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Question 1

What to think of if you see double bubble sign?; Tx?; When Tx?

Answer 1

duodenal atresia
Type 1: web blocking lumen
Type 2: tissue btw two ends
Type 3: gap btw two ends
duodenoduodenostomy
Time: 1-3 days after birth (urgent)

Question 2

What to think of in bilious emesis?

Answer 2

ampulla vaterin altında Tıkanıklık olan tüm hastalıklar: Strangule inguinal herni, duodenal, jejunal , kolon atrezileri, İnvajinasyon, Rektal atrezi, enterit?, Hirsprung, volvulus, bağırsak malrotasyonları.mekonyum ileus

Question 3

With which pathologies is Pentalogy of Cantrell associated? (important for omphalocele)

Answer 3

five defects of: heart, pericardium, diaphragm, sternum, and abdominal

Question 4

How does the location and extend of Omphalocele and gastroschisis differ?

Answer 4

Omphalocele:
-base of the umbilical cord
-herniation of abdominal organs (such as the liver, intestines, and occasionally other organs) through a hole in abdominal muscles
-covered by a protective sac, amnioperitoneal membrane or peritoneum

Gastroschisis:
- typically to right of the umbilical cord insertion
- no protective sac
- hole in the abdominal wall, and the intestines (and sometimes other organs) protrude directly through this hole into the amniotic fluid

Question 5

How are Omphalocele and gastroschisis associated with other diseases?

Answer 5

Omphalocele:
-often associated such as chromosomal abnormalities (like Down syndrome), heart defects, neural tube defects, and genitourinary anomalies
-higher rate of association

Gastroschisis:
- usually an isolated defect
- increased risk of intestinal complications d/t direct exposure to amniotic fluid

Question 6

How is Omphalocele and gastroschisis typically diagnosed?

Answer 6

Prenatal screening:

a. Maternal blood tests:
-alpha-fetoprotein (AFP) screening, -> elevated levels -> may indicate it
-amnion sivida increased acetylcholinesterase

b. Ultrasound

Confirmation and detailed evaluation: If abnormality is suspected:

a. Detailed ultrasound

b. Fetal MRI: more precise images & additional information about the condition -> clearer picture of the abdominal organs and their positioning

c. Amniocentesis: may be recommended, to detect any genetic/ chromosomal abnormalities that may be associated with them

Question 7

Defintion of Hirschsprung Disease

Answer 7

-proximal-to-distal aganglionic segment in the colon -> inability of internal anal sphincter to relax
-often extend up to sigmoid colon
-predominantly in males with familial predisposition

Question 8

Symptoms of Hirschsprung Disease + PE findings

Answer 8

-Distended abdomen, vomiting, and absence of meconium passage within the first 24 hours of birth, Failure to Thrive, palpable fecal mass, squirt sign

Question 9

Complications of Hirschsprung Disease

Answer 9

Possible bacterial spread due to stasis

Question 10

Diagnosis of Hirschsprung Disease

Answer 10

-typically confirmed through a series of tests: barium enema (Kjolonography), anorectal manometry, & rectal biopsy

Question 11

Treatment of Hirschsprung Disease

Answer 11

• aganglionic segment is surgically removed, and the colon is pulled down
• Swenson operation (removing aganglionic segment of the colon, bringing the normally decompressed bowel through the pelvic floor, and anastomosing the bowel to the anorectal verge)

Question 12

Causes of delayed meconium

Answer 12

D - Drugs (Maternal drug use)
E - Endocrine disorders (Hypothyroidism)
L - Lung conditions (Meconium Aspiration Syndrome)
A - Anatomical abnormalities (Meconium Retention)
Y - Cystic Fibrosis (Thickened meconium)
E - Enteric nervous system disorders (Hirschsprung Disease)
D - Delayed passage due to other factors (e.g., transient immaturity)

Visualization: Picture yourself in a delayed airport, waiting for your flight (delayed passage). As you look around, you see people engaged in various activities:

A person nearby is taking drugs (representing maternal drug use).
An airport staff member is holding a sign for an endocrine conference (representing endocrine disorders).
A group of pilots is discussing the risks of meconium aspiration during flight (representing lung conditions).
You notice a large map showing different anatomical abnormalities.
An advertisement appears, showcasing a thickened meconium drink for a fictional CF brand (representing Cystic Fibrosis).
An information booth displays brochures about the enteric nervous system (representing Hirschsprung Disease).
Finally, an announcement is made about the delay being caused by various factors, including transient immaturity.
maternal drugs: Opioids, sedatives, antidepressants, Cocaine

Question 13

Describe Symptoms, dx, tx of Appendicitis

Answer 13

-Epigastric pain progressing to localized pain in the right lower quadrant
-McBurney’s point
-Symptoms: loss of appetite, vomiting, and fever
-Dx: confirmed by ultrasound (USG), if necessary: computed tomography (CT)
-Tx: surgery, hospitalization, IV fluid support, and broad-spectrum antibiotics

Question 14

When to think of Mesenteric Lymphadenitis instead of appendicitis?

