Paediatric Surgery

Question 1

What is the definition of a congenital undescended testes?

Answer 1

Testes that have failed to reach the bottom of the scrotum by 3 months

Question 2

What is the management for undescended testes?

Answer 2

Orchidopexy at 6-18 months age which involves implantation into dartos pouch.

Question 3

What are the classical features of pyloric stenosis?

Answer 3

M>F
Projectile vomiting (non bile-stained) at 4-6 weeks old

Question 4

How do you diagnose pyloric stenosis?

Answer 4

Test feed
USS

Question 5

How do you treat pyloric stenosis?

Answer 5

Hamstedt pyloromyotomy (laparoscopic or laparotomy)

Question 6

What are the features of intusussception?

Answer 6

Telescoping bowel / sausage shaped mass
Proximal or at the level of the ileocaecal valve
Occurs most commonly at 6-9 months of age
red jelly stool and diarrhoea with colicky abdominal pain

Question 7

Treatment of intusussception?

Answer 7

Reduction with air insufflation

Question 8

What is Hirschprungs disease?

Answer 8

The absence of ganglion cells from the myenteric plexus and submucosal plexuses

Question 9

How do you diagnose Hirschprungs disease?

Answer 9

Full thickness rectal biopsy

Question 10

What are the clinical features of Hirschprungs disease?

Answer 10

Delayed passage of meconium accompanied by abdominal distension

Question 11

How do you treat Hirschprungs disease?

Answer 11

Rectal washouts initially followed by an anorectal pull through procedure

Question 12

what are the features of biliary atresia?

Answer 12

Jaundice after 14 days
Increased conjugated bilirubin

Question 13

How do you treat biliary atresia?

Answer 13

An urgent kasai procedure

Question 14

what is the main risk factor for necrotising enterocolitis?

Answer 14

prematurity

Question 15

What are the early features of necrotising enterocolitis?

Answer 15

abdominal distension and the passage of bloody stools

Question 16

What is the treatment for necrotising enterocolitis?

Answer 16

Treatment is with gut rest and TPN, babies with perforations require a laparotomy.

Question 17

What is an omphalocoele?

Answer 17

This is where the abdominal organs protrude through the umbilicus yet still lie within the peritoneum

Question 18

What is gastroschisis?

Answer 18

This is where the abdominal organs lie outside of the abdomen through s defect to the right of the umbilicus?

Question 19

What condition commonly presents with an absent vas deferens?

Answer 19

cystic fibrosis

Question 20

What are the Kocher criteria for septic arthritis?

Answer 20

WIFE

WCC >12,000
Inability to weight bear
Fever
ESR >40

Question 21

What is the underlying cause of cleft lip?

Answer 21

disruption of the muscles of the upper lip and nasolabial region

Question 22

What is the cause of cleft palate?

Answer 22

The cleft palate is a result of non fusion of the palatine shelves which can involve both the hard and soft palate

Question 23

What is the investigation of choice for vesicoureteric reflux with scarring?

Answer 23

DMSA

Question 24

What is the nature of inheritance of osteopetrosis?

Answer 24

Autosomal recessive

Question 25

What is osteopetrosis?

Answer 25

Bones can become harder and more dense. Radiology will present with ‘marble bone’ which is a difficulty in differentiating between the medulla and cortex of the bone.

Question 26

At what age should children with otherwise uncomplicated umbilical hernias be considered for surgery?

Answer 26

After 3 years of age

Question 27

What is a greenstick fracture?

Answer 27

Unilateral cortical disruption only

Question 28

What is a toddlers fracture?

Answer 28

Oblique tibial fracture in infants

Question 29

What is a buckle fracture?

Answer 29

Incomplete cortical disruption resulting in a periosteal haematoma only