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Year 3 > Paediatric Surgery > Flashcards

Paediatric Surgery Flashcards

1
Q

formula for child weight

A

kg = 2(age + 4)

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2
Q

child blood volume

A

80ml/kg

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3
Q

child urine output

A

0.5-1ml/kg/hr

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4
Q

child insensible fluid loss

A

20ml/kg/day

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5
Q

child systolic BP

A

80 + (2 x age)

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6
Q

big differences between children and adults

A
  • Communication
  • Signs
  • Disease processes
  • Physiological parameters
  • Expectations
  • Stress
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7
Q

WHO pain ladder in children

A 
• Paracetamol
o 20mg/kg 4-6 hourly
• Ibuprofen
o 10mg/kg 8 hourly
(• Weak opioid
o Codeine not recommended in <12 years)
• Strong opioid
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8
Q

fluid management in children: resus

A

20ml/kg bolus 0.9% NaCl

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9
Q

fluid management in children: maintenance

A

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

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10
Q

sentinel signs in children

A
  • Feed refusal
  • Bile vomits
  • Colour
  • Tone
  • Temperature
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11
Q

abdominal pain in children: Hx pain

A

closer to umbilicus = less chance of pathology
colic vs constant
movement - cars

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12
Q

abdominal pain in children: Hx vomiting

A

increases sig

bile

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13
Q

abdominal pain in children: exam

A

distraction
general appearance
temperature
guarding

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14
Q

abdominal pain in children: investigations

A

urine - all
FBC - only if diagnostic douby
electrolytes - only if sick/very dry
xrays - rarely

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15
Q

abdominal pain in children: basis of management

A

• GP/A+E decision
o Does this child need a surgical opinion?
• Surgical decision
o Does this child need an operation?

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16
Q

Murphy’s triad for appendicitis

A

pain
vomiting
fever

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17
Q

what is McBurney’s pont?

A

one-third of the distance from the anterior superior iliac spine to the umbilicus

18
Q

complications of appendicitis

A

abscess
mass
peritonitis

19
Q

in what age is appendicitis ratre?

A

<4

20
Q

features of non-specific abdominal pain

A
  • Short duration
  • Central
  • Constant
  • Not made worse by movement
  • No GIT disturbance
  • No temperature
  • Site and severity of tenderness vary
  • Girls > boys
  • 45% of admissions
  • Often recurrent
  • Can mimic an early appendicitis
  • Risk of missing appendicitis is 0.2%
21
Q

features of mesenteric adentitis

A

o High temperature
o URTI often
o Not “unwell”

22
Q

pneumonia with abdominal pain in children

A

o Clue “sicker than abdominal signs”

o Usually right lower lobe

23
Q

pyloric stenosis: age and M:F

A

4-16 wks

5:1

24
Q

pyloric stenosis: features

A 
• Non bilious vomiting “projectile”
• Weight loss
• Capillary gas
o Alkalosis, hypochloraemia, hypokalaemia
• Test feed
• IV fluid
o 0.45% N saline / 5% dextrose + KCL
o 0.9% saline for NG loss
25
Q

pyloric stenosis: investigation and treatment

A

US

• Periumbilical pyloromyotomy

26
Q

malrotation: features

A

3 day old with bile vomiting

27
Q

malrotation: diagnosis + treatmenet

A

malrotation and volvulus
• Upper GI contrast study ASAP
• Laparotomy ASAP

28
Q

intussusception: age

A

nine month - 6-23 months

29
Q

intussusception: features

A

3 day Hx of viral illness then intermittent colic and dying spells
bilious vomiting
on admission - 4sec cap refill
redcurrent jelly stool

30
Q

intussusception: inbestigations

A

USS

target sign

31
Q

intussusception: management

A

pneumostatic reduction - air enema

laparotomy

32
Q

gastroschisis: what

A

abdo wall defect

gut eviscerated and exposed

33
Q

gastroschisis: 10% is associated with

A

atressia

34
Q

gastroschisis: management

A

primary/delayed closure

TPN

35
Q

gastroschisis: survival

A

90% +

36
Q

gastroschisis:why may some not survive?

A

short gut

37
Q

exomphaos: what

A

umbilical defect with covered viscera

38
Q

exomphaos: associated anomalies

A

o 25% cardiac
o 25% chromosomal - Trisomy13, 18, 21
o 15% renal, neurological
o Beckwith-Weideman syndrome

39
Q

exomphaos: management

A

primary/delated closure

40
Q

exomphaos: outcome

A

post natal mortality 25%

Year 3 (164 decks)

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