PEDIATRIC SURGERY Flashcards

1
Q

Congenital diaphragmatic hernia

A

Always on the left

Worry about the hypoplastic lung - wait 3-4 days for lung maturation

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2
Q

Gastroschisis vs omphalocele

A

Gastroischisis - cord is normal and defect is to the right of the cord

Omphalocele - cord goes into the defect

Slowly push abdominal contents back in… Takes about a week
Need TPN for a month because the bowel is angry

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3
Q

Malrotation

A

Green vomiting
Double bubble on X-ray

Bowel can twist on itself and cut off the blood supply and die

Diagnose with:
Contrast enema (safe but not always diagnostic)
Upper GI study (more reliable but unsafe)

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4
Q

Necrotizing enterocolitis

A

Premature infants at first feeding

Feeding intolerance
Abdominal distention
Rapidly dropping platelet count

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5
Q

Meconium ileus

A

Firstborn boys at 3 weeks old
Non bilious projectile vomiting

Visible gastric peristaltic waves
Palpable olive

Diagnose with US

Treat with rehydration and fix hypochloremic hypokalemic metabolic alkalosis then surgery (Ramstedt pyloromyotomy)

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6
Q

Biliary atresia

A

6-8 weeks old
Progressive jaundice

Try to stimulate bile production with one week of phenobarbital

If it doesn’t work you need surgery and eventually a liver transplant

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7
Q

Diagnosis of hirschsprung

A

Full thickness rectal mucosa biopsy

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8
Q

Intussusception

A

6-12 months

Colicky abdominal pain that makes them double up and squat

Vague mass on right side of abdomen
Empty RLQ
Currant jelly stools

Barium or air enema

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9
Q

Pediatric abdominal mass that moves up and down with respiration

A

Malignant liver tumor - hepatoblastoma or hepatocellular carcinoma

Alpha fetoprotein will be elevated

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10
Q

Pediatric abdominal mass that is deeper and doesn’t move

A

Wilms tumor - comes from the kidney

Neuroblastoma - comes from adrenal

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