Surgical

Question 1

What is appendicitis

Answer 1

Inflammation and infection of appendix

Question 2

What can untreated appendicitis lead to

Answer 2

Peritonitis

Question 3

Clinical features of appendicitis

Answer 3

Moderate fever 
Look unwell 
Vomiting 
Pain:
Middle moving toward right iliac fossa

Question 4

Rx for appendicitis

Answer 4

Analgesia
Appendectomy:
Laproscopically

Question 5

Who is non-specific abdominal pain more common in boys or girls

Answer 5

Girls

Question 6

Features of non-specific abdominal pain

Answer 6

Central pain 
Constant pain 
Not exacerbated by movement 
No GIT disturbance 
No temp

Question 7

What is a very important cause of abdominal pain in children

Answer 7

Functional abdominal pain

Question 8

Most common cause of mesenteric adenitis

Answer 8

Viral infections

Question 9

What is there often a history of in mesenteric adenitis

Answer 9

URTI

Question 10

What is mesenteric adentiis

Answer 10

Inflammation of mesenteric LN

Question 11

Symptoms of mesenteric adenitis

Answer 11

High fever

Abdo. pain

Question 12

Rx for mesenteric adenitis

Answer 12

Often self limiting

Analgesi

Question 13

What is pyloric stenosis

Answer 13

Narrowing of the pylorus

Question 14

RF for pyloric stenosis

Answer 14

Male
FH
4-16 wks old

Question 15

Symptoms of pyloric stenosis

Answer 15

Vomiting:
Projectile 
Occurs mins after feeding   
Olive mass in abdomen 
Multiple formula changes
Decreased wet nappies
Constipation
Poor w.t gain 
Irritability 
Lethargy

Question 16

Describe vomiting in pyloric stenosis

Answer 16

Projectile

Occurs mins after feeding

Question 17

What can sometimes be felt on palpation in pyloric stenosis

Answer 17

Olive mass in abdomen

Question 18

Is for pyloric stenosis

Answer 18

Test feed

USS

Question 19

Rx for pyloric stenosis

Answer 19

IV fluids

Surgical:
Periumbilical pyloromyotomy

Question 20

What is malrotation

Answer 20

Intestinal Malrotation is a term used to describe an entire spectrum of rotational and fixation disturbances that can occur during embryonic development

Question 21

What is volvulus

Answer 21

Complication of Malrotation

Bowel twists -> blood supply is cut off

Question 22

Clinical features of malrotation

Answer 22

Can be asymptomatic

Vomiting (may contain bile – green)
Crying
Pulling the legs into body
Passing little/no stool

Question 23

What is the most common cause of intestinal obstruction in children

Answer 23

Intussusception

Question 24

What is intussusception

Answer 24

Prolapse of one part of the intestine into the lumen of adjoining distal part

Question 25

Typical picture of intussusception

Answer 25

9 months | M>F

Question 26

Clinical features of intussusception

Answer 26

Intermittent colic: Abdominal pain that comes and goes ‘Dying’ spells Bilious vomiting Bloody mucous in stools: Redcurrant jelly stool

Question 27

Characteristic stools in intussusception

Answer 27

Bloody mucous | Redcurrant jely

Question 28

Ix for intussusception

Answer 28

USS abdo X-ray Diagnostic enema

Question 29

Sign on x-ray seen in intussusception

Answer 29

Target sign

Question 30

Rx for intussusception

Answer 30

Pneumostatic reduction by air enema Laporotomy is that fails

Question 31

RX for umbilical hernia

Answer 31

``` Low birth w.t Trisomy 21 Hypothyroidism African populations M ```

Question 32

Appearance of umbilical hernia

Answer 32

Bulge at belly button | Usually more prominent when baby cries or strains

Question 33

Ix for umbilical hernia

Answer 33

Clinical O/E

Question 34

Rx for umbilical hernia

Answer 34

Leave alone until 4yrs and see for spontaneous closure Repair if Complicated No closure by 4yrs Large defect

Question 35

How long should yo u leave an umbilical for

Answer 35

4yrs

Question 36

Pathology of epigastric hernia

Answer 36

Defect in linea alba above the umbilicus | Protrusion of preperitoneal fat

Question 37

Which gender is epigastric hernia more common in

Answer 37

Male

Question 38

Clinical features of epigastric hernia

Answer 38

Mass in epigastrum | Commonly enlarges

Question 39

Rx for epigastric hernia

Answer 39

Often leave alone | Sometimes surgery

Question 40

What is gastroschisis

Answer 40

Abdominal wall defect | Intestines develop outside and are open to air when the child is born

Question 41

RF for gastroschisis

Answer 41

Smoking in pregnancy Alcohol in pregnancy Maternal age <20yrs

Question 42

In gastroschisis is there any membrane covering on the intestines

Answer 42

No

Question 43

Ix for gastrochisis

Answer 43

Ofen Dx pre natal USS 2nd trimester

Question 44

Rx for gastrochisis

Answer 44

Bowel protection Primary/delated closure TPN

Question 45

Complications of gastrochisis

Answer 45

Short gut (as sometimes damaged bowels occur and need to be removed)

Question 46

What is exomphalos

Answer 46

Abdominal wall defect Intestines remain inside the umbilical cord/membrane But develop out with the abdomen

Question 47

Is there a membrane covering on the intestines in exomphalos

Answer 47

Yes

Question 48

Associated anomilies with exomphalos

Answer 48

``` Cardiac Chromosomal (trisomy 13,18,21) Renal Neurological Beckwith-Weidman Syndrome ```

Question 49

Ix for exomphalos

Answer 49

Pre-natal USS | 2nd trimester Dx in many cases

Question 50

Rx for exomphalos

Answer 50

Bowel protection | Primary/delayed closure