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Pediatric Surgery > peds > Flashcards

peds Flashcards

1
Q

When does pyloric stenosis typically develop?

A

first few weeks of life (2-12 weeks of age)

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2
Q

Gold standard technique to diagnose pyloric stenosis

A

ultrasound

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3
Q

Complications are known to occur to what systems of the body for CDH?

A

GI, pulmonary, neurodevelopmental complications

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4
Q

Most common abnormality associated with gastroschisis

A

intestinal atresia

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5
Q

Findings on ultrasound for pyloric stenosis:

A

pylorus/pyloric channel length usually 16mm or greater

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6
Q

Diagnostic test for Meckel’s diverticulum:

A

99m Tcpertechnetate radioisotope scan

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7
Q

Males with this genetic disorder are known to sometimes have absence of bilateral vas deferens

A

cystic fibrosis

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8
Q

What treatments/interventions are associated with development of necrotizing enterocolitis?

A

antibiotic use and formula feeding

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9
Q

What lateral sacral ratio is considered normal in anorectal malformations that signifies likely fecal continence?

A

sacral ratio >0.7

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10
Q

True or false. Direct hyperbilirubinemia is always found in infants with biliary atresia

A

True

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11
Q

What type of neuroblastoma is associated with subcutaneous metastases and positive bone marrow for small, round blue cells, and massive hepatomegaly from hepatic metastases?

A

4S disease neuroblastoma; usually spontaneously regresses

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12
Q

In esophageal atresia, primary repair can be achieved when the length (gap) is _____

A

2 vertebral bodies or less

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13
Q

procedure used to resect a thyroglossal duct cyst:

A

Sistrunk procedure; involves excising the tract, cyst, and hyoid bone 1 cm to the left and right of midline up to the level of foramen cecum

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14
Q

Which types of neuroblastoma tend to regress over time and do not require operation?

A

infantile cystic and 4S disease neuroblastoma

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15
Q

Which is more common after NEC, small intestinal strictures or large intestinal strictures?

A

large intestinal strictures

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16
Q

True or false. About a quarter of infants with duodenal atresia have congenital heart disease

A

True

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17
Q

Perforation in the intestine in utero resulting in meconium accumulation in the peritoneal cavity:

A

meconium pseudocyst; tx with ex lap and ostomy or peritoneal drains

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18
Q

Appearance of meconium pseudocyst on imaging:

A

calcified walls surrounding meconium (large cyst with air fluid levels and eggshell calcifications)

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19
Q

Study of choice for children suspected of having malrotation or intermittent midgut volvulus

A

upper GI contrast study

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20
Q

Treatment of prepubescent males with undescended testis

A

orchiopexy

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21
Q

Initial cancer risk for undescended testis and long term risk for undescended testis:

A

initial: gonadoblastoma

long term: seminoma

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22
Q

Most common solid organ intraabdominal malignancy in children:

A

neuroblastoma

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23
Q

Histology of neuroblastoma

A

small round blue cells in rosette formations

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24
Q

treatment of duodenal atresia

A

diamond duodenoduodenostomy

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25
Q

treatment of pectus carinatum:

A

removal of affected costal cartilages and sternal osteostomy with sternal reconstruction (Ravitch procedure)

26
Q

Through what incision are most H type TE fistulas approached?

A

right neck incision; most are located at the level of the thoracic inlet

27
Q

resuscitation regimen for infants:

A

5% dextrose in 0.45% saline with 20mEq/L

28
Q

True or false. Gastroschisis defects usually occur to the right of the umbilicus

A

true

29
Q

True or false. Omphalocele occurs to the right of the umbilicus.