Answer 14

Symptoms: abdominal pain, especially if history of upper respiratory tract infection
-consider if symptoms suggestive of urinary tract infection (UTI)

Question 15

Differential Diagnoses of Appendicitis

Answer 15

intussusception (invagination), Meckel’s diverticulitis, peritonitis, and urinary tract infection (UTI), Mesenteric Lymphadenitis, Pancreatitis, Cholecystitis, FMF, over torsiyonu, kabızlık demek gerekiyor

Question 16

How to differentiate btw ddx of appendicitis?

Answer 16

differentiate via: Symptoms, medical history, laboratory tests (complete blood count), and imaging (X-ray, USG, CT) are used to differentiate these conditions

Question 17

Shaken Baby Syndrome typical presentation

Answer 17

• Syndrome resulting from violent shaking of an infant or young child
• a single mother is living with a partner
• A 2-3-year-old child presents with a seizure lasting less than 20 minutes
  -Physical examination shows no apparent findings

Question 18

What are risk factors for Shaken baby syndrome?

Answer 18

• Prolonged crying episodes in the child
• being the first child
• young parents, step-parents, and other factors
• inconsistencies in child’s history may be present, indicating possible neglect or abuse

Question 19

36 saattir mekonyum çıkışı olmayan bebek. Semptomlar ne olabilir, bulgular ne olabilir, neden kaynaklanır, ayırıcı tanılar, hangi testleri isterim?

Answer 19

Symptoms and Signs:

Abdominal distention or bloating
Abdominal pain or discomfort
Diarrhea or constipation
Vomiting
Poor appetite
Restlessness or excessive sleepiness
Irritability or fussiness
Poor weight gain

Possible Causes:

Meconium ileus: Obstruction of the small intestine preventing meconium from passing
Meconium aspiration syndrome: Inhalation of meconium during or before birth

Differential Diagnoses:

Hirschsprung’s disease: Congenital absence of nerve cells in the rectum and colon, causing a blockage
Intestinal atresia: Abnormal development of the intestine, leading to a blockage
Other gastrointestinal disorders causing obstruction or motility issues

Recommended Tests:

Abdominal X-ray or ultrasound to assess for signs of bowel obstruction
Rectal exam to check for the presence of meconium or any abnormalities in the anus or rectum
Additional tests may be required based on clinical findings and suspected underlying conditions

Question 20

Cerrahi iç içe geçmiş halka ultrason görüntüsü ınvajinasyon belirti safralı kusma vardı ek belirtiler neler; Tedavi gecikirse ne olur; Tedavi nasıl olur;

Answer 20

İNVAJİNASYON: rektal kanama görülebilir. Karında ele gelen sosis benzri kitle en çok ileoçekal bileşkede görülür.
Tedavi gecikirse ne olur: iskemi perforasyon peritonit
Tedavi nasil olur: hidrostatik basınçla, yetmezse cerrahi olarak, iskemi nekroz varsa kolostomi

Question 21

1 yaş süt çocuğunda intestinal obstrüksiyonları say mesela atreziler yenidoğanda olur onu ayırmamız isteniyor

Answer 21

Yenidoğanda atrezileri düşünmek lazım!!!!… YABANCI cisim, Lenfoma, Poliposis, Adhezyon ameliyata bağlı, volvulus. İnvajinasyon?,

Question 22

Name when to operate the following: inmemis testis, hydrocele, inguinal herni, umbilical hernia

Answer 22

inmemis (undescended) testis: latest till 1 year
Hyrdrocele: can go back at its own till 2 years, if not surgery
inguinal hernia: as quick as possible but if incarceration or strangulation is present do sx immediately
umbilical hernia: if it does not go away till 3-4 y.o. do sx

Question 23

What are examination findings in Appendicitis?

