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ABSITE > Fiser Chapter 43 PEDIATRIC SURGERY > Flashcards

Fiser Chapter 43 PEDIATRIC SURGERY Flashcards

1
Q

Pulmonary sequestration diagnosis

A

CTA

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2
Q

Pulmonary sequestration most common location

A

Left lower lobe

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3
Q

Drainage system of extralobar versus intralobar pulm sequestration

A

Extralobar systemic

Inralobar pulmonary vein

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4
Q

Congenital lobar emphysema treatment

A

Lobectomy (no chest tube)

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5
Q

Most common lobation of CLE

A

Left upper lobe

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6
Q

Location of bronchogenic cyst

A

Mediastinum (right posterior to carina)

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7
Q

Treatment of bronchogenic cyst

A

Resection of cyst

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8
Q

Mediastinal masses: anterior, middle, posterior

A

Anterior: T-cell lymphoma, teratoma, germ cell tumors, thyroid cancer
Middle: T-cell lymphoma, teratoma, cysts (cardiogenic or bronchogenic)
Posterior: T-cell lymphoma, neuroblastoma, neurogenic tumor

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9
Q

Choledochal cyst types

A

I: Fusiform of entire CBD, tx resection and hepaticoJ

II: True diverticular cyst off CBD, tx resection

III: Distal dilatation involving sphincter or Oddi, tx resection and choledochoJ via duodenotomy

IV: Intra and extra hepatic cysts, tx resection and lobectomy, maybe transplant

V: Intrahepatic (Caroli’s disease), tx lobectomy versus transplant

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10
Q

Neuroblastoma most common location

A

Adrenals, but can occur anywhere along sympathetic chain

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11
Q

Secretory diarrhea, raccoon eyes, hypertension, unsteady gait (opsomyoclonus), increased catecholamines, VMA, HVA, and metanephrines, in child <2 years old

A

Neuroblastoma

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12
Q

Embryological origin of neurblastoma

A

Neural crest cells

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13
Q

Indicators of worse prognosis in neuroblastoma

A

NSE (neuron specific elastase), LDH, HVA, diploid tumors, and N-myc amplification

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14
Q

Most common malignancies in kids

A

Overall: leukemia (ALL)
Solid: CNS tumors
Gen surg: Neuroblastoma if <2 yo; Wilms if >2 yo

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15
Q

Embryology of Meckel’s

A

Persistent vitelline duct (aka omphalomesenteric duct)

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16
Q

Most common cause of painless lower GIB in kids

A

Meckel’s

17
Q

Pyloric stenosis metabolic abnormalities

A

Hypochloremic hypokalemic metabolic alkalosis

Tx: NS boluses until making urine, then switch to D5-NS with 10 mEq of K

18
Q

Age of presentation for intususception

A

3 months to 3 years

19
Q

Etiology of intestinal atresias

A

Intrauterine vascular accidents

20
Q

Most common site of intestinal atresia

A

Jejunum

21
Q

Associated abnormalities with duodenal atresias

A

Down’s syndrome; cardiac, renal, and other GI abnormalities

22
Q

TEF types

A

A: complete atresia

B: proximal fistula and distal atresia

C: most common, proximal atresia and distal fistula

D: Double fistula

E: H type just fistula

23
Q

VACTERL Syndrome

A 
Vertebral
Anorectal (imperforate anus)
Cardiac
TEF
Esophageal
Radius (thumb) or Renal
Limb
24
Q

Approach to TEF repair

A

Right extrapleural thoracotomy

25
Q

Malrotation diagnosis

A

Upper GI study: duo does not cross midline, duodenojejunal junction displaced to right

26
Q

Treatment of Malro

A

Ladd procedure: resect ladd’s bands, perform counterclockwise rotation (turn back hands of time), place cecum in left lower quadrant, duodenum in RUQ, appendectomy

27
Q

Treatment of meconium ileus

A

Gastrograffin enema, test for CF

28
Q

Appearance of abdominal x ray of meconium ileus

A

Dilated loops of small bowel without air fluid levels; ground glass or soap suds appearance

29
Q

Classic presentation of NEC

A

Bloody stools after first feeding in premature neonates

30
Q

Risk factors for NEC

A

prematurity
hypoxia
sepsis

31
Q

Initial tx of NEC

A

resuscitation, npo, abx, TPN, orogastric tube

32
Q

gastroschisis versus omphalocele

A

Gastroschisis: to the R of midline, no peritoneal lining

Omphalocele: midline with sac; associated congenital anomalies and Cantrell pentalogy (cardiac defects, pericardial defects, sternal cleft or abscess of sternum, diaphragmatic, omphalocele)

33
Q

Hirschsprung’s disease diagnosis

A

Rectal biopsy, absence of ganglion cells in myenteric plexus

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