Intro to Paeds Surgery

Question 1

what should weight of children be

Answer 1

2x(age+4)

Question 2

approximate blood volume children

Answer 2

80mls/kg

Question 3

urine output children

Answer 3

0.5-1ml/kg/hour

Question 4

rough insensible fluid loss children

Answer 4

20ml/kg/day

Question 5

systolic blood pressure children

Answer 5

80+(2xage)

Question 6

over what age should vital signs be approximately the same as adults

Answer 6

> 10

Question 7

WHO pain ladder for kids

Answer 7

paracetamol -> ibuprofen -> weak opiod -> strong opiod

Question 8

what opiod not recommended children <12

Answer 8

codeine

Question 9

fluid resuscitation recommendation

Answer 9

20ml/kg bolus 0.9%NaCl

Question 10

maintenance fluid children

Answer 10

0.9% NaCl / 5% Dextrose +/- 0.15% KCl
4ml/kg 1st 10kg
2ml/kg 2nd 10 kg
1ml/kg every kg thereafter

Question 11

important examination techniques for kids with abdominal pain/ vomitting

Answer 11

• general appearance
• temp
• guarding
• rebound

Question 12

investigations kids with abdominal pain/ vomitting

Answer 12

• urine (always)
• FBC (if diagnostic doubt)
• electrolytes (if dehydrated)
• rarely x-ray

Question 13

Murphy’s triad of appendicitis

Answer 13

• pain (McBurneys point)
• vomitting
• fever

Question 14

complications appendicitis

Answer 14

abscess
mass
peritonitis

Question 15

features NSAP (non-specific abdominal pain)

Answer 15

• short duration
• central
• constant
• not made worse by movement
• no GIT disturbance
• no temperature
• site and severity of tenderness may vary

Question 16

where is pneumonia normally in kids

Answer 16

right LL

Question 17

mesenteric adenitis

Answer 17

condition that more often affects children and teenagers. It causes inflammation and swelling in the lymph nodes inside the abdomen

Question 18

presentation mesenteric adenitis

Answer 18

• high temp
• URTI often
• not ‘unwell’

Question 19

presentation of pyloric stenosis

Answer 19

• non-bilious vomitting
• weight loss
• cap gas (alkalosis, hypocholraemia, hypokalaemia)

Question 20

investigations pyloric stenosis

Answer 20

• test feed
• USS
• periumbilical pyloromyotomy

Question 21

describe malrotation of gut

Answer 21

abnormality that can happen early in pregnancy when a baby’s intestines don’t form into a coil in the abdomen. the intestines are twisting, which can cause obstruction

Question 22

presentation malrotation

Answer 22

• 3 day old baby
• bile vomitting
• fairy liquid green

Question 23

management malrotation

Answer 23

• upper GI contrast study

- laparotomy

Question 24

intussusception

Answer 24

condition in which one segment of intestine “telescopes” inside of another

Question 25

presentation intussusception

Answer 25

• history viral illness
• intermittent colic and dying spells
• bilious vomitting
• delayed cap refill
• bloody mucous PR (red jelly)

Question 26

intussusception investigations

Answer 26

• USS abdomen

‘target sign’ appearance

Question 27

management intussusceptions

Answer 27

• pneumostatic reduction

- laparotomy

Question 28

define gastroschisis

Answer 28

gut eviscerated and exposed through abdominal wall

Question 29

management gastroschisis

Answer 29

• primary/ delayed closure

- TPN

Question 30

examphalos

Answer 30

weakness of the baby’s abdominal wall where the umbilical cord joins it. This weakness allows the abdominal contents, mainly the bowel and the liver to protrude outside the abdominal cavity where they are contained in a loose sac that surrounds the umbilical cord