Common pediatric surgical problems

Question 1

what are the three types of lymphadenopathy? what are the treatments?

Answer 1

infectious - abx
reactive - observation and follow
malignancy - excisional or incisional biopsy

Question 2

what is the duration of acute lymphadenopathy? aub acute? chronic?

Answer 2

acute - less than 2 wk
subacute - up to 6 wk
chronic - over 6 wk

Question 3

what are the features of a thyroglossal duct cyst?

Answer 3

midline near hyoid bone

moves with tongue

Question 4

what are the treatments for congenital toricollis?

Answer 4

PT

surgical division if PT does not work

Question 5

what is indicative of a “barking cough” of tracheomalacia?

Answer 5

esophageal atresia - TE fistula

Question 6

what is the VACTERL association? what is it used for?

Answer 6

vertebral 
anorectal 
CV 
tracheal 
esophageal 
renal 
limb 

rule-out for TE fistula

Question 7

where is the majority of diaphragmatic hernias?

Answer 7

left posterior

Question 8

what anomalies are also associated with omphalocoele?

Answer 8

heart
urinary tract
beckwith-wiedeman

Question 9

gastroschisis

Answer 9

abdominal wall defect to right of umbilicus
often thickened inflammatory serosal surfaces
may have associated atresias of the gut

Question 10

what is critical for gastroschisis / omphalocoele?

Answer 10

heat loss

Question 11

in malrotation / volvulus, what is often found in the vomit?

Answer 11

bile

Question 12

what must be present for diagnosis of malrotation / volvulus?

Answer 12

upper GI series - duodenum does not cross the midline and rise to level of pylorus

Question 13

double bubble sign is indicative of what condition?

Answer 13

duodenal atresia

Question 14

how is duodenal atresia treated?

Answer 14

duodenoduodenostomy

Question 15

duodenal atresia is associated with what other conditions?

Answer 15

down syndrome

heart defects

Question 16

midgut atresia is thought to be due to what process?

Answer 16

in utero mesenteric vascular accident

Question 17

apple peel deformity is indicative of what condition?

Answer 17

midgut atresia

Question 18

what are the three presentations of meckels diverticulum?

Answer 18

diverticulosis (appendicitis-like)
intussuseception
bleeding

Question 19

what is the cause of hirschsprung’s disease?

Answer 19

failure of migration of neural crest cells to end of the gut

Question 20

what is the result of hirschsprung’s disease?

Answer 20

absence of ganglion cells in submucosa - halts peristaltic propagation

Question 21

an infant with distended abdomen and no bilious vomit suggests what condition?

Answer 21

lower GI obstruction

Question 22

what type of imperforate anus is more complicated - high or low?

Answer 22

high

Question 23

what is the characteristic pain associated with intussusception?

Answer 23

paroxysmal - 40m period
crampy
may be normal / subdued between cramps

Question 24

currant jelly stools are associated with what condition?

Answer 24

intussusception

Question 25

what are the features of the vomit seen in pyloric stenosis?

Answer 25

projectile

nonbilious

Question 26

what are the three types of biliary atresia?

Answer 26

A - total fibrosis of ducts
B - fibrosis of proximal ducts only
C - fibrosis of distal ducts only

Question 27

choledochal cyst is associated with an anomaly of what structure?

Answer 27

common bile duct

Question 28

are retractile testes normal?

Answer 28

yes