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Pediatrics Flashcards

1
Q

typical length of pylorus channel in infant with pyloric stenosis

A

16 mm

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2
Q

which drug has a “black box” for administration after tonsillectomy and/or adenoidectomy

A

Coedine, for respiratory depression

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3
Q

before you do a pull through for Hirschsprung disease, what do you need to establish

A

level of disease, you need level biopsies

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4
Q

where is the defect in gastroschisis?

A

to the right of the umbilicus

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5
Q

where is the defect in an omphalocele?

A

through umbilicus

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6
Q

features of gastrochisis

A
  • no sac
  • no amnion
  • cardiac and chromosomal abnormalities are rare
  • defect to the right of umbilicus
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7
Q

child born with a defect through abdominal wall with sac covering contents, what is it?

A

omphalocele

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8
Q

what are kids born with gastrochisis at higher risk for?

A

necrotizing enterocolitis

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9
Q

Patient with pectus carinatum does not tolerate compression bracing, what option do you have left?

A

Ravitch procedure

Removal of cartilage causing defect

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10
Q

VACTERL

A

Vertebral
Anorectal
Cardiac
Tracheal
Esophageal
Renal
Limb deformities

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11
Q

how long after a pyloromyotomy would continued vomiting warrant re-evaluation

A

if vomiting persist for a week post-op you should re-eval for incomplete myotomy

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12
Q

when should a child with the RET protoncogene have his prophylactic thyroidectomy?

A

by age 1

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13
Q

2 year old boy undergoing laparoscopic bilateral inguinal hernia repair, you cannot find vas deferens…what should kid be tested for?

A

cystic fibrosis

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14
Q

when would you administer corticosteroids for a surgery on a pregnant woman?

A

gestation weeks 24-34 for intra-abdominal surgeries with possible infectious etiology

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15
Q

what kind of tissue would you expect from a Meckel Diverticulum?

A
  • gastric
  • pancreatic
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16
Q

typical age range for intussusception

A

3 months to 3 years of age

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17
Q

ultrasound findings for intussusception

A
  • target sign
  • pseudo kidney sign longitudinally
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18
Q

examining a 4 year old boy for undescended testicles and in clinic you are able to bring the testicles down into the scrotum…what is this phenomenon called

A

retractile testis

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19
Q

Treatment for retractile testis

A

yearly examinations till puberty

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20
Q

how are pediatric umbilical hernias repaired

A

primarily with slowly absorbable sutures

Allows for repair to grow with child as they age

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21
Q

what metabolic derangement would you expect from pyloric stenosis

A

hypochloremixc, hypokalemic metabolic alkalosis

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22
Q

32 year old female 4 weeks postpartum presents with erythema and tenderness to periareolar left breast. Initial therapy

A

continue breast feeding

  • likely lactational mastitis
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23
Q

steps to a Sistrunk Procedure

A
  • Excise the cyst
  • excise the tract
  • resect the hyoid bone 1 cm to left and right of midline to level of foramen cecum
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24
Q

3 year old boy with an empty scrotum with diagnosis of non-palpable testis. next step

