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Paediatrics > Intro to Paeds Surgery > Flashcards

Intro to Paeds Surgery Flashcards

1
Q

Equation for working out weight from age

A

2 x (age + 4)

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2
Q

Equation for working out blood volume of kid per kg

A

80mls/kg

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3
Q

Urine output = …../kg/hour

A

0.5-1ml/kg/hour

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4
Q

Insensible fluid loss = …/kg/hour

A

20ml/kg/day

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5
Q

Systolic BP (mm Hg) =

A

80 + (2x Age)

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6
Q

Paeds range of Respiratory rate

A

infants - 30-40

above ten - 15-20

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7
Q

Paeds range of heart rate

A

infants - 110-160

above ten - 60-100

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8
Q

Paeds range of BP

A

infants - 70-90

above ten - 100-120

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9
Q

What is the pain barrier in paeds?

A

kids dont get analgesia as teacher wants to ask parent who wants to ask doctor who wants to ask hospital and all are scared calpol will mask signs

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10
Q

Pain ladder is

A

paracetamol
ibuprofen
weak opiod
strong opiod (morphine)

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11
Q

which weak opiod should not be given to kids?

A

codeine

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12
Q

what rule is used to calculate maintenance fluids in paeds?

A

421 rule

4ml/kg 1st 10kg
2ml/kg 2nd 10 kg
1ml/kg every kg thereafter

10 yrs = 2 x (10+4) = 28kg = 40+20+8 = 68mls/hr

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13
Q

what fluid would you use for maintenance fluid in paeds?

A

0.9% NaCl / 5% Dextrose +/- 0.15% KCl

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14
Q

what fluid would you use for resus in paeds

A

0.9% NaCl

20ml/kg bolus

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15
Q

5 sentinel signs in paeds?

A 
feed refusal
bile vomits
colour
tone
temperature
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16
Q

clues - signs of appendicitis

A

moderate temperature, vomiting

looks unwell

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17
Q

Murphys triad (appendicitis) is

A

pain
vomiting
fever

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18
Q

in appendicitis where do you get tenderness?

A

McBurney’s point

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19
Q

complications of appendicitis

A

abscess
mass
peritonitis

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20
Q

management of appendicitis

A

laparoscopic / open appendicectomy

21
Q

NSAP - non specific abdomen pain FEATURES

A 
short duration
central
constant
not made worse by movement
no GIT disturbance
no temperature
site and severity of tenderness vary
22
Q

mesenteric adenitis is

A

great big swollen glands in abdomen

high temperature
URTI often
not “unwell”

23
Q

Malrotation presentation

A

3 day old baby
with bile vomiting
“fairy liquid” green

24
Q

3 day old baby
with bile vomiting
“fairy liquid free” whats the diagnosis?

A

MALROTATION and VOLVULUS

25
Q

what is malrotation?

A

failure of midgut to rotate during embryogenesis. Mobile midgut with short mesentery and propensity to twist?

26
Q

what is volvulus?

A

where the malrotation twists

27
Q

investigation of malrotation

A

URGENT upper GI contrast study

28
Q

management of malrotation

A

URGENT surgery (laparotomy)

29
Q

What is Intussusception?

A

Telescoping f one portion of bowel into an immediately adjacent segment.
Subsequent restriction of blood supply and oedema of bowel wall rapidly leads to obstruction and potentially gangrene/ perforation

(one bit of bowel sliding into another bit)

30
Q

incidence of intussusception

A

most common in those aged 3 - 12 months

31
Q

symptoms of intussusception

A

3 day history of viral illness then intermittent COLIC and DYING SPELLS
bilious vomiting

32
Q

Whats a DYING SPELL?

A

baby goes floppy and white - parents think they have died- vagal response- crying 20 mins later

33
Q

Signs of intussusception

A

palpable sausage shaped mass, redcurrant jelly stools (PR)

34
Q

investigations of intussusception

A

USS - target sign

35
Q

Management of intussusception

A

reduction with air enema

if this fails - reduction at laparotomy

36
Q

incidence of umbilical hernia

A

1:6 kids

increased risk in LBW, trisomy 21, hypothyroidism

37
Q

Rx of umbilical hernia

A

spontaneous closure by 4 years

38
Q

What is an epigastric hernia?

A

defect in linea alba above the umbilicus

protrusion of peritoneal fat

39
Q

Rx of epigastric hernia

A

leave alone

operative role is cosmetic but leaves big scar instead

40
Q

What is Pyloric Stenosis?

A

Hypertrophy of the gastric pylorius causing upper GI obstruction

41
Q

incidence of pyloric stenosis

A

males 5:1 female, FH often

2-8 weeks

42
Q

Symptoms of pyloric stenosis

A

non bilious - milky - vomiting - “projectile” after every feed, constantly hungry baby, acute weight loss

43
Q

Signs of pyloric stenosis

A

dehydration, palpable olive mass in right upper abdomen,

44
Q

investigations of pyloric stenosis -

A

cap gas
hyperchloraemic, hypokalaemia metabolic alkalosis
Abdo USS

45
Q

Rx of Pyloric stenosis

A

mild by mouth, correct electrolyte abnormalities with iv fluids, NG tube and replace NG losses
surgical pyloromyotomy

46
Q

Gastroschisis is

A

herniation through abdominal wall defect to right of umbilicus. bowel not covered with membrane

bowel comes out in utero and just doesn’t go back in

47
Q

Management of gastroschisis

A

primary surgical closure or delayed if bigger

48
Q

Exomphalos

A

herniation through umbilicus. bowel and viscera covered with membranous sac

associated with other congenital abnormalities

49
Q

Management of Exomphalus

A

primary/ delayed surgical closure

Paediatrics (15 decks)

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