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ABSITE > GPS > Flashcards

GPS Flashcards

1
Q

Foregut

A

lungs, esophagus, stomach, pancreas, liver, gallbladder, bile duct, and duodenum proximal to ampulla

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2
Q

Midgut

A

duodenum distal to ampulla, small bowel, and large bowel to distal ⅓ of transverse colon

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3
Q

Hindgut

A

distal ⅓ of transverse colon to anal canal

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4
Q

Midgut rotates what degree normally? Clockwise?

A

Midgut rotates 270 degrees counterclockwise normally

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5
Q

Low birth weight (number)

A

<2500 g

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6
Q

Pre-term (weeks)

A

< 37 weeks

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7
Q

Which Ig from mother’s milk? Which Ig crosses placenta?

A

IgA/milk; IgG/placenta

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8
Q

1 cause of childhood death

A

Trauma

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9
Q

Peds trauma bolus

A

20 cc/kg x 2; then blood 10 cc/kg

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10
Q

Best indicator of shock in a pediatric patient?

A

Tachycardia (neonate > 150; < 1 year > 120; rest >100)

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11
Q

Children < 6 months old have more/less GFR than adults?

A

Less; only about 25%; poor concentrating ability

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12
Q

Why is ALP so high in peds?

A

Bone growth

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13
Q

What are the components of a normal umbilical cord?

A

1 vein; 2 arteries

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14
Q

Maintenance IVF calculation

A

4/2/1 (10; 10; 1)

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15
Q

Pulmonary sequestration/Accessory lung

A

Aberrant formation of segmental lung tissue that has no connection with the bronchial tree or pulmonary arteries. It is a bronchopulmonary foregut malformation (BPFM).

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16
Q

Anomalous arterial supply of accessory lung

A

Thoracic aorta (MC); abdominal aorta (inferior pulmonary ligament)

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17
Q

Venous drainage of accessory lung (based on extra/intra-lobar)

A

Systemic venous (extra-lobar) or pulmonary venous drainage (intra-lobar)

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18
Q

Pulmonary sequestration most often presents with…

A

Infection; can also p/w respiratory compromise or abnormal CXR

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19
Q

Treatment of pulmonary sequestration

A

Ligate arterial supply (risk of severe hemorrhage); then lobectomy

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20
Q

Most common mediastinal tumor in children

A

Neurogenic (neurofibroma, ganglionoma, neuroblastoma) ** usually located in the posterior mediastinum

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21
Q

Symptoms common to all mediastinal masses regardless of location

A

Respiratory, dysphagia

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22
Q

Anterior mediastinal masses in children

A

T’s: T cell lymphoma, teratoma (other germ cell tumors = MC), thyroid

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23
Q

Middle mediastinal masses in children

A

T cell lymphoma, teratoma, cardio- or broncho-genic cysts

24
Q

Posterior medaistinal masses in children

A

Neuro!

25
Q

T/F Thymoma is rare in children

A

True

26
Q

Do you need to resect choledochal cysts?

A

Yes– risk of cholangiocarcinoma, pancreatitis, cholangitis, obstructive jaundice caused by reflux of pancreatic enzymes into the biliary system in utero

27
Q

Etiology of choledochal cysts.

A

In utero reflux of pancreatic enzymes into the biliary system

28
Q

Types of choledochal cysts

A
  1. Fusiform dilation entire CBD (HJ)
  2. True divertic CBD (Rsxn)
  3. Dilation of distal CBD/Sphincter of Oddi (Rsx)
  4. Multiple cysts (intra+extra) Rsx/Lobe/Txp
  5. Caroli’s disease (intrahepatic cysts) Rsx/Lobe/Txp
29
Q

Lymphadenopathy in children is usually 2/2

A

Suppurative adenitis a/w URI or phayngitis

30
Q

Chronic causes of LAD in children

A

Cat scratch, aypical mycoplasma

31
Q

If fluctuant LAD in a child…

A

FNA, cx, Abx +/- I&D

32
Q

Asymptomatic LAD in a child…

A

Lymphoma until proven otherwise (10 days ABX followed by excisional biopsy)

33
Q

Cystic hygroma

A

Found in lateral cervical regions in neck; get infected and lateral to SCM

34
Q

Which side has greater CDH?

A

L (80%)

35
Q

Major cardiac consequence of CDH

A

Pulmonary HTN

36
Q

T/F 80% children with CDH have associated anomalies

A

True: cardiac, NTD, malro

37
Q

Are both lungs dysfunctional in CDH?

A

Yes

38
Q

Treatment CDH

A

High-frequency ventilation; iNO; ECMO (Stabalize before OR; reduce bowel, repair defect; run the bowel)

39
Q

Two types of CDH

A
  1. Bochdalek-MC-posterior

2. Morgagni: rare, anterior

40
Q

When to perform Nuss

A

Respiratory symptoms, emotional stress

41
Q

1 solid abdominal malignancy in children

A

Neuroblastoma

- Asymp mass

42
Q

Some symptoms of neuroblastoma

A

Secretory diarrhea, raccoon eyes (orbial mets), HTN, opsomyoclonus syndrome (unsteady gait)

43
Q

Neuroblastoma is most often on which organ?

A

Adrenals; but anywhere on the sympathetic chain

44
Q

What are some lab markers of neuroblastoma?

A

Catecholamines, VMA, HVA, metanephrines

45
Q

From what cells are neuroblastomas derived?

A

Neural crest cells

46
Q

Stippled calcifications in a tumor in a child

A

Neuroblastoma

47
Q

What tumor marker is elevated in peds patients with neuroblastoma w/ mets?

A

NSE (LDH, HVA, diploic, N-myc)

48
Q

Resection for neuroblastoma

A

Adrenal & kidney taken

49
Q

What about neoadjuvant chemo for neuroblastoma?

A

Doxorubicin-based chemo

50
Q

Staging neuroblastoma

A
  1. Localized, complete excision
  2. Incomplete excision, does not cross midline
  3. Crosses midline (+/- regional nodes)
  4. Distant mets (nodes/solid organ)
51
Q

Common presentation of Wilms tumor

A

Asymptomatic; hematuria, hypertension; 10% bilateral

52
Q

Mean age diagnosis of Wilms; prognosis is based upon

A

3 year olds; tumor grade (anaplastic and sarcomatous have worst prognosis)

53
Q

In the case of pulmonary mets in Wilms tumor

A

Whole lung XRT

54
Q

Abdominal CT differentiating Wilms from neuroblastoma

A

Wilms: replaces renal parenchyma; Neuro: displaces

55
Q

Treatment of Wilms

A

Nephrectomy +/- resection from vein; examine contralateral kidney & look for peritoneal implants

56
Q

Staging of Wilms

A

1: Limited to kidney, completely excised
2. Beyond, completely excised
3. Residual non-heme
4. Heme mets
5. B/L renal invovlement

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