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Systems: Paediatrics AB > Surgery > Flashcards

Surgery Flashcards

1
Q

How do you calculate children’s weight?

A

2 x (age + 4)

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2
Q

How do you calculate children’s blood volume?

A

80mls/kg

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3
Q

How do you calculate children’s urine output?

A

0.5-1mls/kg/hours

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4
Q

How do you calculate children’s insensible fluid loss?

A

20ml/kg/day

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5
Q

How do you calculate children’s systolic BP?

A

80 + (2 x age)

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6
Q

What are the normal vitals of a child < 1?

A
  • RR 30-40
  • HR 110-160
  • SBP 70-90
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7
Q

What are the normal vitals of a child 2-5?

A
  • RR 25-30
  • HR 95-140
  • SBP 80-100
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8
Q

What are the normal vitals of a child 5-10?

A
  • RR 20-25
  • HR 80-120
  • SBP 90-110
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9
Q

What are the normal vitals of a child >10?

A
  • RR 15-20
  • HR 80-120
  • SBP 100-120
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10
Q

What are the big differences between children and adults?

A
  • Communication
  • Signs
  • Disease processes
  • Physiological parameters
  • Expectations
  • STRESS
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11
Q

What is the WHO pain ladder?

A
  • Paracetmol
  • NSAIDs
  • Weak opioid
  • Strong opioid
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12
Q

What sentinel signs occur in children?

A
  • Feed refusal
  • Bile vomits
  • Colour
  • Tone
  • Temperature
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13
Q

What history may be obtained from a child with abdominal pain?

A

Pain

  • Closer to umbilicus less chance of pathology
  • Colic vs constant
  • Movement (speed bump test)

Vomiting

  • Increases significant
  • Bile is important
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14
Q

What colour is bile vomit?

A

Green

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15
Q

What investigations should be carried out for abdominal pain?

A
  • Urine
  • FBC if diagnostic doubt
  • Electrolytes if sick or dry
  • Rarel x-rays
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16
Q

What is the basis of management?

A
  • Does this child need a surgical opinion?

- Does this child need an operation?

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17
Q

What is the incidence of classical appendicitis?

A
  • Unusual >4 years
  • Can be difficult diagnosis
  • 20% of admissions
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18
Q

How does classical appendicitis present?

A
  • Murphy’s triad (pain, vomiting, fever)

- Tenderness over Mcburney’s point

19
Q

What clues point to classical appendicitis?

A
  • Moderate temperature with vomiting

- Child looks unwell;

20
Q

What are the possible complications of classical appendicitis?

A
  • Abscess
  • Mass
  • Peritonitis
21
Q

What is the incidence of non-specific abdominal pain?

A
  • F>M
  • 45% of admissions
  • Often recurrent
22
Q

What are the features of non-specific abdominal pain?

A
  • Short duration
  • Central
  • Constant
  • Not made worse by movement
  • No GIT disturbance
  • No temperature
  • Site and severity of tenderness vary
23
Q

What can non-specific abdominal pain mimic?

A

Appendicitis

24
Q

What would suggest non-specific abdominal pain was due to mesenteric adenitis?

A
  • High temperature
  • URTI often
  • Not unwell
25
Q

What would suggest on-specific abdominal pain was due to pneumonia?

A
  • Child sicker than the abdominal signs

- Usually RLL

26
Q

What is the incidence of pyloric stenosis?

A
  • M:F 5:1

- Often have FMH

27
Q

How does pyloric stenosis present?

A
  • 4-16/52 history
  • Non bilious projectile vomiting
  • Weight loss
28
Q

What would you find on capillary gases of pyloric stenosis?

A
  • Alkalosis
  • Hypochloraemia
  • Hypokalaemia
29
Q

How is pyloric stenosis investigated?

A
  • Test feed

- US

30
Q

How is pyloric stenosis treated?

A
  • IV fluids with saline /dextrose with KCl

- Periumbilical pyloromyotomy

31
Q

How does malrotation present?

A

Young baby with bile green vomiting

32
Q

How is malrotation investigated?

A

Upper GI contrast study ASAP

33
Q

How is malrotation managed?

A

Laparotomy ASAP

34
Q

How does intussusception present?

A
  • Baby (6-12 months)
  • Short history of viral illness
  • Intermittent colic
  • Dying spells
  • Bilious vomit
  • Delayed cap refill
  • Bloody mucous PR
35
Q

How is intussusception investigated?

A

-USS abdomen (target sign)

36
Q

How is intussusception managed?

A
  • Pneumostatic reduction (air enema)

- Laparotomy

37
Q

What is gastroschisis?

A

Abdominal wall defect where gut is eviscerated and exposed

38
Q

What is gastroschisis sometimes associated with?

A

Atresia

39
Q

How is gastroschisis managed?

A

-Primary or delayed closure

40
Q

What are the survival prospects of gastroschisis?

A
  • 90%+

- Short gut

41
Q

What is exomphalos?

A

Umbilical defect with covered viscera

42
Q

What are the associated anomalies of exomphalos?

A
  • 25% cardia
  • 25% chromosomal
  • 15% renal, neurological
  • Beckwith-Weideman syndrome
43
Q

How is exomphalos managed?

A

Primary or delayed closure

44
Q

What is the prognosis for exomphalos?

A

Post natal mortality is 25%

Systems: Paediatrics AB (31 decks)

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