Answer 23

Findings (Examination):

McBurney’s point tenderness: Tenderness and pain in the lower right side of the abdomen, between the belly button and the hip bone
Rebound tenderness: Increased pain when pressure is released suddenly from the lower right abdomen
Guarding or rigidity: Involuntary tensing of the abdominal muscles to protect the inflamed appendix
Rovsing’s sign: Pain in the lower right abdomen when pressure is applied to the left side of the abdomen
Psoas sign: Increased abdominal pain when the right hip is extended

Question 24

Name examples of Congenital Urogenital Anomalies

Answer 24

Renal Agenesis: Absence of one or both kidneys at birth.
Renal Malposition: Abnormal placement or rotation of the kidneys within the abdomen.
Renal Ectopia: Abnormal location of one or both kidneys outside their normal position.
Horse-Shoe Kidney: Fusion of the lower poles of the kidneys, forming a horseshoe-shaped structure.
Polycystic Kidney: Development of multiple cysts in the kidneys, affecting their function.
Ureteropelvic Junction (UPJ) Obstruction: Narrowing or blockage at the junction between the renal pelvis and the ureter, causing urine flow obstruction.
Hydronephrosis: Accumulation of urine within the kidneys due to obstruction or reflux.
Vesicoureteral Reflux (VUR): Backflow of urine from the bladder into the ureters, which can reach the kidneys

Question 25

What is VUR (vesicoureteral reflux)?

Answer 25

In Vesicoureteral Reflux, urine flows backward from the bladder into the ureters, and sometimes reaches the kidneys. This condition increases the risk of urinary tract infections and can lead to kidney damage

Question 26

What is UPJ (uteropelvic junction)?

Answer 26

Ureteropelvic Junction (UPJ) Obstruction occurs when there is a narrowing or blockage at the connection between the renal pelvis and the ureter. This obstruction can cause urine to back up into the kidney, leading to kidney swelling (hydronephrosis) and impaired kidney function. Surgical intervention may be required to correct the obstruction

Question 27

What is hypospadias?

Answer 27

a birth defect in boys where the opening of the urethra (the tube that carries urine from the bladder to the outside of the body) is not located at the tip of the penis

Question 28

Differentiate indirect, direct, and femoral hernia

Answer 28

Indirect inguinal hernias develop at the internal inguinal ring and are lateral to the inferior epigastric artery
Direct inguinal hernias occur through Hesselbach’s triangle formed by the inguinal ligament inferiorly, the inferior epigastric vessels laterally, and the rectus muscle medially
Femoral hernias develop in the empty space at the medial aspect of the femoral canal, inferior to the inguinal ligament

Question 29

What are factors contributing to the develop. of indirect inguinal hernia?

Answer 29

Urogenital (undescended testis, exstrophy of bladder)
Connective tissue disorders
Increased peritoneal fluid
increased intra-abdominal pressure
cystic fibrosis
Ehlers-Dahnlos Syndrome (connective tissue disorder)
Hunter-Hurler Syndrome (mucopolysaccaridosis)

Question 30

Are the following statement right:
1) Inguinal hernia most commonly presents during the first month of life
2) direct inguinal hernias are the result of failure of closure of the processus vaginalis

Answer 30

1) NO, the answer is: Inguinal hernia most commonly presents during the first year of life with a peak during the first few months
2) NO, the answer is: Indirect inguinal hernias are the result of failure of closure of the processus vaginalis

Question 31

What is ddx to incarceration of hernia? Tx?

Answer 31

testis torsiyonu, hidrosel, kordon kisti, inguinal lenfadenopati veya inmemiş testis
-> en kısa sürede ama inkarsere hernide ya da strangüle herni varlığında acil inguinal girişim zorunludur
laparoscopic sx bir üstünlüğü yok -> cogu cerrah açık tekniği tercih ediyor

Question 32

What is hydrocele?

Answer 32

fluid accumulation btw parietal & visceral layers of tunica vaginalis

Question 33

What is the tx of hydrocele?

Answer 33

tx: prosseus vaginalis 2 yasa kadar spontan kapanabilir
eger gerileme olmazsa sx’de yüksek bağlama uygulanır

Question 34

What is Beckwith-Wiedemann Syndrome?

Answer 34

omfalosel + makroglossi + hipoglisemi-hiperinsülinizm bir komponentini de meydana getirebilir

Question 35

Is it true that omphalocele pts are at high risk for hypothermia?

