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Pediatrics > Paediatric Surgery > Flashcards

Paediatric Surgery Flashcards

1
Q

What are the top 5 main causes of a vomiting baby?

A 
overfeeding
Possetting
Gastro-oesophageal refulx
Pyloric Stenosis
Obstruction (green is obstruction until proven otherwise)
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2
Q

What is the age of onset of pyloric stenosis?

A

2-6 weeks?

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3
Q

Which babies are more likely to get pyloric stenosis?

A

boys are 5x more likely to get it than girls

fHx also contributes

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4
Q

What are the signs and symptoms of pyloric stenosis?

A 
projectile vomiting with no bile, soon after feeds.
 Acute weight loss
dehydration
hypochloraemic
hypokalaemic
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5
Q

What is the management of pyloric stenosis?

A

Electrolyte balance before surgery

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6
Q

What are the 6 most common causes of bilious vomiting in a baby?

A 
Volvulus until proven otherwise
Necrotising enterocolitis
Sepsis
Atresia
Hirschsprungs disease
Meconium Disease
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7
Q

In paeds what is malrotation?

A

Failure of the orientation of the gut to orientate itself properly in utero. 3 landmarks are DJ flexure to left of midline, caecum in RIF and transverse colon ant. to S.I. mesentery

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8
Q

How is malrotation diagnosed in a baby?

A

barium contrast study

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9
Q

What is Necrotising Enterocolitis?

A

A disease affecting premature infants where inflammation leads to death of the bowel

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10
Q

Give 5 features of necrotising enterocolitis

A 
abdominal distention
blood in stools
feeding intolerence
vomiting
pyrexia
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11
Q

What is Atresia of the intestine?

A

Congenital malformation - narrowing or absence of a section of the intestine.

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12
Q

What is the most common site for atresia of the intestine to occur?

A

along the ileum or the jejunum

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13
Q

Where is intestinal atresia most likely to occur in an infant with Downs Syndrome?

A

The duodenum

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14
Q

What is Hirschsprungs disease and what is it otherwise known as?

A

Cigenitial aganglionic megacolon, a section of bowel does not contain ganglia

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15
Q

What is the natural history of Hirschsprungs Disease?

A

Starts at the anus and progresses up the bowel

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16
Q

How does Hirschsprungs Disease most commonly present?

A

90% present with delayed passage of the meconium

17
Q

What are the 5 most common causes of abdominal pain in children?

A 
Acute Appendicitis
Mesenteric Adenitis 
Constipation 
Gastroenteritis
UTI
18
Q

What 5 x-ray findings may be present in a child with acute appendicitis

A 
Scoliosis due to pain 
Fecolith
Absent Right posts shadowing 
intraperitoneal gas in perf
small bowel dilatation
19
Q

What is a fecolith?

A

a mass of hardened of stool that may be visible on imaging in acute appendicitis

20
Q

What is the definition of Intussusception?

A

`Full thickness invagination of the proximal bowel into the distal intestine

21
Q

What is the most common site for intussusception to occur?

A

Ileo-colic margin

22
Q

What is meckel’s diverticulum?

A

The most common congenital abnormality of the GI tract. Incomplete obliteration of the omphalomesenteric duct and leads to out-pouching

23
Q

What are the two types of complication which can arise from meckel’s diverticulum?

A

Ectopic mucosa which leads to GI bleeding and inflammation/ obstruction/ intussusception/ perforation

24
Q

What are the three most common predisposing conditions which can lead to intussusception?

A

Meckels, Henoch-schonlein Purpura and Cystic Fibrosis

25
Q

What is the classic triad of symptoms on intussusception?>

A

Intermittent abdo pain, redcurrent jelly stools and vomiting. Pulling knees up to chest in babies is also common

26
Q

What is the method of diagnosis in intussusception?

A

x-ray is used as first line but is insensitive, USS is sensitive but Barium or air enemas are both diagnostic and theraputic in up to 90% of cases

27
Q

What is the definition of a hydrocele?

A

fluid in the scrotum

28
Q

What is the causes of a hydrocele in children?

A

patent processus vaginalis

29
Q

On clinical examination how would you differentiate between a hydrocele and a inguinal hernia?

A

You can ‘get above’ a hydrocele

30
Q

What are the 5 differential diagnoses for a boy with testicular pain?

A 
Testicular torsion
Torsion of the appendage 
Epidydimo-orchitis
Hydrocele (rarely painful)
Ideopathic scrotal odema (usually bilateral rarely painful)
31
Q

In testicular torsion what is the ‘appendage?

A

Hydatid of Morgagni

32
Q

At what age are boys most likely to get testicular torsion?

A

around 1 year old and then between 10 and 15 years old

33
Q

A 5 year old boy presents to ED with scrotal pain, what is the most likely diagnosis?

A

epididymo-orchitis because it peaks at this age

34
Q

A 10 year old boy presents to ED with scrotal pain, what is the most likely diagnosis?

A

Torsion of hydatid of morgagni, because its peak incidence is 10 years old. May also be torsion of testicle

Pediatrics (15 decks)

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