Emergencies

Question 1

At 6 weeks what is the most common abdominal complaint?

Answer 1

Pyloric stenosis.

Question 2

How does pyloric stenosis present?

Answer 2

Abdominal gas, windy child, poor growth, vomiting

Question 3

How is pyloric stenosis fixed?

Answer 3

Surgical split of the pylorus.

Question 4

What causes pyloric stenosis?

Answer 4

Hypertrophy of the pyloric muscle

Question 5

How is pyloric stenosis diagnosed?

Answer 5

USS

Question 6

At 6 months what is the most common abdominal complaint?

Answer 6

intussusception

Question 7

What symptoms will intussusception present with?

Answer 7

Vomiting green
Firm mass on palpation
Melena in nappy

Question 8

How is intussusception diagnosed?

Answer 8

US

Question 9

What will the US show in intussusception?

Answer 9

swirly target lesion which is layers of bowel inside one another

Question 10

How is intussusception solved?

Answer 10

Air reduction (air enema)

Question 11

What is malrotation?

Answer 11

The superior mesentery is unstable and not fixed well to the peritoneum and can wrap around the bowel

Question 12

How will malrotation present?

Answer 12

Vomiting green bile
Abdo pain
Eating little and often
Small faeces

Question 13

What investigation is needed for a malrotation?

Answer 13

Upper GI contrast and follow through

Question 14

What is the risk after a GI surgery?

Answer 14

Adhesions

Question 15

What is the most common cause for scrotal pain?

Answer 15

Hyatid of Morgagni, an accessory testicle

Question 16

How does this Hyatid of Morgagni cause pain?

Answer 16

If it undergoes torsion then it can cause necrosis, swell and be painful.

Question 17

How can you tell if it is a Hyatid of Morgagni?

Answer 17

May feel like a bead on the scrotum
May look like a bruise
Have a high level of suspicion

Question 18

What is the treatment for a hyatid of morgagni?

Answer 18

Surgical removal of the growth will fix the issue

Question 19

What is idiopathic scrotal oedema?

Answer 19

Oedema of the dartos fascia, possibly by eosinophilia

Question 20

How does idiopathic scrotal oedema present?

Answer 20

Erythema spreading perianally to the IF.

Scrotum will be swollen, feel waterlogged and possibly itchy.

Question 21

How is idiopathic scrotal oedema cured?

Answer 21

Supportive treatment with reassurance that it will resolve in

Question 22

What is banalitis xerotica obliterates?

Answer 22

Scarring of the foreskin which may cause the inability to retract it

Question 23

What is the only treatment for BXO?

Answer 23

Circumcision

Question 24

What is paraphimosis?

Answer 24

Foreskin which is stuck behind the glans and cannot be retracted

Question 25

How is paraphimosis solved?

Answer 25

Manual manoeuvre where the foreskin is moved back into its anatomical position.
A dorsal slit is sometimes used to aid this.

Question 26

What is a hypospadias?

Answer 26

Congenital abnormality of the urethral tract so the urethra is not on the glans

Question 27

At what age can a hypospadias be fixed?

Answer 27

Over 3 months

Question 28

What is a hydrocele?

Answer 28

Collection of fluid around the testicle

Question 29

What causes a hydrocele?

Answer 29

Patent processus vaginalis. Occurs embryologically when testis is descending from peritoneum

Question 30

What is the pattern of a hydrocele?

Answer 30

May be absent in the morning as the fluid drains out and present in the evening.

Question 31

On examination, what is a hydrocele like?

Answer 31

Can get fingers above it and can feel fluid.

May be transilluminable.

Question 32

Why must an undescended testicle be forcibly descended?

Answer 32

Higher cancer risk
Infertiity
If something goes wrong, you can’t find it!

Question 33

Where might the undescended testicle lie?

Answer 33

At the deep ring, where the testicular vessels and vas deferens meet.

Question 34

If on ABCDE, C is not adequate how can this be addressed?

Answer 34

20ml/kg of 0.9% saline