Answer 35

yes

Question 36

With what may gastrozisis be associated?

Answer 36

less associations, but may with jejunoileal atresia

Question 37

Gastroşisiz görseli. Omphaleceleden farkını da konuştuk. Bu hastalık hangi anomilelerle beraber görülür? Ve böyle bir çocuk geldiğinde ne yapmalıyız?

Answer 37

Bir aile sağlığı merkezinde gelirse mutlaka hipotermiden korumak için sargı bezleri ile sarmalayıp en yakın merkeze sevki olmalı. İv yol açmakla vakit kaybedilmemeli

Question 38

Projectile vomiting and thickness in the pylorus? DDX? Tx? Symptoms?

Answer 38

Hypertrophic pyloric stenosis -
differential diagnosis: Gastroesophageal reflux, intestinal atresia, malrotation, and Hirschsprung’s disease (intestinal obstructions), urea cycle disorders or organic acidemias (metabolic disorders), UTI
other symptoms: olive mass is important, classic projectile vomiting in 21 days; an olive-like mass, US muscle thickness (>4mm), and pylorus length are significant in diagnosis or can be seen on a barium study
Tx: pyloromyotomy.
Symptoms: may include dehydration, failure to thrive, and weight loss. Hypochloremia and hypokalemic alkalosis!!!
The pH should be corrected, and surgical treatment should be performed

Question 39

What does torticollis result from? Tx?

Answer 39

-results from fibrosis and shortening in the SCM; fibrosis presented by olive shaped mass
-Physical therapy (head and neck exercises)
-If persists beyond 12-15 months, SCM is surgically transected. If left untreated, fascial and cranial asymmetry develops

Question 40

DDx of torticollis

Answer 40

non ocular causes: cong. disorders (hearing defects, muscular postural), acquired disorders (trauma, non-traumatic)
ocular causes: Nystagmus, strabismus, visual field defects

Question 41

tx of Strangule inguinal herni, duodenal, jejunal , kolon atrezileri, İnvajinasyon, Rektal atrezi, enterit?, Hirsprung, volvulus, bağırsak malrotasyonları.mekonyum ileus

Answer 41

Strangulated inguinal hernia: Immediate surgical intervention is necessary to relieve the strangulation and repair the hernia.

Duodenal, jejunal, and colon atresia: Surgical repair is typically required to remove the obstructed segment of the intestine and reestablish continuity of the gastrointestinal tract.

Intussusception (invagination): In many cases, nonsurgical treatment can be attempted initially using an air or contrast enema to guide the intussusception back into its normal position. However, if nonsurgical reduction is unsuccessful or if there are signs of bowel compromise, surgical intervention may be necessary.

Rectal atresia: Surgical repair is necessary to create an opening in the rectum and establish proper bowel continuity.

Enteritis: Treatment for enteritis involves supportive care, including fluid and electrolyte replacement, management of symptoms such as diarrhea and vomiting, and addressing the underlying cause, such as bacterial or viral infection.

Hirschsprung’s disease: Surgery is the main treatment for Hirschsprung’s disease. The procedure involves removing the affected portion of the bowel and reconnecting the healthy segments.

Volvulus: Emergency surgical intervention is typically required to untwist the twisted segment of the intestine and restore blood flow.

Intestinal malrotation: Surgical correction is necessary to correct the abnormal positioning of the intestines and prevent complications such as volvulus.

Meconium ileus: Treatment for meconium ileus often involves a combination of medical and surgical interventions. Nonoperative measures may include the use of medications and enemas to help soften and dislodge the meconium. If conservative measures are unsuccessful, surgical intervention may be necessary to remove the impacted meconium.

Question 42

What are criteria which require immediate surgery in case of trauma?

Answer 42

If transfusion of half the blood volume is needed, perforation of hollow organs (stomach, intestines, gallbladder, bladder, and rectum), inability to control bleeding, SHOCK, presence of retroperitoneal air, bladder rupture

Question 43

Case:
1) What should be checked in a patient who had a bicycle accident and was hit by the handlebar?
2) What tests and procedures should be done based on the patient’s condition?
3) What are the commonly injured organs in blunt abdominal traumas?
4) What are the indications for laparotomy?
5) When is splenectomy performed?
6) What is the recommended treatment after splenectomy?
7) What organs does the pancreas usually accompany?
8) How is the pancreas monitored?
9) What interventions are used in treatment?

