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Paediatrics > Surgery > Flashcards

Surgery Flashcards

1
Q

What is the daily fluid requirement for neonates?

A

150ml/kg/day

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2
Q

What is the most common maintenance fluid given to children?

A

0.45% saline/5% dextrose

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3
Q

What fluid and what volume is given in paediatric resuscitation?

A

10ml/kg of 0.9% saline

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4
Q

After which volume of resuscitation fluids with no response from the child should a surgeon/ITU be contacted?

A

40ml/kg

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5
Q

Give 4 important questions to ask when a baby presents with vomiting

A
  • Is it bilious vomit? (fairy liquid green)
  • Projectile?
  • Feeding?
  • Weight gain?
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6
Q

Give 4 causes of non-bilious vomiting in a baby

A

Overfeeding

Possetting

GORD

Pyloric stenosis

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7
Q

At which age and gender is pyloric stenosis likely to occur?

A

2-6 weeks

Male

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8
Q

Give 3 features in a pyloric stenosis history

A

Acute weight loss

Vomit after feeds

Hungry baby

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9
Q

Give 3 clinical features of pyloric stenosis

A

Dehydration

Hypokalaemia

Metabolic acidosis

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10
Q

Which 2 methods can diagnose pyloric stenosis?

A

Test feed (visible peristalsis and ‘olive’ mass)

USS

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11
Q

What is the Tx of pyloric stenosis?

A

Correct electrolytes with IV fluids

Surgery

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12
Q

Give 4 causes of bilious vomiting in a baby

A
  • Malrotation
  • NEC
  • Atresia
  • Hirschsprung’s
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13
Q

How does malrotation occur?

A

Failure of intestinal fixation at 4-12 weeks gestation =

narrow midgut mesentery liable to twist

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14
Q

How is malrotation diagnosed?

A

Barium contrast studies

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15
Q

How is malrotation treated?

A

Resuscitation then early laparotomy

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16
Q

What is necrotising enterocolitis?

A

Acute inflammatory disease in intestines of premature babies

17
Q

Give 4 features of NEC

A

o Abdominal distension
o Blood in stool
o Feeding intolerance
o Vomiting

18
Q

How is NEC treated?

A

Stop feeds
IV Fluids/ABX

Severe: resection + stoma

19
Q

What is atresia of intestine?

A

Congenital, narrowed/absent segment of intestine commonly in jejunum/ileum

20
Q

What is Hirschsprung’s disease?

A

Congenital ganglionic megacolon starting at anus and progressing upwards

21
Q

Give 3 features of Hirschsprung’s disease

A

Delayed meconium

Distension

FTT

22
Q

Give 4 key questions in an acute abdomen history

A
  • Pain using SOCRATES
  • Urinary/bowel symptoms
  • Last menstrual period in girls
  • Last meal
23
Q

Give 5 differentials for an acute abdomen

A
  • Acute appendicitis
  • Mesenteric adenitis
  • Constipation
  • Gastroenteritis
  • UTI
24
Q

What is intussusception?

A

Full thickness invagination of proximal bowel into distal intestine, commonly ileo-colic

25
Q

What is the triad of intussusception?

A

Severe intermittent abdominal pain

Redcurrant jelly stools

Vomiting

26
Q

Give 3 risk factors for inguinal hernias

A

Male
Premature
Low birth weight

27
Q

How are inguinal hernias managed?

A

Elective surgery soon after diagnosis

28
Q

What is a hydrocele?

A

Fluid in scrotum due to patent processus vaginalis

29
Q

Give 3 features of a hydrocele on examination

A

Swollen

Translluminates

Can’t get above it

30
Q

When should undescended testes be operated on?

A

3-6 months and no later than 1st birthday

31
Q

Give 4 differentials for an acute scrotum

A
  1. Testicular torsion
  2. Torsion of appendage
  3. Epidydimo-orchitis
  4. Hydrocele (rarely painful)
32
Q

Give 5 key questions to ask in head trauma

A
  • How did it happen?
  • Vomiting?
  • Loss of consciousness or post traumatic amnesia?
  • Any other injuries?
  • Does the story fit (NAI)?
33
Q

Give 3 indications for a child with a head injury to have.a CT

A
  • Witnessed LOC >5 minutes
  • Abnormal drowsiness
  • 3 or more discrete episodes of vomiting

Paediatrics (18 decks)

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