paediatric surgery Flashcards
How to calculate weight from age
2 x (age + 4)
What is the blood volume in a child
80ml/kg
What is the usual urine output in a child
1ml/kg/hour
How to calculate systolic blood pressure from age
80 + (2 x age)
How does respiratory rate change from 1 - 10
decreases from 30-40 to 15-20
How does heart rate change from 1-10 years
Starts at 110-160 at 1 and changes to 60-100 at 10 years
How does blood pressure change as you go from 1 year to 10 years
Increases from 70-90 at 1 to 100-120 at 10
Describe the pain management ladder for children
- Paracetamol
- Ibuprofen
- Weak opioid
- Strong opioid
(codeine should be avoided in <12)
What fluid is given for resuscitation
20ml/kg bolus 0.9% sodium chloride
What is given for maintenance fluid management in children
0.9% NaCl/5% desxtrose with or without KCl
- 4ml/kg for first 10 kg
- 2ml/kg for 2nd 10 kg
- 1ml/kg for every kg after
What is the amount of maintenance fluid given in a 60kg child
4x10 + 2x10 + 1x40 = 100 ml
What is the presentation of appendicitis in a child
- Murphys triad (pain, fever and vomiting)
- Tenderness over McBurneys point
What are the features of non specific abdominal pain
- Short duration
- central
- constant
- not made worse by movement
- No GI disturbance
- No temperature
What is the presentation of mesenteric adenitis
- High temperature
- URTI often
- doesnt appear unwell
- Palpable glands
What are the features of pneumonia in a child
- They are sicker then what their abdominal signs show
- Usually right lower lobe
What is the management of malrotation and volvulus
Laparotomy
What is the presentation of intussusception
- History of viral illness
- Colic
- Floppy
- Pale
- billous vomiting
- Bloody mucous PR
- 4 second capillary refill
- Targe sign on ultrasound
What is the management of intussusception
- Pneumostatic reduction (air enema)
- Laparotomy
What is the presentation of an umbilical hernia
- umbilical swelling
- present from few days old
- worse with crying
- easily reducible
When are umbilical hernias expected to spontaneously resolve
by 4 years
What is gastroschisis
Abdominal wall defect where the gut is outside of the abdomen when the child is born
What is the management of gastroschisis
- Primary or delayed closure
- TPN - total parental nutrition
What is exomphalos
Umbilical defect with covered viscera
What are the associated anomalies with exomphalos
- 25% cardiac abnormalities
- 25 Chromosomal - trisamy 13,18 and 21
- 15% renal and neurological
- Beckwith-weidenman syndrome
What is the management of examphalos
Primary/delayed closure
