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Y5 Paeds > Surgery > Flashcards

Surgery Flashcards

1
Q

What is congenital diaphragmatic hernia

A

Bowels with bowel gas above the diaphragm, pushing heart to side

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2
Q

What is oesophagael atreasia

A

Stricture of oesophagus or joining of oesophagus to trachea

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3
Q

XR sign of duodenal atresia

A

Double bubble

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4
Q

What is duodenal atresia associated with

A

Downs

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5
Q

What causes SB atresia

A

Hypoxia in utero

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6
Q

what is meconium ileus

A

xs mucous causing sticky meconium

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7
Q

assoication with meconium ileus

A

CF

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8
Q

2 types of anorectal anomalies

A

High - ectopic faecal-urinary pathway
Low

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9
Q

What is gastroschisis

A

Defect under umbilicus where bowel is extruded out of body
Picked up on 20 week scan

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10
Q

What is exomphalos

A

Similar to gastroschisis but assoicated with trisomys/other syndromes

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11
Q

what is bladder extrophy

A

bladder is open on abdominal wall
Small, splayed open penis
anterior ectopic anus

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12
Q

What is NEC

A

Intramural gas
Patchy necrosis of bowel

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13
Q

2 types of interesting vomitting to surgeons

A

Projectile (2 to 6 weeks)
Green - bile

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14
Q

Is projectile vomitting common?

A

YES - all children will have it, but they dont mean proper projectile, which would not go down the childs front, but hit the wall

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15
Q

Dx of pyloric stenosis

A

USS

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16
Q

PC of pyloric stenosis

A

Projectile vomitting
Hungry
Dehydrated

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17
Q

Electrolyte imbalance in pyloric stenosis

A

Hypocholoraemic alkalosis

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18
Q

What age group gets pyloric stenosis

A

2-6 weeks

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19
Q

What is malrotation

A

duodenum is fixed to abdominal wall, causing short mesentery which causes DJ flexure to be very high. Causes small bowel to twist on itself

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20
Q

what does a dark green vomit indicate

A

malrotation

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21
Q

when does malrotation surgery need to be done

A

within 4-6 hours

22
Q

3 months to 2 year old baby with sudden colicky pain. Dx?

A

Intususception

23
Q

pathognomonic late sign of intussusception

A

red currant jelly stool

24
Q

XR sign of intussusception

A

dilated small bowel loops

25
Q

Dx of intussusception

A

USS

26
Q

Mx of intussusception

A

IV ABx
80% Air enema - CO2 per rectum under measured pressures to push bowel back
20% need

27
Q

what is intussusception

A

invaginated ileum (telescopes into itself)

28
Q

what chronic abdo pain would you worry about

A

Persistent / recurrent pain that interferes with school
Non central abdo pain - H/Pylori etc

29
Q

What inguinal lumps need urgent surgery

A

under 2 years old and painful ones

30
Q

what inguinal lumps are non urgent

A

reducible hernia (the majority)
old than 2 years old
empty scrotum

31
Q

when do you operate on undescended testes

A

by 2 years of age

32
Q

what is the risk of undescended testes

A

poor fertility
increased risk of malignancy (3-11x increase risk, up to 25% if intrabdominal)
cosmetic appearance

33
Q

Ix of undescended testes

A

Laparoscopy
better than USS (can’t see) or MRI (needs GA)

34
Q

how long do you have to operate on testicular torsion

A

4-6 hours

35
Q

age peaks of torsion

A

neonates
pubertal

36
Q

PC of testicular torsion

A

RIF pain
hemiscrotum red
whole scrotum hard and tender

37
Q

Dx of epididimorchitis

A

surgery - can’t clinically tell from torsion

38
Q

non urgent scrotal conditions

A

infantile hydrocele
painless lumps - epidymal cysts
varicocele

39
Q

describe natural history of foreskin

A

starts as narrow opening of prepuce, inner layer of prepuce adhered to the glans of penis
then either of 2 problems can occur…
adhesion separates but smegma accumulates causing balanitis
OR
early retractile of foreskin, where prepuce stays adhered

40
Q

Tx of balanitis

A

Regular washing

41
Q

what is hypospadias

A

incomplete foreskin ventrally but excess dorsally
ureter not at the tip of the glans as it should be

42
Q

what are the most urgent things to deal with if swallowed?

A

button batteries
causing dysphagia
sharp

43
Q

if something passes into the stomach, what is the Mx?

A

LEAVE IT - it will pass if its got that far

44
Q

why are button batteries so dangerous?

A

In oesophagus they can cause burns and erosions

45
Q

what lumps need urgent surgery?

A

Large
Painful
Erythema / oedema - not always fluctuant
Anxiogenic (worried)

46
Q

non acute lumps

A

acute midline cervical
branchial
lymph nodes under 2cm
haemangiomas in infants

47
Q

when do you operate on umbilical hernias & why

A

4 years old - many are gone by then

48
Q

if you see a midline neck lump, what do you ask child to do?
which lump are you trying to identify here?

A

stick tongue out - branchial cyst will move

49
Q

why do you leave haemangiomas alone in infants?

A

they often stabalise and self resolve

50
Q

what group is associated with rectal prolapse

A

toddlers with CF

Y5 Paeds (13 decks)

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