A
  • diagnostic laparoscopy to assess its location
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25
What is the Ravtich procedure?
- removal of cartilage wedged between the ribs and sternum - reshapes and reposition the freed-up sternum
26
Which chest deformity can you use the ravtich procedure on?
both pectus carinatum and excavatum
27
long term complication pattern of diaphragmatic repair survivors
gastrointestinal neurodevelopmental pulmonary
28
diagnostic approach for 12 year old girl with painless blood per rectum...and why
- 99m Tc-pertechnetate radio-isotope scan - this is a Meckel scan and you're suspecting a Meckel Diverticulum with gastric mucosa
29
neonate with an imperforate anus and a bucket handle deformity, what do you do next?
perform primary anoplasty
30
what is a hydrocolpos?
dilated vagina
31
what is cloaca?
single orifice for both excretory and genital products
32
most common incision used to repair a congenital diaphragmatic hernia
subcostal incision, approximately two finger breadths below the subcostal margin
33
what should infants who had an omphalocele or gastroschisis closed be monitored for?
- abdominal compartment syndrome - done by monitor UOP and ventilation requirements
34
What are branchial anomalies associated with
branchial-oto-renal syndrome - ear and kidney issues (should image kidneys)
35
when would you do a segmental resection of small bowel for a Mekel's diverticulum?
- base greater than 2 cm - active inflammation at the base
36
When would it be appropriate to use intra-operative fetal heart tracing if operating on a gravid woman?
at viability ~ 24 weeks of gestation
37
what is the most common abnormality associated with gastrochisis
intestinal atresia
38
child with a midline neck mass that moves up and down with swallowing
thyroglossal duct cyst
39
most common etiology for ileocolic intussusception
hypertrophic lymphoid patches in the terminal ileum
40
what would an US 3 weeks post-op from a pyloromyotomy show in an asx patient?
hypertrophied pylorus even if myotomy was complete
41
what are the treatment options for infants presenting with omphalocele
- primary repair - staged repair - paint and wait technique
42
what is the most common congenital hemostasis mutation?
Von Willebrand's disease
43
how do you test for Von Willebrand Disease
plasma Von Willebrand Disease antigen test
44
first step in a new born with gastrochisis?
placement of a bowel bag up to the midchest
45
A Meckel's diverticulum is a remnant of what fetal structure
Vitellin duct
46
most common solid extra-cranial tumor in children
Neuroblastomas - 85% of abdominal tumors, most present before the age of 2
47
what is the silk glove sign
thickening of the spermatic cord on the side of a hernia, in infants
48
what are indications to delay a surgery in a neonate
- low weight (< 2kg) - major cardiac defect - extreme prematurity
49
benefit of laparoscopic approach to hernia repair in children
easier to identify femoral hernias - length of stay and post op the same between lap and open hernia repairs
50
What would be the next step in a child presenting with a white reflex in their eye
fundus examination, rule out retinoblastoma
51
What lab measure monitors a deficiency in Factor IX
PTT
52
when performing cannulation for ECMO in a kid with CDH, what should the surgeon be aware of
hypoplasia of internal jugular and carotid vessels (pertains to cervical cannulation)
53
what is the maximum pressure used to reduce intussusception with air
120 mmHg
54
Most common reason for incontinence in children after pull-through for Hirschsprung disease
Chronic constipation with overflow of stool
55
how long of a gap would warrant delayed repair in esophageal atresia
1-2 vertebral spaces - most kids will grow enough to bridge that gap in 1-3 months
56
how long of a gap would warrant traction sutures in esophageal atresia
greater than 2 vertebral spaces
57
in which direction do you twist bowel to undo a midgut volvulus
counterclockwise
58
infant with bilious emesis, KUB shows dilated loops of bowel and air fluid levels. Contrast enema shows micro-colon with reflux of contrast into dilated terminal ileum...what does the newborn have
meconium ileus
59
how do you treat meconium ileus in a newborn
- water soluble contrast enemas - resuscitation - successful 2/3 of the time
60
infant with abnormally high direct bilirubin and HIDA scan showing failure of excretion of contrast. What is the next step
Percutaneous needly biopsy of the liver - Could be biliary atresia OR Alagille syndrome
61
What does the 99m-technetium pertechnetate scan have an affinity for?
Gastric mucosa
62
What is involved in a Ladd’s procedure
Lysis of adhesions, counterclockwise reduction of volvulois, appendectomy, widening of mesentery, small bowel on left, colon on right
63
lateral neck mass in a child that expresses fluid, what is the most likely diagnosis
second branchial sinus
64
Type 1 jejunoileal atresia
intact bowel wall and mesentery with a mucosal atresia
65
Type 2 jujunoileal atresia
blind ends separated by a fibrous cord, but with intact mesentery
66
Type 3a jujunoileal atresia
blind end atresia with a V-shaped mesentery defect
67
Type 3b jujunoileal atresia
blind end atresia with large mesentery defect
68
Type 4 jujnoileal atresia
multiple atresias
69
which service should you consult for a child younger than 5 who sustained head trauma
ophthalmology for possible retinal damage
70
Most common cause of significant GI bleed in children
Meckel's diverticulum
71
Most common cause of self limited GI bleed in children
intestinal polyps
72
after laparoscopically reducing intussusception in a 2 year old the bowel looks dusky, what do you do
wait 10-15 minutes to see if bowel appearance improves to avoid resection and anastomosis

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