abdomen

Question 1

correct placement of UAC

Answer 1

low or high

ow - L3-L5 or

high - T8-T10

“8 is great, 9 is fine”

Question 2

what time frame do you see hypertrophic pyloric stenosis?

Answer 2

3 wk to 3 months

Question 3

2 month old

Answer 3

Question 4

criteria for HPS

Answer 4

4 mm thickness and 14 mm long

Question 5

2 year old

Answer 5

Question 6

intussuception < 2.5 cm

Answer 6

small bowel - small bowel intussusception

does NOT get an air enema

Question 7

intussuception > 2.5 cm

Answer 7

illeocolic intussuception

DOES get an air enema

(pressure cannot exceed 120 mmHg)

Question 8

contraindications to an air enema

Answer 8

free air (check the plain film)

peritonitis (based on physical exam)

Question 9

air enema pressure should not exceed:

Answer 9

120 mmHg

Question 10

Answer 10

Question 11

mechanism of duodenal atresia

Answer 11

failure to cannulate

Question 12

mechanism of jejunal atresia

Answer 12

vascular insult (clots)

associated with multiple atresias

Question 13

double bubble is associated with

Answer 13

T21, duodenal atresia

Question 14

Answer 14

malrotation

fatty wall = artery and should be on the same side of the aorta

SMV should be on the same side as the aorta

Question 15

bilious vomiting, next step?

Answer 15

midgut volvulus –> UGI

SURGICAL EMERGENCY!

Question 16

non bilious vomiting, next step?

Answer 16

Hypertrophic pyloric stenosis –> US

Question 17

difference between meconium plug syndrome and meconium ileus?

Answer 17

meconium plug syndrome = Diabetic mom or mom who got mag sulfate (eclampsia)

Meconium ileus = CF

Question 18

Answer 18

sawtooth = mucosal spasm

Question 19

babies with no asshole (imperforate anus), next step?

Answer 19

screening US for tethered cord

Question 20

Answer 20

Question 21

when do you do a meckel scan?

Answer 21

when the patient is not bleeding

Question 22

if a meckel diverticulum patient is bleeding, what scan do you do?

Answer 22

tagged RBC scan

Question 23

Who gets necrotising enterocolitis?

Answer 23

Question 24

bowel most commonly affected by NEC?

Answer 24

right lower quadrant - terminal ileum and right colon

Question 25

How can NEC present on abdominal radiograph?

Answer 25

• pneumatosis
• FOCAL DILATED BOWEL in the RLQ
• featureless small bowel
• unchanging bowel gas pattern (poop will move, pneumatosis will stay still)

(TI and right colon are most commonly affected by NEC)

Question 26

first question to ask if you are suspecting NEC, but can’t tell if it is food or poop?

Answer 26

Ask has the kid eaten

no food = no poop = NEC