Peds

Question 1

Indication for surgery after peds pt noted with EDH

Answer 1

> 1.5cm thickness
0.5cm midline shift

2/2 middle meningeal artery injury

Question 2

Indication for surgery after pt noted with SDH

Answer 2

> 1cm thickness
0.5cm midline shift

2/2 bridging vein injury

Question 3

Indication for surgery after pt noted with IPH

Answer 3

large clot causing mass effect

>0.5cm midline shift

Question 4

Tracheoesophageal fistula repair complications

Answer 4

Anastomotic leak is common. Majority heal spontaneously. Tx: NPO Abx

Stricture (~40%). Tx: serial dilations.

Recurrent TEF in ~10%

Question 5

Noncommunicating hydroceles

Answer 5

delayed fluid absorption or abnormal fluid dynamics

Resolve spontaneously during infancy

Question 6

Communicating hydroceles

Answer 6

Patent processus vaginalis that contains peritoneal fluid
Increase in size during the day/when upright, decrease in size overnight
Period of obs for 1 year, elective repair

Question 7

Indirect inguinal hernia

Answer 7

Patent processus vaginalis that contains peritoneal fluid, bowel, momentum, gonads, other other abd contents
Inguinal hernia repair w/in a few weeks of Dx

Question 8

Hydrocele of spermatic cord

Answer 8

Fluid w/in segment of processus vaginalis with the canal obliterated proximally and distally
Usually spontaneously resolves

Question 9

Difference between esophageal atresia w/out TEF and esophageal atresia w/ TEF

Answer 9

Gas is present in GI tract below diaphragm w/ TEF

Question 10

MC type of esophageal atresia

Answer 10

EA + distal TEF

Question 11

Earliest indicator of shock in kid

Answer 11

Tachycardia

Question 12

Blood loss to produce tachycardia in kid

Answer 12

> 30%

Question 13

Resuscitation for kid with hypotension and tachycardia (shock)

Answer 13

1) bolus 20mL/kg of crystalloid
2) repeat crystalloid bolus
3) If not responsive to fluids -> blood; 10mL/kg

Question 14

Bilious emesis, distended abdomen, mutation in CFTR gene

Answer 14

Meconium ileus

MI is often first sign of cystic fibrosis

Question 15

Causes of intussusception in kids

Answer 15

idiopathic: Peter’s patches after viral illness
pathologic: meckel’s diverticulum (MC), bowel duplications, polyps, tumors (lymphoma), hematoma

Risk of intussusception d/t pathologic lead point increases with age. 3% in infants, 30% in kids > 5yo

Question 16

4 yo w/ esophageal varices, GI bleeding, splenomegaly, CT showing portal vein thrombosis. What is source?

Answer 16

In patients that were in ICU as baby, likely used umbilical vein as a target for IV access -> umbilical vein infection -> portal vein thrombosis