paediatric surgery Flashcards

1
Q

average weight (kg) =

A

2 x (age + 4)

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2
Q

average blood volume (mls) =

A

80mls/kg

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3
Q

average urine output =

A

1ml/kg/hr

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4
Q

insensible fluid loss =

A

20ml/kg/day

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5
Q

avg systolic BP (mmHg) =

A

80 + (2 x age)

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6
Q

the pain barrier

A

if child has pain they must rely on someone to give them it - teacher waits for mum, mum waits for dr etc.

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7
Q

pain management in children

A

WHO pain ladder

paracetamol
ibuprofen
weak opioid (not codeine in <12yrs)
strong opioid

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8
Q

fluid management in children: resuscitation

A

20ml/kg bolus 0.9% sodium chloride

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9
Q

fluid management in children: maintenance

A

0.9% NaCl or 5% dextrose +/- KCl

4ml/kg 1st 10kg
2ml/kg 2nd 10kg
1ml/kg every kg thereafter

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10
Q

sentinel signs

A
feed refusal
bile vomits - green
colour - grey is bad
tone - floppy/hyperrigidity
temperature - warm or cold
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11
Q

appendicitis presenting features

A
pain - mid abdo then localises RLQ
vomiting
diarrhoea
anorexia
fever
raised neutrophils
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12
Q

appendicitis investigations

A

FBC
CRP
USS
CT

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13
Q

apendicitis complications

A

abscess
mass
peritonitis

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14
Q

abdo pain investigations

A

urine - all
FBC - if diagnostic doubt
electrolytes - only if sick/very dry
x-rays - rarely

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15
Q

management of apendicitis

A

analgesia - oral paracetamol

surgery

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16
Q

features of non-specific abdominal pain

A
short duration 
central - periumbilical
constant
not made worse by movement
no Gi disturbance
no temp 
site and severity vary
17
Q

investigation if presents with bilious green vomiting

A

upper GI contrast study asap

18
Q

intussusception

A

prolapse of part of intestine into lumen of adjoining distal part
most often ilio-caecal region
causes intenstinal obsrtuction

19
Q

intussusception features

A

bilious vomiiting
colicky abdo pain
bloody mucous PR - redcurrant jelly stool
pallor
palpable abdo mass
lethargy/irritability between waves of pain

20
Q

USS intussusception

A

target sign

21
Q

intussusception Rx

A

pneumostatic reduction - air enema

laparotomy

22
Q

malrotation and volvulus

A

Malrotation predisposes patients to a risk of midgut volvulus
volvulus have twisting and loss of blood supply

23
Q

malrotation and volvulus features

A

bilious vomitng
abdo pain, distention
normal abdo exam
tachycardia

24
Q

malrotation and volvulus Ix

A

upper GI contrast study

25
malrotation and volvulus Rx
laparotomy asap
26
umbilical hernia
defect of anterior abdominal wall | umbilical rings fails to close
27
umbilical hernia features
umbilical swelling worse when crying easily reducible most close by 4yrs
28
umbilical hernia complications
strangulation incarceration rupture
29
when to repair umbilical hernia
complications persists >4yrs large, aesthetic reasons
30
gastroschisis
abdo wall defect, gut eviscerated and exposed with no protective sac 10% assoc atresia
31
exomphalos
umbilical defect with covered viscera assoc anomalies: cardiac, neurological, renal, trisomy 21