A

false. occurs through the umbilicus

30
Q

most common incision for repair of CDH

A

subcostal

31
Q

Management of midgut volvulus is decompression by rotating the bowel ______

A

counterclockwise

32
Q

Management of violation of duodenal mucosa during pyloromyotomy:

A

repair mucosal defect and place omental patch; alternatively, close the mucosa and the muscle, rotate pylorus 180 degrees and perform a new pyloromyotomy

33
Q

True or false. R0 resection is not mandatory for neuroblastoma

A

true

34
Q

Operative principles of Wilm’s tumor:

A

must palpate renal artery for tumor thrombus; tumor rupture should be avoided as it upstages disease and leads to recurrences; requires lymph node staging; acquired von Willebrand disease can lead to intraop bleeding

35
Q

True or false. Recent evidence suggests there is equivalent risk of rebleeding or continued bleeding for either limited segmental resection or simple diverticulectomy in tx of Meckel’s diverticulum in children

A

true

36
Q

True or false. Abnormal intestinal rotation is seen in all patients with gastroschisis or omphalocele

A

True

37
Q

Electrolyte abnormalities of pyloric stenosis:

A

hypokalemic, hypochloremic metabolic alkalosis

38
Q

How is the pyloromyotomy made for pyloric stenosis?

A

longitudinal incision from serosa/extramucosal of pylorus just proximal to the hypertrophied muscle to just proximal to the pyloric vein; extend onto antrum of stomach

39
Q

What abnormality is associated with difficulty in getting ECMO access in CDH patients?

A

vascular (IJ & carotid) hypoplasia

40
Q

What structure is at risk of injury during high ligation of an inguinal hernia in females?

A

fallopian tube

41
Q

Primary modality of treatment for 3rd and 4th branchial anomaly fistula that can be visualized

A

endoscopic cautery or chemical ablation

42
Q

What amplification in neuroblastoma is associated with a good prognosis?

A

MYCN

43
Q

What amplification in neuroblastoma is associated with a bad prognosis?

A

TrkA

44
Q

What is secondary to failure of closure of the pleuroperitoneal canal?

A

congenital diaphragmatic hernia
posterolateral - Bochdalek type (most common)
anteromedial - Morgagni type; less common

45
Q

Nonfunctional pulmonary tissue fed by an anomalous systemic arterial supply with no connection to the tracheobronchial tree:

A

bronchopulmonary sequestration

46
Q

Abnormality due to poorly developed alveoli structure resulting in recurrent infections and respiratory compromise:

A

congenital cystic adenomatoid malformation

47
Q

Failure in development of bronchus cartilage resulting in air trapping with expiration

A

congenital lobar emphysema

48
Q

True or false. Hirschsprung disease can present in later childhood with chronic constipation after weaning from breastmilk in short segment disease

A

true

49
Q

treatment of hepatoblastoma:

A

surgical resection upfront is mainstay followed by chemo; if unresectable/metastatic, give chemo upfront to decrease size

50
Q

Most undescended testes resolve spontaneously in the first ____ of life

A

6 months

51
Q

where do lymph nodes need to be biopsied for Wilm’s tumor:

A

renal hilum, vena cava, and aorta

52
Q

Drug of choice for PDA

A

indomethacin

53
Q

Standard operation for biliary atresia:

A

Roux en Y hepatic portoenterostomy (Kasai procedure)

54
Q

most common location for undescended testes

A

superficial inguinal ring

55
Q

temporizing measures for infants born with transposition of great vessels:

A

IV prostaglandin E1 to maintain PDA and then balloon atrial septostomy

56
Q

incomplete recanalization of the duodenum during 8-10 weeks gestation resulting in persistent membranous structure in the lumen of the duodenum that appears like a windsock

A

duodenal web

57
Q

Diagnosis and tx of duodenal web

A

UGI with barium; tx with duodenotomy and excision of web

58
Q

complete failure of duodenum to recanalize

A

duodenal atresia; bilious atresia, double bubble on radiograph

59
Q

True or false. There is no consensus on the indications for lap chole in children with biliary dyskinesia

A

true

60
Q

True or false. All button battery ingestions should be removed (even gastric)

A

true

61
Q

True or false. Incidentally discovered malrotation must be surgically managed.

A

true

62
Q

Steps of Ladd’s procedure:

A 
untwisting of volvulized bowel
release of cecal bands
broaden the small bowel mesentery 
incidental appy
place small bowel to right and colon to the left

Pediatric Surgery (1 decks)

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