Answer 43

1) A B C D E (Airway, Breathing, Circulation, Disability, Exposure)
2) Complete blood count, urinary catheterization for monitoring, N/G tube for air decompression, systemic examinations
3) Spleen and liver, and possibly the pancreas
4) Shock, hollow organ injury, need for transfusion up to half of the total blood volume, presence of air in the X-rays, bladder rupture
5) If bleeding cannot be controlled or if the hilum is detached
6) Post-splenectomy antibiotics
7) The duodenum
8) Serum amylase and lipase levels
9) Total parenteral nutrition, intravenous fluids, and antibiotics

Question 44

DDx of Hirschsprung disease

Answer 44

1) Functional constipation
2) Intestinal obstruction: intestinal atresia, meconium ileus, or intestinal malrotation
3) Hypothyroidism
4) Anorectal malformations: anal atresia

Question 45

Symptoms of an inguinal hernia

Answer 45

1) Bulge or swelling in the groin area or scrotum: This bulge may be more noticeable when standing, coughing, or straining.
2) Pain or discomfort: The bulge can be associated with pain or aching sensation, especially during physical activity or when lifting heavy objects.
3) Heaviness or pressure in the groin.

Question 46

Differential diagnosis for groin swelling

Answer 46

1) Inguinal hernia: This occurs when a part of the intestine or other abdominal tissue protrudes through a weak spot in the abdominal wall.
2) Femoral hernia: Similar to inguinal hernia but occurs lower down in the groin, through the femoral canal.
3) Hydrocele: Fluid accumulation around the testicle, resulting in scrotal swelling.
4) Inguinal lymphadenopathy: Enlarged lymph nodes in the groin area due to an infection or other causes.
5) Lipoma: A noncancerous growth of fatty tissue that can occur in the groin or other areas of the body.

Question 47

Case: Gastroşizisi anlatan bir vakaydı. Bununla ilgili ameliyat ne zaman yapılır, hangi bulgular gözlenir Nasıl oluşur?

Answer 47

Gastroschisis is a condition where a baby is born with a defect in the abdominal wall, typically to the right of the umbilical cord. Here are the answers to your questions regarding the timing of surgery, observed symptoms, and how it occurs:

Timing of surgery for gastroschisis:
typically shortly after birth, ideally within the first few hours or days of life
timing depends: overall stability & any associated complications
-> Early surgical intervention is important to protect the exposed abdominal organs & facilitate their proper development and function.

Observed symptoms in gastroschisis:

1) Visible abdominal organs: One of the primary symptoms is the presence of abdominal organs, such as the intestines, liver, and sometimes stomach, outside the baby’s body. These organs are not covered by a protective membrane.
2) Redness and swelling: The exposed organs may appear red and swollen due to direct contact with the amniotic fluid and exposure to the external environment.
3) Difficulty feeding: Gastroschisis can lead to difficulty with feeding due to the exposed and compromised nature of the abdominal organs.

How gastroschisis occurs:
Gastroschisis is believed to occur during fetal development. The exact cause is not fully understood, but it is thought to result from a failure of the abdominal wall to form correctly during early embryonic development. This defect allows the abdominal organs to protrude outside the body, usually to the right of the umbilical cord. Unlike other abdominal wall defects, such as omphalocele, which is covered by a sac, gastroschisis has a direct exposure of the organs to the amniotic fluid.

Question 48

solunum sikintisi yapacak cerrahi problemler

Answer 48

Choana atrezi
diafram hernisi
diyafram evantrasyonu
TEF, Özefageal Atrezi
Pierre Robin Sendromu ile Mikrognati, Congenital Lobar amfizem, Hemanjiom,Trakeo ve Laringomalazi…

Question 49

akut karın ne demektir, ayırıcı tanılar nelerdir, 9 yaşında çocukta neler olabilir, semptom bulgu farkı

