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3rd Year - Paediatrics > 9. Paediatric Surgery > Flashcards

9. Paediatric Surgery Flashcards

1
Q

What is the Formula for Calculating the Ideal Weight of Children?

A

Weight (Kg) = 2 x (Age (Years) + 4)

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2
Q

What is the Formula for Calculating the Ideal Blood Volume (mLs) of Children?

A

Blood Volume (mLs) = 80mg / Kg

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3
Q

What should the Urine Output for a Child be?

A

1mg / Kg / Hour

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4
Q

What is the Insensible Fluid Loss of a Child?

A

20mg / Kg / Day

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5
Q

What is the Formula for Calculating the Ideal Systolic Blood Pressure?

A

Systolic Blood Pressure (mmHg) = 80 + (2 x Age (Years))

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6
Q

What should the Vital Signs be for a Child:

  1. < 1 Year Old?
  2. 2-5 Years Old?
  3. 5-10 Years Old?
  4. > 10 Years Old?
A

Age: / Respiratory Rate: / Heart Rate: / Blood Pressure:

  1. <1 / 30-40 / 110-160 / 70-90
  2. 2-5 / 25-30 / 95-140 / 80-100
  3. 5-10 / 20-25 / 80-120 / 90-110
  4. > 10 / 15-20 / 60-100 / 100-120
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7
Q

What Pain Management is included in the WHO Pain Ladder?

A
  1. Mild Pain - Paracetamol / Ibuprofen
  2. Moderate Pain - (1.) + Diclofenac +/- Codeine Phosphate / Morphine
  3. Severe Pain - Entonox + Diamorphine (then/or) I.V. Morphine + Oral Analgesia Supplement
    Note - Codeine is not recommended < 12 Years Old
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8
Q

What Fluid Management is used in:

  1. Resuscitation?
  2. Maintenance?
A
  1. 20mg/Kg Bolus 0.9% Saline
  2. 0.9% Saline / 5% Dextrose +/- KCl:
  3. a) 4mg / Kg for the First 10 Kg
  4. b) 2mg / Kg for the Second 10Kg
  5. c) 1ml/Kg Every Kg Thereafter
    10 Year = (2 x (10+4))Kg = 28Kg = 40+20+8 = 68mL/Hour
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9
Q

What are the Sentinel Signs?

A
  1. Feed Refusal
  2. Bile Vomits
  3. Colour
  4. Tone
  5. Temperature
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10
Q

What Features of the History are Paediatric Surgeons interested in?

A
  1. Pain - Colic vs Constant / Movement
  2. Vomiting - Increases Significance / Bile?
  3. Diarrhoea - Retro-Ileal / Retro-Colic / Tenesmus in Pelvic Appendix
  4. Anorexia
  5. Previous Episodes - Lessens Chances of Surgery
  6. Menstrual History
    Note - “If it’s not Simple, It’s not Surgical”
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11
Q

What Features of the Examination are Paediatric Surgeons interested in?

A
  1. Distraction Techniques Essential
  2. General Appearance Important
  3. Temperature
  4. “Guarding and Rebound”
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12
Q

What Investigations will be done, Prior to Surgery?

A
  1. Urine
  2. Full Blood Count
  3. Electrolytes - only if Sick / Very Dry
  4. X-Rays - Rarely
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13
Q

What are the Clinical Features of Appendicitis?

A 
Murphy's Triad
1. Pain - Tenderness over McBurney's Point
2. Fever - Moderate Temperature
3. Vomiting - Looks Unwell
Note - Unusual < 4 Years old
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14
Q

What are the Complications of Appendicitis?

A
  1. Abscess
  2. Mass
  3. Peritonitis
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15
Q

What is the Management of Appendicitis?

A
  1. Analgesia - Oral Paracetamol

2. Surgery - Laparoscopic Appendectomy

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16
Q

What are the Features of Non-Specific Abdominal Pain?

A
  1. Short-Duration
  2. Central
  3. Constant
  4. Not made Worse by Movement
  5. No GI Tract Disturbance
  6. No Temperature
  7. Site / Severity of Tenderness Vary
17
Q

What are common Causes of Non-Specific Abdominal Pain?

A
  1. Mesenteric Adenitis

2. Pneumonia

18
Q

What is the Presentation of a Child with Malrotation?

A
  1. Very Young (Days)
  2. Presenting with Bile Vomiting - Fairy Liquid Green
    Note = Malrotation and Volvulus
19
Q

What Investigation follows a Suspected Diagnosis of Malrotation?

A

Urgent Upper G.I. Contrast Study

20
Q

What is the Treatment of Malrotation?

A

Laparotomy - ASAP

21
Q

What is the Presentation of Intussusception?

A
  1. Older than Malrotation - Months
  2. Bilious Vomiting
  3. Viral Illness followed by Colic and Dying Spells
  4. Slow Capillary Refill
  5. Bloody Mucus PR - Redcurrant Jelly Stool
22
Q

What is the Investigation for Intussusception?

A

Ultrasound Scan of the Abdomen - “Target Sign”

23
Q

What is the Management of Intussusception?

A
  1. Pneumostatic Reduction - Air Enema

2. Laparotomy

24
Q

What increases the Risk of an Umbilical Hernia?

A
  1. Low Birth Weight
  2. Trisomy 21
  3. Hypoparathyroidism
  4. Mucopolysaccharidosis
    Note - Common (1:6 Children)
25
Q

What is the Treatment of an Umbilical Hernia?

A
  1. Spontaneous Closure by 4 Years is Rule
  2. Complications are Rare
  3. Repair if there are Complications / Relative Persistence
    Note - Should be Distinguished from a Paraumbilical Hernia
26
Q

What is an Epigastric Hernia?

A

Defect in the Linea Alba, above the Umbilicus, causing a Protrusion of Preperitoneal Fat

27
Q

What is the Treatment of an Epigastric Hernia?

A

Operative - Cosmetc Reasons Only

3rd Year - Paediatrics (40 decks)

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