14
Q 
Signs of malrotation all except 
corkscrew appearance 
Whirlpool appearance
Neuhauser sign
Bird beak in 3rd part of duodenum
A

Neuhauser sign is seen in meconium ileus is terminal part of ileum with contrast enema or upper gi series

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15
Q

Pentalogy of Cantrell does not include

  1. Omphalocele
  2. Bochdalek hernia
  3. Sternum cleft
  4. Ectopia cordis
  5. Intracardiac defects
A

Anterior diaphragmatic are present not posterior

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16
Q

Exomphalos true are all except

  1. Defect less than 4cm is called Hernia of cord
  2. Associated with trisomy 13,15,18 and 21
  3. Membrane covering consists of peritoneum outside and amnion inside
  4. Escharotic agents like betadine or silver nitrate are used in giant opmhalaocele
Study These Flashcards
A

Membrane covering is amnion outside and peritoneum inside

Escharotic agents are used in giant omphaloceles to thicken and epithelialize the membrane

surgery 101 (9 decks)

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