Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pediatrics > Common Pediatric Surgeries > Flashcards

Common Pediatric Surgeries Flashcards

1
Q

Defect of anterior abdominal wall to the right of the umbilical cord- Gastroschisis or Omphalocele?

A

Gastroschisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which is more common- gastroschisis or omphalocele?

A

Omphalocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which is associated with other anomalies-gastroschisis or omphalocele?

A

Omphalocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which one is the umbilical cord within the defect-gastroschisis or omphalocele?

A

Omphalocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which is considered a lateral defect (to the right)-gastroschisis or omphalocele?

A

Gastroschisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which is associated with Beckwith-Wiedemann Syndrome-gastroschisis or omphalocele??

A

Omphalocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which is associated with less damage to the abdominal contents- gastroschisis or omphalocele?

A

Omphalocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which is associated with only large and small intestine involvement- gastroschisis or omphalocele?

A

Gastroschisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which is associated with small fascial defect (2-5cm)- gastroschisis or omphalocele?

A

Gastroschisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What vascular event is associated with gastroschisis?

A

Abnormality of the right omphalomesenteric artery and/or right umbilical vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 5 abnormalities associated with Beckwith- Wiedemann Syndrome?

A
  1. Omphalocele
  2. Visceromegaly
  3. Macroglossia
  4. Microcephaly
  5. Hypoglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the preferred method of abdominal wall abnormalities- primary repair or staged?

A

Staged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Over how many days is the abdominal cavity repaired over in a staged repair approach?

A

3-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some negative effects of tight abdominal closure?

A
  1. Impairs diaphragmatic excursion (inadequate ventilation, increased airway pressure)
  2. Impedes venous return (profound hypotension)
  3. Aortocaval compression (bowel ischemia, decreased CO, renal and hepatic dysfunction).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are unsafe primary abdominal closure parameters?

A
  1. Intragastric pressure >20mmHg
  2. Change in CVP >4mmHg from baseline
  3. EtCO2 > 50mmHg
  4. Peak Inspiratory Pressure > 35 cm H2O
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How should massive fluid losses be mitigated for abdominal wall abnormalities?

A

MIVF 2-4 x maintenance rate
Urine output 1-2ml/kg/hr.
Normothermia with covered abd contents with warm saline soaked gauze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are post-operative management for abdominal wall abnormalities?

A
  1. Mech vent for 24-48hrs
  2. Fluid requirements watched closely
  3. Cynanotic lower limbs and bowel ischemia
  4. Prevent infection
  5. Prolonged post-operative ileus (TPN required for days).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Post-operative complications for abdominal wall repair?

A
  1. Pneumonia
  2. NEC
  3. Renal insufficiency
  4. Abdominal wall breakdown
  5. GERD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How frequent is CDH in live births?

A

1: 2,000-5,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the potential cause of CDH?

A

Prenatal history of Polyhydramnios

21
Q

What are the associated anomalies with CDH?

A

Malrotation of gut 40%.
Cardiovascular 20%.
CNS/GI/GU 15-30%

22
Q

CDH complications factors?

A
  1. Bilateral lung hypoplasia
  2. Pulmonary HTN and arteriolar reactivity
  3. Left ventricular dysfunction
23
Q

What is classic triad of clinical presentation with CDH?

A
  1. Dyspnea
  2. Cyanosis
  3. Apparent dextrocardia
24
Q

What are 5 things found on physical exam for CDH?

A
  1. Bulging chest
  2. Scaphoid abdomen
  3. Decreased breath sounds
  4. Distant or right displaced heart sounds
  5. Bowel sounds in the chest
25
What are current standards for medical management and preoperative treatment of CDH?
1. Maximize arterial oxygenation 2. Correct acidosis 3. Intubation with mindset to minimize barotrauma/volutrauma. 4. Hyperventilation 5. Nitric oxide- decrease PVR 6. ECMO
26
What are criteria for ECMO?
1. Weigh greater than 2.0 kg | 2. Gestation >35weeks
27
Anesthetic management for CDH?
1. Awake intubation or RSI (Avoid mask ventilation). 2. Avoid N2O 3. Avoid hypoxia/acidosis 4. Prevent hypothermia
28
CDH Postoperative management?
1. Vent support 2. Meticulous fluid/nutrition management 3. Hemodynamic monitoring 4. Often honeymoon period followed by deterioration
29
What typically occurs after the honeymoon period following CDH repair?
1. Increased intrabdominal pressure 2. Decreased perfusion of the viscera and the periphery 3. Decreased diaphragmatic excursion 4. Worsening pulmonary compliance./
30
How often does pyloric stenosis occur in live births?
1: 5,000
31
Are males or females more prone to pyloric stenosis?
Males 4:1
32
T/F: Pyloric stenosis causes forceful projectile bilious vomiting?
False; it is non-bilious
33
What can be done to verify pyloric stenosis diagnosis?
1. Upper GI series with barium 2. Xray 3. Abdominal US
34
What types of acid-base imbalance does pyloric stenosis cause?
Metabolic alkalosis d/t loss of acidic gastric juices rich in H+, Cl-, and Na+
35
What electrolyte abnormalities can result from pyloric stenosis?
1. Hyponatremia 2. Hypokalemia 3. Hypochloremia 4. Metabolic alkalosis
36
What could cause pyloric stenosis to change from a metabolic alkalosis to a metabolic acidosis?
Severe dehydration and hypoperfusion
37
Is pyloric stenosis a surgical emergency?
No; but it is a medical emergency (must correct fluid and electrolyte disturbances).
38
What is the primary anesthetic management concern for pyloric stenosis repair?
Aspiration of gastric fluid
39
Describe induction for pyloric stenosis?
1. IV in place 2. O2 by mask 3. Atropine 10-20mcg/kg 4. Suction stomach with large bore catheter 5. RSI with succ/tylenol/propofol (DO NOT VENTILATE)
40
Why should narcotics be avoided with pyloric stenosis repair?
Patients are prone to post-operative respiratory depression secondary to preexisting central alkalosis
41
What is clinical presentation of transesophageal fistula (TEF)?
1. Inability to manage oral secretions 2. Excessive salivation 3. Choking on first feed 4. Coughing 5. Cyanosis 6. Aspiration 7. Gastric distention 8. Pneumonia
42
How is TEF diagnosed?
Inability to pass suction catheter/orogastric tube into stomach with CXR confirmation of catheter position in esophageal pouch
43
Describe VACTERL:
``` Vertebral anomalies Anorectal anomalies Cardiac anomalies TEF Esophageal atresia Renal anomalies Limb anomalies ```
44
What is considered mandatory preoperative preparation for TEF repair?
12 Lead EKG, ECHO d/t 20% cardiac anomaly risk
45
How would anesthetic management change for an unstable infant vs stable infant?
Unstable: consider gastrostomy insertion and awake intubation Stable: IH induction with spont vent or IV induction with minimal PPV or RSI
46
How does ETT placement technique differ with TEF repair?
Right mainstem intubation, withdraw ETT until breath sunds are confirmed at the L axilla.
47
What positioning method is typically used for TEF repair?
Left lateral decubitus position for Right thoracotomy
48
What are introperative complications for TEF repair?
1. Airway compromise (intubate fistula, R mainstem, ETT obstruction 2. Hypothermia 3. Hypoglycemia 4. Resumption of fetal circulation (R-L shunting).
49
What are post-operative concerns for TEF repair?
1. No extension of head (puts tension on the anastomosis). 2. No esophageal suctiong beyond the level of esophageal anastomosis 3. Long term= tracheomalacia, GERD, esophageal strictures

Pediatrics (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions