general surgery of childhood

Question 1

what are the the differential diagnosis of acute scrotum ?

Answer 1

testicular torsion
strangulated inguinal hernia
epididymo-orchitis
torsion of testicular appendages

Question 2

what is the first line of management in an acute scrotum patient ?

Answer 2

history and exam

Question 3

what is the presentation of strangulated inguinal hernia ?

Answer 3

reducible hernia

vomiting

Question 4

what is the presentation of testicular torsion?

Answer 4

acute onset
testis is higher in position than normal
unilateral loss of cremasteric reflex
no relief of pain on elevation

Question 5

what is the test of choice for definitive diagnosis of testicular torsion ?

Answer 5

ultrasound with doppler ( reduced vascularity )

Question 6

what is the time period of surgical indication associated with suspected testicular torsion ?

Answer 6

surgical exploration within 6 hours

Question 7

how to initiate cremasteric reflex ?

Answer 7

scratch the medial side of the upper thigh

Question 8

what is the prognosis of torsion of testicular appendages ?

Answer 8

causes pain
but of no value
not an emergency

Question 9

what are the DDx of acute abdomen ?

Answer 9

acute appendicitis 
intestinal obstruction 
ovarian torsion 
torsion ovarian cyst 
colitis - mesenteric lymph adenoids 
stones

Question 10

what is the presentation of acute appendicitis ?

Answer 10

severe abdominal pain
guarding of the right iliac fossa
generalized then becomes localized to right illiac

Question 11

what does the pain of acute appendicitis mimic ?

Answer 11

lower lobe pneumonia

Question 12

what is the treatment for intussusception ?

Answer 12

air enema

Question 13

what is a sausage shaped mass suggestive off on radiology ?

Answer 13

intussusception

along with bilous vomiting and bleeding per rectum

Question 14

what is coffee bean sign on radiology suggested off ?

Answer 14

sigmoid volvulus

Question 15

what is the initial management for any intestinal obstruction ?

Answer 15

drip and suck

Question 16

how does hydrocele present ?

Answer 16

painless swelling of one or both testicles
trans illuminates
fluid drains back at night

Question 17

what is the management for hydrocele ?

Answer 17

just observational

should resolve within a year

Question 18

what is the most common complication of hydrocele ?

Answer 18

indirect inguinal hernia

Question 19

what is hypospadias ?

Answer 19

opening of the urethra is not located at the tip of the penis

Question 20

when should repair of hypospadias occur ?

Answer 20

between 6 months and 2 years

Question 21

what is the contraindication to performing a circumcision ?

Answer 21

presence of hypospadias

curvature of the penis

Question 22

when is surgery for UDT recommended ?

Answer 22

again at the age of 6 months

Question 23

how should bleeding after circumcision be dealt with ?

Answer 23

compress
resuscitate
refer to a surgeon

Question 24

what is the prognosis of an umbilical hernia ?

Answer 24

usually the defect closes at around 4-5 years of age

Question 25

what is the presentation of pyloric stenosis ?

Answer 25

projectile vomiting non-bilious
visible peristaltic waves
olive shaped mass
immediately hungry after vomiting

Question 26

child with reducible swelling in left groin which increases in size with crying , what is the diagnosis ?

Answer 26

inguinoscrotal hernia

Question 27

what is cryptorchidism ?

Answer 27

failure of one or both of the testes to descend

Question 28

what is the presentation of cryptorchidism ?

Answer 28

one of the testes or both may appear to be missing or are palpable in the abdomen

Question 29

what is the definitive treatment for pyloric stenosis ?

Answer 29

pyloromyotomy

Question 30

what is a double bubble sign on imaging an indication off ?

Answer 30

duodenal atresia ( not an emergency)

Question 31

what chromosomal abnormality is often associated with duodenal atresia ?

Answer 31

down syndrome

VATER association

Question 32

how is pyloric stenosis diagnosed with imaging ?

Answer 32

string sign on barium meal

Question 33

what is the differential diagnosis of meconium ileus ?

Answer 33

cystic fibrosis

hirschsprung disease

Question 34

what is the surgery for intestinal malrotation ?

Answer 34

ladd’s surgery

Question 35

what is the gold standard for the diagnosis of hirschsprung ?

Answer 35

rectal biopsy

Question 36

antenatally what is duodenal atresia associated with ?

Answer 36

polyhydramnios