Surgery Flashcards
(52 cards)
What are the layers covering the contents of the hernia in omphalocele?
Peritoneum and amnion
Distinguishing between ?septic arthritis and ?transient synovitis?
Kocher criteria used to distinguish septic arthritis from transient synovitis in a child presenting with an inflamed hip are fever > 38.5°C, ESR > 40 mm/hr, WCC > 12 000 cells/mm3, and non-weight bearing. The probability of septic arthritis is 93% if 3 are positive, and 99% if 4.
Reduced internal rotation is a common sign in which orthopaedic complaint?
Reduced internal rotation is a common sign in transient synovitis.
Vomiting before the onset of pain is a feature of what appendix orientation?
Retrocecal
The inflamed appendix irritates the duodenum causing vomiting before RLQ pain.
What is the most common complication of appendicitis in children?
Perforation
Testicular swelling in babies?
Inguinal hernia is important to exclude, it occurs in 3-5% of term babies and up to 30% in premature babies!
However, an inguinal hernia would not be transilluminable and you should be able to separate it from the testes.
Likewise, you cannot normally get above an inguinal hernia.
A varicocele again is separate from the testes, as is an epididymal cyst, though a cyst will be transilluminable like a hydrocele.
What is the median age of a neonate when presenting with Hirschsprung’s disease?
Often presents with meconium ileus at 2 DAYS
Passage of redcurrant jelly stool is a late sign of?
intussusception
At what age does pyloric stenosis typically present?
4-6 weeks
What is the first line definitive treatment for a child with a renal stone under 10mm who has not been able to pass the stone?
Ureteroscopy or shockwave lithotripsy
Which types of kidney stones are the most common in childhood?
Calcium and struvite
What is the gold standard tool used to diagnose Hirschsprung’s disease?
Rectal suction biopsy
If the protruding organs have a protective membrane covering them, which diagnosis is more likely?
Omphalocele
Key feature of hypospadias?
Dorsal hooded foreskin is the key feature.
Surgical management of testicular torsion?
An orchidopexy is done to detort and fix the testicle in place to prevent further episodes of torsion.
It is done bilaterally to reduce the risk of torsion occuring in the contralateral testicle.
An orchidectomy is done if the tesicle is unsalvageable.
What does a palpable mass at McBurneys point in the RLQ suggest?
Appendix perforation
What sign is seen on abdominal ultrasound in intussusception?
Target sign
What sign is seen on AXR in perforation
Rigler’s and football sign is found on AXR in perforation
What sign is seen on AXR in duodenal atresia?
Double bubble is seen in duodenal atresia on AXR.
Main contraindication to enema intervention in intussusception?
Perforation i.e. rigglers sign on AXR
What finding on USS is indicative of gastroschisis?
With gastroschisis, ultrasound can show echogenic and dilated loops of bowel freely floating in the amniotic cavity. Although, some cases are missed and diagnosed clinically at birth.
What is the management of a retractile testis at 3 months of age?
Monitor annually for ascending testicle
What is embryologically responsible for the descent of the testis?
Gubernaculum
Which blood markers may be raised in perinatal testing that could indicate omphalocele?
Alpha-fetoprotein
