Pretest Peds

Question 1

Imperforate anus (two classification and basis)

Answer 1

• High or low

- Above or below the level of levator ani complex

Question 2

Which type of imperforate anus is more likely to result in continence?

Answer 2

Low/below levator ani muscles

Question 3

Hirschsprung disease (mgmt)

Answer 3

• Initially, colostomy decompression

- Surgical repair after delay

Question 4

Which midline abdominal defect closes spontaneously in children and when?

Answer 4

• Umbilical hernia

- 4yo

Question 5

Patent urachus vs patent vitelline (omphalomesenteric) ducts

Answer 5

• Urachus: imcomplete closure form bladder to abdominal wall

- Omphalomesenteric duct: ileum to abdominal wall

Question 6

Patent urachus, patent omphalomesenteric ducts (tx)

Answer 6

Excision of tracts and closure

Question 7

Imperforate anus (complication)

Answer 7

Incontinence

Question 8

Intestinal atresia (mgmt)

Answer 8

Resection and primary anastomosis

Question 9

Obstruction 2/2 annular pancreas (tx)

Answer 9

Bypass procedure (eg, duodenoduodenostomy)

Question 10

MC type of intussusception

Answer 10

Ileocolic

Question 11

Meckel diverticulum (mgmt)

Answer 11

Remove if symptomatic or discovered during appendectomy

Question 12

Omphalocele membrane (components)

Answer 12

Peritoneum on the inside, amnion on the outside

Question 13

What should the workup include in pts w/ omphalocele?

Answer 13

Karyotype (tri 13, 18, 21)

Question 14

Midgut volvulus (etiology)

Answer 14

Malrotation = abnormal intestinal rotation and fixation

Question 15

What happens when the gut return into the abdomen by the 10th wk of gestation

Answer 15

Rotates counterclockwise 270*, place ligament of Treitz in LUQ, and cecum in RLQ

Question 16

MC cause of short gut syndrome in children

Answer 16

NEC

Question 17

Most important risk factor in NEC

Answer 17

Prematurity

Question 18

NEC complication after medical/surgical therapy

Answer 18

Intestinal strictures

Question 19

Mgmt of meconium ileus, if first line tx fails

Answer 19

Surgery: enterotomy

Question 20

Delay in dx of biliary atresia (complication)

Answer 20

Irreversible fibrosis of liver

Question 21

Biliary atresia (pathology)

Answer 21

Progressive obliteration of extrahepatic and intrahepatic bile ducts

Question 22

Biliary atresia (surgical procedure)

Answer 22

Kasai hepatoportoenterostomy

Question 23

Which organ herniates in congential diaphragmatic hernias?

Answer 23

Any abdominal organ

Question 24

With what two other cardiac conditions is aortic coarctation associated?

Answer 24

VSD and aortic stenosis

Question 25

Under what circumstances is surgery indicated for VSDs? (x3)

Answer 25

• CHF
• Rising pulmonary vascular resistance
• Not closed by 5yo