Surgery Flashcards
What is the typical blood volume in children?
80mls/kg
What is the typical urine output of a child?
0.5-1ml/kg/hr
What is the typical insensible fluid loss in a child?
20ml/kg/dy
What is the typical systolic BP in a child?
80 + (2 x age)
What drug is not recommended in <12yrs?
Codeine
What is the dosage of paracetamol in children?
20mg/kg 4-6hrly
What is the dosage of ibuprofen in children?
10mg/kg 8hrly
What are sentinel signs?
Feed refusal Bile vomits Colour Tone Temp
What is Murphy’s triad for appendicitis?
Pain
Vomiting
Fever
What are signs of appendicitis?
Murphy’s Triad
Tenderness over McBurney’s point
What are complications of appendicitis?
Abscess
Mass
Peritonitis
What are symptoms that are clues to appendicitis?
Moderate temp
Vomiting
Looks unwell
What is NSAP?
Non specific abdominal pain
What are features of NSAP?
Short duration Central Constant Not made worse by movement No GI disturbance No temp Site and severity of tenderness may vary
What sex does NSAP occur in more?
Girls
What can NSAP mimic?
Early appendicitis
What is mesenteric adenitis?
Inflammation and swelling of lymph nodes inside abdomen
What are signs of mesenteric adenitis?
High temp
URTI often
Not ‘unwell’
What are signs of pyloric stenosis?
Non bilious vomiting - ‘projectile’
Weight loss
What sex does pyloric stenosis occur in more?
Males
What are blood gas signs of pyloric stenosis?
Alkalosis
Hypochloraemia
Hypolakaemia
What is the management of pyloric stenosis?
Test feed
IV fluid
US
Periumbilical pyloromyotomy
What are signs of malrotation?
Bile vomiting - green
What is the investigation for malrotation?
Upper GI contrast study
What is the management for malrotation?
Laparotomy
What are the signs/symptoms of intussusception?
Colic Dying spells - acute hypoxia Bilious vomiting Long cap refill Bloody mucous PR
What is the investigation for intussusception and what is a classic sign?
US abdomen
‘Target sign’
What is the management for intussusception?
Pneumostatic reduction
Laparotomy
What is gastroschisis?
Abdominal wall defect, bowel develops outside body
What is the management for gastroschisis?
Primary/delayed closure
TPN
What is examphalos?
Umbilical defect with covered viscera
What are associated anomalies with exomphalos?
Cardiac Chromosomal Renal Neurological Beckwith-Weideman syndrome
What is the management of exomphalos?
Primary/delayed closure
