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Person Peds > Stevens #1 Common Surgeries > Flashcards

Stevens #1 Common Surgeries Flashcards

1
Q

What is palpated in Hypertrophic Pyloric Stenosis?

A

-olive shaped mass between midline and RUQ

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2
Q

What is Hypertrophic Pyloric Stenosis

A

Hypertrophy of muscularis layer

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3
Q

How is Hypertrophic Pyloric Stenosis diagnoisis made?

A

Ultrasound or barium swallow

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4
Q

What is the priority with Hypertrophic Pyloric Stenosis

A
  • Intravascular volume

- Metabolic stabilization

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5
Q

Hypertrophic Pyloric Stenosis anesthesia considreations

A
  • Empty stomach
  • Local anesthetic is enough
  • Careful w/ opioids
  • Rectal tylenol
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6
Q

Hyperosmolar enemas are given w/ Duodenal and Ileal Obstruction Why, and what may occur?

A
  • Clear viscid meconium plugs

- Shifts in intravascular volume

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7
Q

Duodenal Atresia is associated with what?

A
  • Bilious vomiting 24-48hr after birth

- Small bowels cannot pass stomach contents

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8
Q

What does Xray reveal w/ Duodenal Atresia?

A

-Double bubble sign

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9
Q

When can elective nonincarcerated hernia be repaired?

A

-With no bowel obstruction

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10
Q

What is a sign of a high spinal.

A
  • Sudden cessation of crying

- Apnea

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11
Q

When to wait for hernia repair in premies and why?

A
  • 55 weeks post gestation

- Higher risk of apnea

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12
Q

What is omphalocele?

A

infant’s intestine or other abdominal organs stick out of the belly button

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13
Q

What is Gastroschisis

A

infant’s intestines stick out of the body through a defect of the umbilical cord.

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14
Q

What causes Omphalocle and Gastroschisis

A
  • Folic acid deficiency
  • Hypoxia
  • Salicylates (pepto)
  • ↑ Maternal serum alpha-fetoprotein
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15
Q

What occurs in associations with Omphalocle and Gastroschisis?

A

Polyhydraminos (too much amnotic fluid)

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16
Q

Neonate w/ omphalocele are usually in no distress, unless?

A

Associated hypoplasia

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17
Q

repair of omphalacele may precipitate __________, and ______ support

A
  • Respiratory failure

- ventilator

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18
Q

Incidence of Gastroschisis is increasing to what 2 things?

A
  • Young maternal age

- Low gravidity

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19
Q

Gastroschisis develops as a result of what?

A

occlusion of the omphalomesenteric artery during gestation

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20
Q

Gastroschisis is ______ with other anomalies

A

Not associated

21
Q

What should be done w/ Gastroschisis preop and why?

A
  • Plastic wrap
  • ↓ volume loss
  • ↓ hypothermia risk
22
Q

If Gastroschisis closure is not possible due a _____ is created until ________ has resolved

A
  • Silo

- Inflammation

23
Q

What must be minimized w/ Gastroschisis?

A

-Fluid, electrolyte and heat loss

24
Q

When should Gastroschisis silo be removed?

A
  • Within a week

- Prevent infection

25
Q

What is myelodysplasia?

A
  • bone marrow does not function normally

- produces ↓ number of normal blood cells.

26
Q

Myelodysplasia defects in spine are known as what?

A

Spina bifida

27
Q

Meningoceles are lesions containing CSF w/o what?

A

Spinal tissue

28
Q

Meningomyelocele is a meningocele with _______ _______ within the lesion.

A

Neural Tissue

29
Q

In Myelodysplasia a ______ is needed for hydrocephalus.

A

VP Shunt

30
Q

Myelodysplasia increases risk for what sensitivity?

A

Latex

31
Q

Myelodysplasia anesthetic concerns

A
  • Position for intubation

- Blood loss from skin graft

32
Q

What is Arnold-Chiari Malformation?

A
  • bony abnormality in the posterior fossa and upper cervical spine
  • Caudal displacement below foramen magnum
33
Q

Arnold-Chiari can present in healthy children as?

A

-Headache and neck pain

34
Q

What is cystic fibrosis?

A

mucus to build up in the lungs, digestive tract, and other areas of the body

35
Q

What is the most common fatal inherited disease?

A

Cystic fibrosis

36
Q

Disruption of electrolyte transport in cystic fibrosis can cause what?

A

Elevated sweat chloride

37
Q

What is the main cause of morbidity w/ cystic fibrosis?

A

-Lung disease

38
Q

Pathophysiology of cystic fibrosis includes what?

A
  • mucus plug
  • infection
  • inflammation
  • epithelial injury
39
Q

What causes slow mucus clearance in cystic fibrosis?

A

-Na absorption
-Chloride secretion
= decreased liquid on luminal surfaces

40
Q

What are 3 common pathogens in cystic fibrosis?

A
  • Staph Aureus
  • Influenzae
  • Psudamonas (later in life)
41
Q

In cystic fibrosis pulmonary function are obstructive in nature and cause what?

A
  • ↑ FRC
  • ↓ FEV1
  • ↓ peak flow rate
  • ↓ vital capacity
42
Q

In cystic fibrosis what produces lowered PaCO2?

A

Compensatory hyperventilation

43
Q

In cystic fibrosis end stage cor pulmonale leads to what?

A
  • Cardiomegaly
  • fluid retention
  • hepatomegaly
44
Q

Low weight and BMI, are closely related to what?

A

Poor lung function

45
Q

How dose diabetes arise from cystic fibrosis?

A

-Pancreatic disease

46
Q

Hepatic dysfunction results in what?

A
  • ↓ cholinesterase
  • ↓ clotting factors
  • ↓ Vitamin K
47
Q

In cystic fibrosis, induction may be prolonged due to what 3 things?

A
  • Large FRC
  • Small tidal volume
  • V/Q mismatch
48
Q

What should be used in general anesthesia for cystic fibrosis and why?

A
  • Humidified warmers

- to reach isothermic saturation point.

Person Peds (7 decks)

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