pestana: pediatric Flashcards
esophageal atresia presentation
excessive salivation and choking spells after birth
most common type of esophageal atresia
blind pouch of upper esophagus
lower esophagus fistula to tracheobronchial tree
manage esophageal atresia
rule out other VACTER anomalies: anus, CXR, echo, US (renal)
surgical repair. gastrostomy to protect lungs
manage imperforate anus
if fistula present: delay repairing until further growth
if no fistula: make colostomy if high pouch or repair if low pouch
congenital diaphragmatic hernia always on right or left
left
manage congenital diaphragmatic hernia
wait 3-4 days for repair to allow lungs to mature
meanwhile: intubation, ventilation, sedation, NG suction
gastroschisis vs omaphalocele presentation
g: defect to the right of a nl cord, no protective membrane, angry bowel
o: cord goes to defect, protective membrane, nl bowel
manage gastroschisis and omaphalocele
large defects need siliastic “silo” to protect bowel, gradual over week squeezed into belly.
wont work for a month so need parenteral nutrition
extrosphy of the urinary bladder management
repair within first 1-2 days
extrosphy of the urinary presentation
abdominal wall defect over pubis
red bladder mucosa, wet shining with urine
malrotation diagnosed how
contrast enema or upper GI study
differential for green vomiting and a “double bubble”
duodenal atresia
annular pancreas
malrotation
intestinal atresia cause and effect
vascular accident in utero–> multiple air fluid levels of atresia areas
necrotizing enterocolitis presentation
premature infants
feeding intolerance, distention, low platelets (sepsis)
treat necrotizing enterocolitis
stop feeding
broad spec abx
IVF, IV nutrition
surgery if air present
what is this: x rays should multiple dilated loops of small bowel and ground glass appearance in lower abdomen
meconium ileus
meconium ileus presentation
CF baby
feeding intolerance, bilous vomiting
diagnosing meconium ileus
gastrograffin enema- also therapeutic
pyloric stenosis vomiting- bilous or non bilous?
non bilous
biliary atresia presentation
6-8 week old baby
persistent progressive jaundice- conjugated bili
manage/diagnose biliary atresia
- r/o with sweat test
- HIDA scan after phenobarbital
- surgical ex
cardinal symptom of hirschspring
constipation
intussusception presentation (age and symp)
age: 6-12 months
symp: 1 minute episodes of colicky abdominal pain, making them squat
undescended testicle management
orchiopexy
what is this: testicle in the canal at birth, but can be easily pulled down where it belongs
overactive cremasteric muscle
mass presentation in malignant liver tumor in kid vs wilms tumor/neuroblastoma
liver: mass moves with respiration, AFP elevated
wilms/neuroblastoma: deep and nonmobile mass
