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Paediatrics > Surgical > Flashcards

Surgical Flashcards

1
Q

What is appendicitis

A

Inflammation and infection of appendix

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2
Q

What can untreated appendicitis lead to

A

Peritonitis

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3
Q

Clinical features of appendicitis

A 
Moderate fever 
Look unwell 
Vomiting 
Pain:
Middle moving toward right iliac fossa
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4
Q

Rx for appendicitis

A

Analgesia
Appendectomy:
Laproscopically

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5
Q

Who is non-specific abdominal pain more common in boys or girls

A

Girls

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6
Q

Features of non-specific abdominal pain

A 
Central pain 
Constant pain 
Not exacerbated by movement 
No GIT disturbance 
No temp
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7
Q

What is a very important cause of abdominal pain in children

A

Functional abdominal pain

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8
Q

Most common cause of mesenteric adenitis

A

Viral infections

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9
Q

What is there often a history of in mesenteric adenitis

A

URTI

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10
Q

What is mesenteric adentiis

A

Inflammation of mesenteric LN

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11
Q

Symptoms of mesenteric adenitis

A

High fever

Abdo. pain

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12
Q

Rx for mesenteric adenitis

A

Often self limiting

Analgesi

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13
Q

What is pyloric stenosis

A

Narrowing of the pylorus

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14
Q

RF for pyloric stenosis

A

Male
FH
4-16 wks old

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15
Q

Symptoms of pyloric stenosis

A 
Vomiting:
Projectile 
Occurs mins after feeding   
Olive mass in abdomen 
Multiple formula changes
Decreased wet nappies
Constipation
Poor w.t gain 
Irritability 
Lethargy
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16
Q

Describe vomiting in pyloric stenosis

A

Projectile

Occurs mins after feeding

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17
Q

What can sometimes be felt on palpation in pyloric stenosis

A

Olive mass in abdomen

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18
Q

Is for pyloric stenosis

A

Test feed

USS

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19
Q

Rx for pyloric stenosis

A

IV fluids

Surgical:
Periumbilical pyloromyotomy

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20
Q

What is malrotation

A

Intestinal Malrotation is a term used to describe an entire spectrum of rotational and fixation disturbances that can occur during embryonic development

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21
Q

What is volvulus

A

Complication of Malrotation

Bowel twists -> blood supply is cut off

22
Q

Clinical features of malrotation

A

Can be asymptomatic

Vomiting (may contain bile – green)
Crying
Pulling the legs into body
Passing little/no stool

23
Q

What is the most common cause of intestinal obstruction in children

A

Intussusception

24
Q

What is intussusception

A

Prolapse of one part of the intestine into the lumen of adjoining distal part

25
Q

Typical picture of intussusception

A

9 months

M>F

26
Q

Clinical features of intussusception

A

Intermittent colic:
Abdominal pain that comes and goes

‘Dying’ spells

Bilious vomiting

Bloody mucous in stools:
Redcurrant jelly stool

27
Q

Characteristic stools in intussusception

A

Bloody mucous

Redcurrant jely

28
Q

Ix for intussusception

A

USS abdo
X-ray
Diagnostic enema

29
Q

Sign on x-ray seen in intussusception

A

Target sign

30
Q

Rx for intussusception

A

Pneumostatic reduction by air enema

Laporotomy is that fails

31
Q

RX for umbilical hernia

A 
Low birth w.t
Trisomy 21
Hypothyroidism 
African populations 
M
32
Q

Appearance of umbilical hernia

A

Bulge at belly button

Usually more prominent when baby cries or strains

33
Q

Ix for umbilical hernia

A

Clinical O/E

34
Q

Rx for umbilical hernia

A

Leave alone until 4yrs and see for spontaneous closure

Repair if
Complicated
No closure by 4yrs
Large defect

35
Q

How long should yo u leave an umbilical for

A

4yrs

36
Q

Pathology of epigastric hernia

A

Defect in linea alba above the umbilicus

Protrusion of preperitoneal fat

37
Q

Which gender is epigastric hernia more common in

A

Male

38
Q

Clinical features of epigastric hernia

A

Mass in epigastrum

Commonly enlarges

39
Q

Rx for epigastric hernia

A

Often leave alone

Sometimes surgery

40
Q

What is gastroschisis

A

Abdominal wall defect

Intestines develop outside and are open to air when the child is born

41
Q

RF for gastroschisis

A

Smoking in pregnancy
Alcohol in pregnancy
Maternal age <20yrs

42
Q

In gastroschisis is there any membrane covering on the intestines

A

No

43
Q

Ix for gastrochisis

A

Ofen Dx pre natal USS 2nd trimester

44
Q

Rx for gastrochisis

A

Bowel protection
Primary/delated closure
TPN

45
Q

Complications of gastrochisis

A

Short gut (as sometimes damaged bowels occur and need to be removed)

46
Q

What is exomphalos

A

Abdominal wall defect Intestines remain inside the umbilical cord/membrane
But develop out with the abdomen

47
Q

Is there a membrane covering on the intestines in exomphalos

A

Yes

48
Q

Associated anomilies with exomphalos

A 
Cardiac 
Chromosomal (trisomy 13,18,21)
Renal 
Neurological 
Beckwith-Weidman Syndrome
49
Q

Ix for exomphalos

A

Pre-natal USS

2nd trimester Dx in many cases

50
Q

Rx for exomphalos

A

Bowel protection

Primary/delayed closure

Paediatrics (13 decks)

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