Answer 49

Appendicitis: Inflammation of the appendix, which typically presents with localized pain in the lower right abdomen, nausea, vomiting, and fever.
Gastroenteritis: Infection or inflammation of the gastrointestinal tract, causing symptoms like abdominal pain, diarrhea, vomiting, and sometimes fever.
Intestinal obstruction: Blockage of the intestine, which can result from various causes, leading to abdominal distension, crampy pain, vomiting, and constipation.
Urinary tract infection (UTI): Infections in the urinary tract, which can cause lower abdominal pain, frequent urination, pain during urination, and sometimes fever.
Pancreatitis: Inflammation of the pancreas, causing severe abdominal pain that may radiate to the back, nausea, vomiting, and fever.
Gastrointestinal perforation: A hole or tear in the gastrointestinal tract, which can cause sudden and severe abdominal pain, tenderness, rigidity, and signs of peritonitis.
Symptom and sign differences:
Symptoms refer to what the patient experiences and reports, while signs are objective findings observed during physical examination. In a child with an acute abdomen, symptoms may include abdominal pain, tenderness, cramping, vomiting, fever, and changes in bowel movements. Signs that a healthcare provider may observe during examination can include abdominal distension, guarding (protective tensing of the abdominal muscles), rebound tenderness, absent bowel sounds, and signs of dehydration.

Question 50

Yenidogan obstruksuyon bulgularini say, Obstruksiyon sebepleri say, Duodenal atrezi

Answer 50

Abdominal distension: The abdomen appears swollen or bloated.
Vomiting: Frequent and forceful vomiting, often with a bile-stained appearance.
Failure to pass meconium: Delayed or absent passage of the first stool.
Poor feeding or feeding intolerance: Difficulty or inability to feed properly, leading to inadequate weight gain.
Abdominal pain: The infant may display signs of discomfort or colicky abdominal pain.
Causes of neonatal obstruction can be attributed to various factors, including:

Duodenal atresia: A congenital condition where there is a complete blockage or narrowing of the duodenum (the first part of the small intestine). It is caused by abnormal development during fetal development.
Intestinal malrotation: An abnormality in the rotation and fixation of the intestines during fetal development, which can lead to twisting and obstruction.
Meconium ileus: A condition primarily seen in infants with cystic fibrosis, where meconium (the first stool) becomes thick and sticky, causing an intestinal blockage.
Hirschsprung’s disease: A condition characterized by the absence of nerve cells in parts of the intestine, leading to functional obstruction.
Intestinal atresia: Blockage or absence of a portion of the intestines due to improper development.

Question 51

gastroşizde yönetim nasıl olur (ısı ve sıvı kaybını önlemek için üzerini örterim gibi)

Answer 51

As for the management of gastroschisis, the primary goal is to prevent heat and fluid loss and protect the exposed organs. This is typically done by:

Placing the baby in a temperature-controlled environment to prevent heat loss.
Covering the exposed abdominal organs with a sterile, saline-soaked dressing or plastic wrap to reduce evaporative fluid loss.
Administering intravenous fluids to maintain hydration and electrolyte balance.
Initiating early enteral feeding through a nasogastric tube or other feeding methods under medical supervision.
Monitoring the baby closely for any signs of infection, bowel function, and overall well-being.

Question 52

Differentiate omphalocele from gastroschisis

Answer 52

Omphalocele:

In omphalocele, abdominal organs such as the intestines, liver, and sometimes the stomach, are covered by a sac-like membrane that protrudes through the abdominal wall near the umbilical cord.
The sac provides some protection to the exposed organs and helps prevent direct contact with the external environment.
Omphalocele is often associated with other congenital anomalies or genetic conditions.
Surgical intervention is typically required to place the organs back into the abdominal cavity and close the defect. The timing of surgery depends on the size of the omphalocele and associated factors.
Gastroschisis:

In gastroschisis, there is a hole or defect in the abdominal wall, usually to the right of the umbilical cord, through which abdominal organs, primarily the intestines, protrude.
Unlike omphalocele, there is no protective sac covering the exposed organs in gastroschisis. The organs are directly exposed to the amniotic fluid and external environment.
Gastroschisis is not typically associated with other congenital anomalies or genetic conditions.
Immediate surgical intervention is required after birth to return the organs to the abdominal cavity and close the abdominal wall defect.

Question 53

Cerrahi özafagus atrezisi izole fistülsüz, Tipleri neler en sık görülen tipi, Görüntü de hangi tip olduğunu düşünürsün — mide de hava olmadığı ve çocukta aspirasyon vb olmadığı için; ne dusunursun?

Answer 53

fistülsüz EA düşünürüm
Long gap, izole(A) distal proximal izole fistüllü çift fistüllü
mide de hava?= type c
aspiration= type b
none symptom= type a

Question 54

When is the operative repair of Hypospadias?

