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COMAT - Surgery > Pediatric Part 1 > Flashcards

Pediatric Part 1 Flashcards

1
Q

If you suspect a TE fistula, what diagnostic should you obtain?

A

NG tube placement + X-ray

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2
Q

What will be seen on X-ray after NG tube placement if a TE fistula is present?

A

NG tube coils in the blind esophagus

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3
Q

What diagnostic measure should be obtained when an imperforate anus is present?

A

Cross table X-ray

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4
Q

What are the 2 treatment options for an imperforate anus?

A
  1. Surgery
  2. Colostomy until surgery later in life
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5
Q

TE fistulas and imperforate anus are part of what group of abnormalities?

A

VACTERL
- Vertebral
- Anal
- Cardiac
- Tracheal
- Esophageal
- Renal
- Limb

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6
Q

Describe what will be seen with Gastroschisis?

A

Bowel herniates to RIGHT of midline on the anterior abdomen and it is NOT covered by membrane

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7
Q

Describe what will be seen with an Omphalocele?

A

Bowel herniates at midline on the anterior abdomen and it IS covered by membrane

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8
Q

What is a treatment option for both Gastroschosis and Omphaloceles?

A

Silo bag to reduce the bowel back into the abdomen

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9
Q

What condition may look similar to Gastroschisis or Omphalocele?

A

Extrophy of the Bladder

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10
Q

Describe what will be seen with Extrophy of the Bladder?

A

Red, Wet and Shining bladder that has herniated at midline of the anterior abdomen

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11
Q

Bowel herniates into the chest with Congenital Diaphragmatic Hernias. What signs will be present?

A

Scaphoid abdomen
Bowel sounds in the chest
+/- pulmonary hypoplasia = respiratory distress

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12
Q

What diagnostic test will confirm Congenital Diaphragmatic Hernias?

A

X-ray shows bowel in the chest

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13
Q

What other measures may need to be done if respiratory distress is present with Congenital Diaphragmatic Hernias?

A

Intubation + Surfactant administration

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14
Q

If Biliary Emesis is present, that means the problem is where?

A

Distal to where the gallbladder drains into the duodenum

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15
Q

What 2 conditions can present with “double bubbles” on xray?

A

Duodenal atresia
Annular pancreas

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16
Q

What condition will present with a “triple bubble” on xray? What caused this condition?

A

Jejunal atresia
– Mother used cocaine while pregnant which caused infarction/vasoconstriction of blood supply to intestines

17
Q

Duodenal/Jejunal Atresia and Annular pancreas will both present how?

A

Biliary emesis

18
Q

If a preemie has a bloody bowel movement, what should you be considered about?

A

Necrotizing Enterocolitis

19
Q

What will be seen on X-ray with Necrotizing Enterocolitis?

A

Pneumatosis Intestinalis = air in the bowel wall

20
Q

What is the treatment for Necrotizing Enterocolitis?

A

NPO, TPN, IVF, Antibiotics and resection of dead bowel

21
Q

A meconium plug often occurs in CF infants. What is the diagnostic and therapeutic measure?

A

Water-soluble contrast enema

22
Q

What may be seen on X-ray if a CF infant has a meconium plug?

A

Gas filled plug

23
Q

What causes Hirschsprung’s Disease?

A

Failure of inhibitory neurons to migrate to the distal colon

24
Q

What will be absent from the distal colon with Hirschsprung’s Disease?

A
  • Myenteric plexus
  • Auerbach plexus
  • Peristalsis
  • Colonic relaxation
25
Q

The distal colon is unable to relax/aperistaltic with Hirschsprung’s Disease. How may that present in a newborn or toddler?

A

Newborn = failure to pass meconium
Toddler = overflow incontinence

26
Q

What is the best diagnostic test for Hirschsprung’s Disease?

A

Biopsy

27
Q

What will be seen on X-ray with Hirschsprung’s?

A

Narrowed distal colon

28
Q

What signs/symptoms will be present with Intussusception? (3)

A
  • Episodic abdominal pain that is relieved by being in the fetal position
  • Currant jelly stool
  • Sausage shaped mass
29
Q

What test is diagnostic and therapeutic for Intussusception?

A

Air contrast enema

30
Q

What signs/symptoms will be present with Pyloric Stenosis?

A
  • Projectile vomiting
  • Visible peristalsis
  • Olive shaped mass
31
Q

What diagnostic test should be done for Pyloric stenosis and what will you see?

A

Abdominal US
= Donut sign

32
Q

What should you do before proceeding with a pyloromyotomy?

A

Correct the electrolyte disturbances

33
Q

What electrolyte disturbances are often present with pyloric stenosis?

A

Hypokalemic Hypochloremic Metabolic Alkalosis
– From the persistent vomiting

34
Q

What is Biliary Atresia?

A

Absent biliary tree

35
Q

What is a sign of Biliary Atresia?

A

Worsening direct hyperbilirubinemia

36
Q

How is Biliary Atresia diagnosed?

A

Phenobarbital HIDA scan

37
Q

What is the presentation of Choanal Atresia?

A

Baby turns blue when feeding because they are unable to breathe through their nose
– corrects when not feeding

38
Q

What is diagnostic of choanal atresia?

A

Catheter unable to pass through the nares

COMAT - Surgery (13 decks)

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