Pediatric Surgery Flashcards
What is the treatment of congenital inguinal hernia (usually in males, premature, on R side)?
high ligation of the sac
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T/F: Communicating hydrocele of the testis and congenital inguinal hernia are due to the same defect.
True (failure of the processus vaginalis to fuse, leaving an open communication from the abdomen to the tunica albuginea)! But while the hernia contains abdominal contents, the hydrocele contains only fluid.
T/F: An umbilical hernia is universally present at birth.
True!
How does the difference between adult and pediatric omentum affect the response to appendicitis?
A thickened adult omentum can contain a perforated appendix, creating an abscess. But a young child’s omentum is typically thin and flimxy and perforation usually leads to diffuse peritonitis.
T/F: Barium enema is contraindicated in the presence of peritoneal signs.
True
A confirmatory ultrasound of the abdomen showing pyloric stenosis would evidence a pyloric wall thickness of ___ mm and a channel length of ___ mm
thickness: >3 mm
channel length: >16 mm
What are etiologies of mesenteric adenitits?
Yersinia enterocolitica, Group A streptococcus pharyngitis, IBD, lymphoma. Viral infection is most common.
What is the most appropriate maintenance fluid for young children (age 2ish and under) with normal electrolytes?
D5 1/4 NS because children’s kidneys do not acquire significant ability to concentrate sodium until well after age of 2 years
After a fall in a young child, what is more important: cervical spine films to r/o spine injury or a head CT to r/o hemorrhage?
Head CT! Due to ligamentous flexibility and plasticity of hte cartilaginous infant skeleton, both bony spinal injuries and skull fracture are uncommon.
What is the standard bolus for fluid replacement?
10-20mL/kg
In full term infants, there is increased risk for apneic events in the first 24 hours after general anesthesia until age ___ weeks. In preemies, this risk extends until ___ weeks.
full term: 50 weeks
preemies: 60 weeks
T/F: While follicular adenomas are more common in adult thyroids, a solitary nodule is likely to be a ______ in children.
papillary carcinoma
Since all cryptorchid testicles are accompanied by an inguinal hernia, ______ should always accompany and orchiopexy for cryptorchism.
herniorraphy
What is the treatment of a breast mass in prepubescent girls?
Defer excision until after puberty! Exceedingly rare that it would be cancer
T/F: Children desaturate more quickly when respirations are held.
True–they have higher cardiac indices and a more rapid metabolism
