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Peds Flashcards

1
Q

Todani classification of choledochal cysts;

A
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2
Q

MC primary malignant liver tumor in children?

A

Hepatoblastoma

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3
Q

TOF;

A
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4
Q

WAGR syndrome:

A

Wilms
Aniridia
Genito-urinary abnormalities
Mental retardation

2/2 deletion of short arm of chromosome 11

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5
Q

Tx for omental/mesenteric cysts?

A

Resect

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6
Q

Double bubble sign, maternal polyhydramnios, projectile vomiting; what does this baby have?

A

Duodenal atresia

1/3 of pts have Down syndrome

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7
Q

After a pyloromyotomy for hypertrophic pyloric stenosis, why do we perform a leak test?

A

To make sure no mucosal injury present and assess potency of pyloric channel

If mucosal injury is present, repair with absorbable suture, with an omental patch on top

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8
Q

2nd most common pediatric solid tumor and tx?

A

Neuroblastoma

Typically surgery

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9
Q

3 approaches to treat Hirschsprung disease:

A

Swenson
Soave
Duhammel

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10
Q

Swenson procedure to HD?

A

Pull through procedure

Aganglionic segment is resected and an end-to-end anastomosis to rectum is created

Has high risk of anastomotic stricture

Requires pelvic dissection, can lead to damage to pelvic tissues/organs

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11
Q

Soave procedure for HD?

A

Meant to avoid the extensive pelvic dissection seen with a Swenson

Removes mucosa and submucosa of rectum

Proximal bowel is attached to a cuff of rectal muscle

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12
Q

Duhammel procedure for HD>?

A

Normal proximal bowel is brought down retro-rectally and attached to the rectum in an end-to-side fashion
This creates a large anastomosis with low risk for stricture

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13
Q

Tx for type III choledochoceles?

A

ERCP + sphincterotomy

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14
Q

WAGR syndrome?

A

Deletion of short arm of chromosome 11

Wilms tumor
Aniridia
GU abnormalities
Mental retardation

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15
Q

TOF?

A

Overriding aorta
VSD
RV outflow tract obstruction
RV hypertrophy

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16
Q

Steps of a Ladds procedure;

A

Detorse volvulized bowel (counter clockwise fashion)
Cut Ladd bands before peritoneum and cecum
Appendectomy
Colon re-oriented to pts left abdomen, small bowel to patient’s right abdomen

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17
Q

Tx for pediatric hepatoblastoma after 4 cycles of chemotherapy?

A

Liver tx

4 cycles is max

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18
Q

Pulm sequestrations?

A

Extralobar vs intralobar; both tend to be found more on the left side of

Usually have no communication with bronchial tree and arterial supply is from systemic circulation

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19
Q

Palpable flank mass, sxs of diarrhea, HTN, ataxia?

A

Neuroblastoma; most common solid organ tumor in kids

Work up shows elevated catecholamines and metanephrines

> 1 y/o, n-myc LDH, NSH—-> all portend a poor prognosis

20
Q

Loops of matted intestine protruding to the right of the umbilicus with a fibrous peel:

A

Gastroschisis

21
Q

What are some other anomalies associated with gastroschisis?

A

GI anomalies likes intestinal atresia

22
Q

Failure of lateral body folds to fuse, always at umbilicus;

A

Omphalocele

Assc w/ other genetic anomalies

23
Q

Tx for duodenal atresia?

A

Duodenoduodenostomy

24
Q

Cause of TEF?

A

Development problems during 4th week of gestation

25
Q

HD caused by mutation of what?

A

RET proto-oncogenes

26
Q

Diagnostic measurements of pyloric stenosis on US:

A

Pi; 3.14

3 mm pyloric muscle thickness

15-17 mm longitudinal length

27
Q

Most common congenital anomaly of GI tract:

A

Meckels

True diverticulum

28
Q

Tx for biliary atresia?

A

Kauai hepatoportoenterostomy

29
Q

Wilms tumor;

A

Typically 3-5 years old
Palpable flank mass

30
Q

How do we diagnose pancreas divisum ?

A

Secretin enhanced MRCP

31
Q

Minimum requirements on US for HPS?

A

Minimal thickness of 3 mm

Minimal length of 15 mm

32
Q

Type A TEF?

A

Esophageal atresia, with NO TEF

See a gasless abdomen; babies vomiting after feeds

2nd MC type after type C

33
Q

Type C TEF?

A

Esophageal atresia with distal TEF

MC TEF

34
Q

Bochdalek hernia;

A

Usually left side

35
Q

VACTERL;

A

Vertebral
Anal
Cardiac
TEF
Renal/Radial bone
Limb defects

36
Q

Anteromedial congenital diaphragmatic hernia?

A

Morgnagni

37
Q

Incomplete closure of umbilicus at anterior abd wall during embryogenesis?

A

Omphalocele

38
Q

Operation of choice for Wilms tumor?

A

Radial nephroureterectomy

Ligate artery first

Take ureter close to bladder

Sample nodes aortocavally and renal hilum

39
Q

Doing a pyloromyotomy; when do you know you’re complete?

A

When you see mucosa/submucosa protruding thru the incision

40
Q

Fluids for burns in kids:

A

> 14 y/o; 2 cc x KG x %TBSA

<14 y/o; 3 cc x kg x % TBSA

Infants/young children <30 kg; 3 cc x kg x %TBS + D5LR @ maintenance

Electrical burns; 4 cc x kg x %TBSA

41
Q

MC gene mutation seen in Hirschsprung dx?

A

RET

42
Q

Long segment Hirschsprung dx pts have mutation of RET gene; what other anomaly should we screen for?

A

Medullary thyroid Ca; assc with MEN 2 syndrome

43
Q

What drug can be used to close a PDA?

A

Indomethacin

44
Q

Ductus arteriosus;

A

Connection between aorta and pulmonary artery; normal during development

Rise in oxygen tension, decrease pulmonary resistance, and decrease PGs levels force the DA to close

Failure to close results in PDA and a left to right shunt

45
Q

Pathology of biliary atresia shows what?

A

Bile ductular proliferation
See bile stasis, periportal inflammation, giant cells, fibrosis

46
Q

Testes that have not descended after 6 months?

A

Need surgery; unlikely to descend on their own after 6 months

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