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Paediatrics > Surgery and Urology > Flashcards

Surgery and Urology Flashcards

1
Q

What is the symptomatic triad of appendicitis?

A 
Murphy's:
Pain
Vomiting
Fever
McBurney's point - one-third of the distance from the anterior superior iliac spine to the umbilicus
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2
Q

How is appendicitis treated?

A

Surgical removal

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3
Q

What are the complications of appendicitis?

A

Abscess
Mass
Peritonitis

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4
Q

What is malrotation?

A

When the intestine doesn’t form properly

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5
Q

What are the signs of malrotation?

A

Bilious vomiting

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6
Q

What investigations would be done if malrotation was suspected?

A

Upper GI contrast study

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7
Q

How is malrotation treated?

A

Laparotomy

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8
Q

What are the complications of malrotation?

A

Volvulus - loop of intestine twists around itself causing bowel obstruction

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9
Q

What age group is malrotation common in?

A

First few weeks - first few months

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10
Q

What is the pathology of intussusception?

A

Bowel invaginate into itself

Leads to obstruction of faeces through the bowel

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11
Q

What are the signs of intussusception?

A 
Preceding viral illness
Severe, colicky abdominal pain
Palpable mass - RUQ, sausage shaped
Pallor
Lethargic
Stool - redcurrent jelly (late)
Vomiting
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12
Q

What investigation would be done if intussusception was suspected?

A

Ultrasound - looks like a target

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13
Q

How is intussusception treated?

A

Pneumostatic air reduction (air enema)

Laparotomy

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14
Q

What are the complications of intussusception?

A

Obstruction
Gangrenous bowel
Perforation

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15
Q

What age group is intussusception more common in?

A

Infants 6 months to 2 years

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16
Q

What is the pathology of a hernia?

A

Direct - caused by weakness in the posterior muscular wall of the inguinal canal
Indirect - contents pass through the canal and exit through the superficial inguinal ring

17
Q

What is a major risk factor for a hernia?

A

Increased risk with prematurity

18
Q

What are the signs of a hernia?

A

Groin swelling

19
Q

How are hernia’s treated?

A

<1 year - urgent referral, repair
>1 year - elective referral and repair
Incarcerated - reduce and repair on the same admission

20
Q

What are the complications of hernia’s?

A

Incarcerated - bowel obstruction

21
Q

What type of hernias are most common and in which sex?

A

99% indirect

Boys 9:1

22
Q

What is a hydrocele?

A

Fluid filled sac around the testes

23
Q

What are the signs of a hydrocele?

A

Bluish scrotal swelling

Painless - increases with crying, straining

24
Q

What investigations would be done if a hydrocele was suspected?

A

Ultrasound

Trans illuminate with light

25
Q

How are hydroceles treated?

A

Conservative until 5yrs of age

26
Q

What is the pathology of cryptorchidism?

A

When the testes don’t descent from the abdomen into the scrotum (mostly inguinal)

27
Q

How is cryptorchidism treated?

A

Newborns - watch and wait (most descent in first 3-6 months)
Refer to paediatric urologist if not descended by 6 months
Orchiodexopathy

28
Q

What are the complications of cryptorchidism?

A

If left untreated - testicular cancer

29
Q

What is the pathology of vesicle-uterine reflux?

A

Urine flows back into the ureters/kidneys away from the bladder

30
Q

How is vesicle-uterine reflux treated?

A

Conservative - voiding advice

31
Q

What is the WHO pain ladder for children?

A

Paracetamol – 20mg/kg 4-6hrly
Ibuprofen – 10mg/kg 8hrly
Weak opioid – codeine not recommended <12 years
Strong opioid

32
Q

Fluid resuscitation

A

20ml/kg bolus 0.9 NaCl

33
Q

Fluid maintenance

A

0.9% NaCl/5% Dextrose +/- 0.15% KCl
4ml/kg 1st 10kg
2ml/kg 2nd 10kg
1ml/kg every kg thereafter

34
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 varies

Paediatrics (17 decks)

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