Pediatrics

Question 1

__ % of the population will get appendicitis
Peak age range

Answer 1

10
10-18

Question 2

main intuss cause
3 others
peak age in kids`

Answer 2

Peyers
meckels, tumor, duplication
10m

Question 3

50% of cases of malrotation volvulus occur before

Answer 3

1m

Question 4

obstruction pain type

Answer 4

colic

Question 5

peds LGIB ddg

Answer 5

milk allergy, hirch, intuss, infect, ibd, meckels

Question 6

2 clinically significant GI polyps for peds

Answer 6

solitary juvenile hamartomatous (90%)

aden polyps—- FAP

Question 7

MCC of LGIB in children after infancy

Answer 7

polyps

Question 8

4 peds LGIB situations requiring intervention surgically

Answer 8

malro, meckels, intuss(multiple failed enemas), nec entero with free air

Question 9

pathophys progression of intuss, complication?

Answer 9

venous obstruction, art obst, ishemia

Question 10

currant jelly stool?

Answer 10

intuss

Question 11

GS for intuss imaging

obsolete modality?

Answer 11

u/s with dopplar

contrast enema

Question 12

intuss preferred tx

success rate?

Answer 12

air enema
80%

Question 13

down side to auto appy for any peds exploration

Answer 13

inc cost, inc LOS and inc post op bowel obst

Question 14

MC TEF

Answer 14

Esoph atresia w/ distal TEF

Question 15

TEF associated abnormalities

Answer 15

Question 16

VACTERYL needs these 4 imaging evals

Answer 16

renal us, spinal us, echo, babygram

Question 17

Why is an assoc TEF with esoph atresia better than not

Answer 17

can have single stage repair

Question 18

Which side is a TEF repair approached

Answer 18

right thoracotomy

Question 19

Describe TEF repair

Answer 19

A right thoracotomy approach is made because the aortic arch is usually left-sided.
The incision is made at the fourth intercostal space.
Extrapleural dissection is used to gain access to the posterior mediastinum.
The azygous vein is ligated.
The distal fistula is identified at its insertion into the trachea and transected.
The tracheal opening is closed with interrupted sutures.
The upper pouch is mobilized from the thoracic inlet and anastomosed to the lower pouch using interrupted sutures.
Minimally invasive techniques of repair with thoracoscopy are being increasingly applied

Question 20

most important preop eval before esoph atresia / TEF surgery

Answer 20

echo

Question 21

What is a cloaca

Answer 21

malformation of urethra, rectum and vagina

Question 22

10% of hirschsprung patients have _____ or _____

Answer 22

trisomy 21; family hx

Question 23

what is a typical occurence for hisrch

Answer 23

no meconium for 48h

Question 24

no meconium for 48h think….

Answer 24

HSD

Question 25

first step in work up for hirsch

Answer 25

contrast enema then rectal bx if needed

Question 26

bx features of HSD

Answer 26

Absence of ganglion cells
Presence of hypertrophic nerves
Abnormal pattern of cholinesterase staining
Absence of calretinin staining

Question 27

What is the distance cutoff for esoph atresia primary delayed repair

if longer?

Answer 27

2 vert bodies or less

traction sutures

Question 28

What is the next intervention for end ileostomy stenosis when they fail lax and softeners

Answer 28

local revision and maturation

Question 29

treatment for small duodenal mucosal perforation during pyloromyotomy for child

Answer 29

sew SM and cover with patch