Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics > Paediatric surgery > Flashcards

Paediatric surgery Flashcards

1
Q

What are the essential surgery topics in paediatrics?

A 
Acute abdomen in children
Acute scrotum
Foreskin problems
Groin swellings
Head and neck lumps
Umbilicus
Undescended testes
Vomiting infant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is it important to do with a child presenting with abdominal pain?

A

Always examine testes in males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you diagnose testicular torsion?

A

Surgical exploration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do you diagnose acute scrotal pain?

A

Surgical exploration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How long do you have to save the testicle from onset of testicular torsion?

A

6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the differential diagnoses of acute scrotal pain?

A 
TESTICULAR TORSION
Torsion of hydatid (torsion of appendix testis)
Epididymo-orchitis
Trauma - needs to be significant
Acute hydrocele
Idiopathic scrotal oedema (3,4,5)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What investigations should you do in a child with acute scrotal pain?

A

Surgical exploration

Urine dip - rules out epididymo-orchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How common is testicular torsion?

A

2 peaks of incidence - neonatal and puberty
1 in 4000/year
Can happen at any time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the S&S of testicular torsion?

A

Sudden onset pain
Often severe pain so vomiting
Tender testicle
Redness and swelling are LATE signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the appendix testis?

A

Hydatid of morgagni

Remnant of paramesonephric/malarian duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the S&S of torsion of appendix testis?

A

Mimics testicular torsion
Often in pre-pubertal boys
Pain not usually as severe or as acute onset as torsion
Can be blue dot in 1/3 cases - infarcted section on upper pole of testes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is idiopathic scrotal oedema?

A

Condition that occurs in young children with no particular cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the S&S of idiopathic scrotal oedema?

A 
Becomes red and swollen
Urticarial appearance
Oedema
Redness goes up onto groin area and down onto perianal area
Not particularly painful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is idiopathic scrotal oedema treated?

A

Rest

NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is non-retractile foreskin normal?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What condition should you circumcise?

A

Balanitis xerotica obliterans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why do we circumcise BXO?

A

If untreated goes on to affect the glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is hypospadias?

A

Birth defect where opening of urethra located at tip of penis
Foreskin is hooded
Penis has bend when erect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What should you check in a child with hypospadias and why?

A

Check testes are palpable
Check whether baby is actually XX but has been exposed to a lot of testosterone in womb due to congenital adrenal hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the other problem with congenital adrenal hyperplasia?

A

Aldosterone not working properly so baby can get very ill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do you treat hypospadia?

A

Recommend to parents not to get baby circumcised even for religious reasons
Refer to paediatric urology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the importance of the inguinal canal?

A

Testes descend through inguinal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the two main groin problems?

A

Hernia

Hydrocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do you differentiate between a hernia and a hydrocele?

A

Can you get above it?

Can’t get above a hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How common are inguinal hernias?

A

Incidence 1%
80% male
Slight R>L
10% bilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which inguinal hernia do you get in children?

A

Indirect (through deep inguinal ring)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Do you more urgently repair a hernia in younger or older children and why?

A

Younger
- Within days in neonates
- Within weeks in infants
Higher risk of complications such as strangulation in younger children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How common are hydroceles?

A

Very common in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

By what age do hydroceles tend to have cleared by?

A

4/5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How do you treat a hydrocele?

A

Leave them

If symptomatic/very large/haven’t cleared by 4/5 may do surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Why should you not transiluminate in children?

A

Bowel will also transiluminate due to thin bowel wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are possible differentials of neck lumps in children?

A 
Lymph nodes
Thyroglossal remnants
Malignany
Branchial arch/cleft remnants
Sternomastoid tumour
Cystic hydroma
Haemangioma
Pilomatrixoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the possible differentials for head lumps?

A

Lymph nodes
Dermoid cyst
Encephalocoele
Tumour secondaries

34
Q

What is a thyroglossal remnant?

A

Moves when stick tongue out
Need surgery as can become infected/inflamed
Chunk of hyoid bone often removed too to prevent recurrence

35
Q

What happens with branchial arch/cleft remants?

A

Sinus
Fistula
Cyst
Often weeps on neck

36
Q

What is a dermoid cyst?

A

Folds of skin in development get trapped under other folds of skin
Get larger over time
If laterally over face don’t need to worry
If in midline then high risk of tracking into CSF so refer to neurosurgeons

37
Q

When do we worry with lymphadenopathy?

A

> 2cm
Inflamed > 2 weeks
Enlarging
BUT very common in children and may not go back down in size

38
Q

When do you operate on capillary haemangiomas?

A

If covering something like eye/nose

39
Q

How are umbilical hernias treated?

A

Leave, conservative management
95% resolve spontaneously
Risk of incarceration very low
Operate age 4-5 if not closed

40
Q

What is omphalitis?

A

Umbilical infection

41
Q

Why is omphalitis very serious?