Answer 54

Operative repair at 12-18 months of age

NO CIRCUMCISION BEFORE SURGERY

Question 55

Name different head and neck pathologies

Answer 55

cervical lymphadenopathies - lymphadenitis
dermoid and epidermoid cysts
thyroglossal duct cysts
branchial cleft cysts
torticollis
cystic hygromas

Question 56

What is the difference btw cervical lymphadenopathy and cervical lymphadenitis?

Answer 56

1) Cervical lymphadenopathy – Enlarged lymph node(s) of the neck,lymphadenopathy encompasses (both inflamed & noninflamed lymph nodes)
2) Cervical lymphadenitis – Enlarged, inflamed, and tender lymph node(s) of the neck; although strictly speaking, “lymphadenitis” refers to inflamed lymph nodes, the terms “lymphadenitis” and usually caused by an infectious process.

Question 57

What to do in cervical lymphadenitis?

Answer 57

Antibiotics and drainage if needed

Question 58

What is the main difference btw dermoid and epidermoid cyst?

Answer 58

dermoids have accessory glandular contents

Question 59

Where are dermoid cysts located?

Answer 59

most common: supraorbital & corner of the eyebrow
-> can occur anywhere on scalp, face, spinal axis, or other body sites

Question 60

Describe a dermoid cyst

Answer 60

non-pulsatile, non- compressible, non- tender masses that appear skin colored or bluish

Question 61

How to manage dermoid cyst?

Answer 61

d/t risk of associated complications surgical excision should be done: Rupture and spillage, Risk of infection, Potential for growth and enlargement, Potential for malignancy

Question 62

Describe Thyroglossal duct cyst

Answer 62

smooth, soft and nontender mass in the midline of the neck

Question 63

Describe management of Thyroglossal duct cyst

Answer 63

Frequent infections with oral flora & malignancy risk -> surgical excision

Question 64

Describe the pain type of appendicitis

Answer 64

Acute appendicitis typically causes a combination of visceral and somatic pain. The initial stages of pain in acute appendicitis are generally visceral in nature, originating from the inflamed appendix itself. Visceral pain is often described as dull, poorly localized, and difficult to pinpoint. It is caused by the stimulation of pain receptors in the internal organs and is often perceived as a vague discomfort or pressure.

As acute appendicitis progresses and the inflammation worsens, somatic pain can develop. Somatic pain arises from the irritation or inflammation of the parietal peritoneum, the lining of the abdominal cavity. This type of pain is usually more localized and well-defined compared to visceral pain. It can be sharp, intense, and easier to pinpoint to a specific area, typically in the lower right quadrant of the abdomen

Question 65

Describe the pain of meckel diverticulum

Answer 65

mostly asymptomatic
cramp-like, intermittent, or colicky in nature

Question 66

Sut cocugunda intestinal obstruksuyon 5 tane say

Answer 66

-invajinasyon
-herni
-volvulus
-fekalit
-mezenter lenfadenit
-hipotiroid ve sepsis

Question 67

Symptoms of Intussusception

Answer 67

Abdominal pain
Abdominal swelling
“Currant jelly” stools
Vomiting
Lethargy or irritability
Sausage-shaped mass
draw their knees to their chest

Question 68

DDx of acute abdomen

Answer 68

TRAUMATIC
Duodenal hematoma
Ruptured spleen
Perforated viscus
Traumatic pancreatitis

FUNCTIONAL
Constipation*
Irritable bowel syndrome*
Dysmenorrhea*
Mittelschmerz (ovulation)*
Infantile colic*
Abdominal migraine

INFECTIOUS
Appendicitis*
Viral or bacterial gastroenteritis/adenitis*
Abscess
Spontaneous bacterial peritonitis
Pelvic inflammatory disease
Cholecystitis
Urinary tract infection*
Pneumonia
Bacterial typhlitis
Hepatitis

GENITAL
Testicular torsion
Ovarian torsion
Ruptured ovarian cyst
Ectopic pregnancy

GENETIC
Sickle cell crisis*
Familial Mediterranean fever
Porphyria
Hereditary angioedema

METABOLIC
Diabetic ketoacidosis
Fabry disease

INFLAMMATORY
Inflammatory bowel disease
Vasculitis
Henoch-Schönlein purpura*
Pancreatitis

OBSTRUCTIVE
Intussusception*
Malrotation with volvulus
Ileus*
Incarcerated hernia

Question 69

Cerrahi de bana da kabak gibi bariz bağırsaklar thorax da görüyosun o zaman ne ?

Answer 69

bochdalek hernie

Question 70

What does bochdalek hernie do?

Answer 70

kalp sesi akc sesi azalmış, ScaphoidKaşık abdomen
Pulm hipoplazi pulmHT persistan fetal dolaşım (PDA)

Question 71

When to do surgery in morgagni hernia?

Answer 71

also known as: retrosternal/ anterior diaphragmatic hernia
ACİL değilmiş - önce stabilize et sonra al 2-3 gün sonra alabilirsin

Question 72

nefes darlığı yapan surgical situation in children

Answer 72

EA: Esophageal atresia is a congenital condition where the esophagus ends in a blind pouch, preventing the passage of food and fluids from the mouth to the stomach.

DH: Diaphragmatic hernia is a defect in the diaphragm, allowing abdominal organs to protrude into the chest cavity, potentially compressing the lungs and causing respiratory difficulties.

Vascular ring: Vascular rings are congenital anomalies where the blood vessels surrounding the trachea and esophagus form abnormal configurations, leading to compression of these structures and respiratory symptoms.

Pierre Robin with retrognathia: Pierre Robin sequence is a condition characterized by a small lower jaw (micrognathia), a tongue that falls back into the throat (glossoptosis), and difficulty breathing. Retrognathia refers to a jaw that is set back or receded.

Question 73

tx of intussusception

Answer 73

önce hidrostatik redüksiyon,olmazsa cerrahi

Question 74

Where is intussusception most commonly located?

Answer 74

ileocecal

Question 75

When does umbilical hernia become visible?

Answer 75

after 15 days, when the umbilical cord stump falls off

Question 76

What happens with children who are vomiting alot e.g. in case of pyloric stenosis?

Answer 76

vomiting causes:
1) hypochloremia (low chloride levels)
2) hypokalemia (low potassium levels)
3) excess of bicarbonate
->hypochloremic hypokalemic alkalosis

Question 77

ddx of hydrocele

Answer 77

Inguinal hernia: Inguinal hernia is a condition where there is a protrusion of abdominal contents (such as intestines) through a weakened area or defect in the inguinal canal. Inguinal hernia may present with a similar swelling in the groin or scrotum, which can sometimes be mistaken for a hydrocele.

Epididymitis: Epididymitis refers to inflammation of the epididymis, which is a structure located at the back of the testicle. It can cause pain, swelling, and discomfort in the scrotum, which may mimic the presentation of a hydrocele.

Testicular torsion: Testicular torsion occurs when the testicle rotates, causing twisting of the spermatic cord that supplies blood to the testicle. This condition typically presents with sudden and severe testicular pain, swelling, and possible scrotal discoloration. Although less common, testicular torsion can sometimes be mistaken for a hydrocele.

Varicocele: A varicocele is an abnormal enlargement of the veins within the scrotum, similar to varicose veins. It can cause swelling and discomfort in the scrotum, which may be mistaken for a hydrocele.

Spermatocele: A spermatocele is a cyst-like mass that forms within the epididymis and contains fluid and sperm. It can present as a painless swelling in the scrotum, similar to a hydrocele.

Hematocele: Hematocele refers to the accumulation of blood within the scrotum, typically due to trauma or injury. It can cause swelling and discoloration, resembling a hydrocele.

Question 78

Scrotumu şiş ve kızarık çocuk geldi, ağrısı var, ayırıcı tanıda neler düşünürsün, görüntülemede ne kullanırsın?

Answer 78

Epididymitis: Inflammation of the epididymis, often caused by a bacterial infection. It can cause swelling, redness, and pain in the scrotum.

Orchitis: Inflammation of the testicle, usually resulting from a viral or bacterial infection. It can cause scrotal swelling, redness, and discomfort.

Testicular torsion: Twisting of the spermatic cord that supplies blood to the testicle. It is a medical emergency and can cause severe pain, swelling, and redness of the scrotum.

Fournier’s gangrene: A severe infection of the scrotum and surrounding tissues, typically caused by bacteria. It leads to rapid onset of swelling, redness, severe pain, and tissue necrosis.

Trauma or injury: Trauma to the scrotum, such as a direct blow or injury, can cause swelling, bruising, and redness.

Question 79

yenidoğan çocuk beslenemiyor ağzından sürekli salya akıyor ne düşünürsün

Answer 79

Tracheoesophageal Fistula (TEF) with Esophageal Atresia (EA)