Wk3 Peds GI surg

Question 1

signs and sx of abd pain and tenderness, a clinical presentation that often requires emergency surgical therapy:

Answer 1

acute abdomen

Question 2

4 causes of acute abdomen:

Answer 2

1. infx
2. obstruction
3. ischemia
4. perforation

Question 3

no C-loop

ligament of treitz on right side and does not cross midline

Answer 3

Malrotation

Question 4

Presentation for Malrotation:

Answer 4

first month of life

BILIOUS emesis

lethargy

Toxic (if late)

Question 5

Duodenal “birds beak” on right side fo upper GI contrast study:

Answer 5

Malrotation

Question 6

First thing to do for Malrotation?

Answer 6

IV fluid resus

Question 7

Dx test of choice for pyloric stenosis:

Answer 7

Ultrasound

Question 8

“String sign”

Answer 8

pyloric stenosis on upper GI study with contrast

Question 9

First thing to do in pyloric stenosis dx before surgery:

Answer 9

Correct electrolytes

Question 10

inversion of one portion of the intestine within another:

Answer 10

Intussusception

Question 11

“Currant jelly” stools

Colicky abd pain

Answer 11

Intussusception

Question 12

“target sign”

Answer 12

intussusception

Question 13

Pre-surgical tx for intussusception:

Answer 13

Barium enema

Question 14

meniscus sign

Answer 14

intussusception

Question 15

coiled spring sign:

Answer 15

intussusception

Question 16

Most common cause of acute surgical abd in children?

Most common age?

Answer 16

Appendicitis

12-18 yo

Question 17

Most common etiology of appendicitis:

Answer 17

fecolith

then- lymphoid hyperplasia, foreign body

Question 18

Periumbilical pain that moves to RLQ:

Answer 18

Appendicitis

Question 19

Lift off of LLQ = pain in RLQ

Answer 19

Rovsing sign

Appendicitis

Question 20

WBC in urine w/o bacteria:

Answer 20

Sterile pyuria

**appendicitis

Question 21

Do you always need imaging for appendicitis dx:

Answer 21

nope

Question 22

Small bowel, TRUE diverticulum (all layers of bowel wall)

Answer 22

Meckel’s Diverticulum

Question 23

Rule of 2’s?

Answer 23

Meckel’s diverticulum:

2% of the population

within 2 feet of ileocecal valve

2 types of tissue: gastric, pancreatic

2 inches in length

2 years old

Question 24

Painless lower GI bleed?

Answer 24

Meckel’s diverticulum

Question 25

**Test Q

Cause of painless lower GI bleed in Meckel’s?

Answer 25

gastric tissue contained in the diverticulum

Question 26

Meckel’s diverticulum can look like what on PE?

Answer 26

Appendicitis

Question 27

**Test Q

Cause of Hirschsprung’s Disease:

Answer 27

absence of ganglion cells in the myenteric and submucosal plexus

Question 28

High risk for Hirschsprung’s:

Answer 28

family hx

Down syndrome

Question 29

**Test Q

Presentation of Hirschsprung’s

Answer 29

Abd distention

Bilious emesis

**Failure to pass meconium in the first 24 hrs

Question 30

Gold standard for Hirschsprung’s dx:

Answer 30

Full thickness rectal biopsy

Question 31

Exposed stomach contents covered by peritonium:

Answer 31

Omphalocele

Question 32

Exposed intestines with no cover:

Answer 32

Gastroschisis