Pedia Surgery

Question 1

Criteria used to stratify neonates who have esophageal atresia and / or tracheoesophageal fistula into prognostic categories based on birth weight, the presence of pneumonia, and the identification of other congenital anomalies.

Answer 1

Waterston Criteria

Question 2

Omphalocele features

Answer 2

1. Remnant of amnion are not absorbed
2. Abdominal organs in the hernia
3. Not covered by membranes
4. Abdominal wall defect in midline

Question 3

Common cause of inguinal hernia in infancy?

Answer 3

Patent processus vaginalis

Question 4

Commonly injured nerve in the surgical closure of PDA.

Answer 4

Recurrent laryngeal nerve

Question 5

Self-limited disease most often confused with acute appendicitis in children?

Answer 5

Acute mesenteric adenitis

Pain is usually diffused , Tenderness is not as sharply localized

Question 6

An 8 yo / M swallowed a one peso coin 3hrs PTC. Plain abd xray is compatible with the foreign body being located at the gastro-duodenal area. As teh attending dr, what will you advice the parents?

Answer 6

Clinical observation

Question 7

A newborn baby girl presents with persistent non-bilous vomiting and failure to thrive. This is clinically suspicious for ________?

Answer 7

Hypertropjic pyloric stenosis

Question 8

Which of the following best describes gastrochisis?

Answer 8

There is no overlying sac

Question 9

Defect in the abdominal wall associated with Beckwith-Weidemann Syndrome

Answer 9

Omphalocele

Question 10

Syndrome of lax lower abdominal musculature , dilated urinary tract , and bilateral undescended testes

Answer 10

Prune belly syndrome

Question 11

Directional mobility of mesenteric cysts?

Answer 11

Lateral

Omental cysts - mobile in all directions

Question 12

Rule of 2’s of Meckels diverticulum

Answer 12

A. 2% of the population
B. 2:1 male predominance
C. 2 feet proximal to ileoceccal valve
D. 1/2 of symptomatic are <2yo
E. 2 types of mucosae ( gastric & pancreatic)
F. 2 inches in length

Remember that the rule of 2 is just a rough guide. For example , the usual distance of Meckels is whithin 100cm from the IVC , not 2 feet.

Question 13

Sign seen in abdominal ultrasound of intussusception where two rings of low echogenicity are separated by a hyperechoic ring.

Answer 13

Donut sign / Target sign

Question 14

Most common and lethal gastrointestinal disorder affecting preterm neonate?

Answer 14

Necrotizing enterocolitis

Question 15

Pertains to Osteonecrosis of the proximal femoral epiphysis of the pediatric hip and is thought to be due to vascular compromise?

Answer 15

Legg Calve Perthes / Cox Plana

Question 16

The most common location of congenital diaphragmatic hernia is ?

Answer 16

Left posterolateral

Bochdalek’s hernia / Congenital Diaphragmatic hernia is common on the left by 80-90% of the cases.

Question 17

Is the caudal displacement of the cerebellar tonsils below the foramen magnum?

Answer 17

Chiari I Malformation

Usually asymptomatic but if with symptoms it may pressent :
- headache , neck pain, symptoms of myelopathy, including numbness or weakness in the extremities

Question 18

More severe and involves caudal displacement of the lower brain stem and stretching of the lower cranial nerves.

Answer 18

Chiari II malformation

Question 19

Beckwith - Weidemann anomalies? (5)

Answer 19

Macrohlossia
Macrosomia
Hypoglycemia
Visceromegaly
Omphalocele

Question 20

Cantrell Pentalogy? (5)

Answer 20

Lower thoracic wall malformation
1. Cleft sternum
2. Ectopia cordis
3. Epigastric omphalocele
4. Ant midline diaphragmatic hernia
5. Cardiac anomalies