A

Good lymphatic drainage connections to IVC via umbilical ligament so can rapidly cause sepsis

42
Q

How is omphalitis treated?

A

Admit and treat with IV antibiotics

43
Q

How are granulomas of the umbilicus treated?

A

Treat with saline washes

44
Q

How common are undescended testes?

A

Up to 5% at birth

1% at 6 months - a lot will slowly descend if leave

45
Q

When should you operate on undescended testes and why?

A

Optimal around 9 months
If not descended after 6 months then unlikely to descend any more, if leave after 1 year then unlikely to be fertile testes

46
Q

How commonly might you be able to palpate an undescended testes?

A

Palpable 80%
Impalpable 20% - not there? Intrabdominal? Ectopic?
Bilateral impalpable testes in newborn male - medical emergency

47
Q

How do you investigate undescended testes?

A

Surgical exploration

48
Q

How is an undescended testes treated?

A

Move the testes
Laparoscopy and examination under anaesthetic for impalpable
May need 2 stages for intrabdominal
Risk of re-ascent later in life

49
Q

What should you thing of and do with a baby with bright green vomit?

A

Malrotation

Refer to surgery immediately

50
Q

What is gastroschisis?

A

Bowel exposed and come through umbilicus

51
Q

How common is gastroschisis?

A

1 in 1000

Not really related to congenital abnormalities (when it is it’s related to bowel injury)

52
Q

How is gastroschisis treated?

A

Reduced surgically or preformed silo (generally silo as abdomen often too small as bowel hasn’t developed in abdomen)

53
Q

What is exomphalos?

A

Bowel come through umbilicus but still in a sac

54
Q

How common is exomphalos?

A

1 in 5000
Related to congenital anomalies - chromosomal, cardiac, Beckwith-Weidemann
Can be giant including liver through too

55
Q

What can cause neonatal surgical respiratory distress?

A

Oesophageal atresia
Thoracic problems
- Congenital diaphragmatic hernia
- Congenital pulmonary airway malformations

56
Q

How common is oesophageal atresia?

A

1 in 3000

VACTERL associated

57
Q

What is VACTERL association?

A 
Vertebral defects
Anal atresia
Cardiac defects
Tracheo-oesophageal fistula
Renal anomalies
Limb abnormalities
58
Q

What are the two types of oesophageal atresia?

A

Proximal - no way through at all

Distal - attached to airway instead

59
Q

How is the oesophagus formed?

A

Lungs formed from bud within embryonic foregut which will form oesophagus and trachea

60
Q

How common are congenital diaphragmatic hernias?

A 
1 in 2500
50% overall survival rate
Antenatal diagnosis
Usually left sided
Usually posterolateral
61
Q

How common are congenital pulmonary airway malformations?

A

1 in 10,000
Leave alone if small and asymptomatic
Antenatal diagnosis

62
Q

How common is duodenal atresia and what is it associated with?

A

1 in 5000
Trisomy 21
VACTERL

63
Q

How does duodenal atresia present?

A

Double bubble appearance on XR

90% bilious vomiting

64
Q

How common are small bowel atresias?

A

1 in 5000
Can be multiple
Can be short bowel (bowel loss)
Can be very discrepant - might have to anastamose bowel

65
Q

How common are anorectal malformations and what is it related to?

A

1 in 5000
VACTERL
Many different types

66
Q

How are anorectal malformations treated?

A

Stoma then PSARP operation

67
Q

How common is Hirschsprung’s disease?

A

1 in 5000

68
Q

What is Hirschsprung’s disease?

A

Distal aganglionosis

69
Q

How does Hirschsprung’s disease present?

A

Failure to pass meconium (normally 95% passed by 24 hrs)

Progressive abdominal distension

70
Q

How is Hirschsprung’s disease treated?

A

Washouts

Pullthrough operation

71
Q

What is meconium ileus related to?

A

10% CF patients

72
Q

Why is meconium ileus related to CF?

A

Thick intestinal secretions form pellets

Blocks terminal ileum

73
Q

How is meconium ileus treated?

A

Laparotomy

74
Q

How common is trauma in children?

A

Leading cause of death in over 15s

Cancer higher until then

75
Q

How is trauma different to adults?

A

Different injury patterns
Different imaging protocols
Different management

76
Q

Who gets necrotising enterocolitis?

A

Premature babies

77
Q

How does necrotising enterocolitis present?

A 
Red distended abdomen
Bowel inflamed - undergoes necrosis
Pneumatosis
Blood in stool
Bile vomit
Feed intolerance
78
Q

Why does necrotising enterocolitis occur?

A

Premature babies have immature and fragile bowels but still need feeding and some get infection

79
Q

How is necrotising enterocolitis treated?

A

Bowel rest

Might need surgery to prevent bowel dying and to repair any perforations

80
Q

What is the prognosis of necrotising enterocolitis?

A

50% mortality rate in those needing surgery

Paediatrics (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions