43 Pediatric Surgery
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Questions and Answers

Which part of the gastrointestinal tract includes the stomach, pancreas, liver, and gallbladder?

  • Esophagus
  • Midgut
  • Foregut (correct)
  • Hindgut

What becomes the median umbilical ligaments in adults?

  • 2 umbilical arteries (correct)
  • Vitelline duct
  • 1 umbilical vein
  • Urachus

Which condition may result from the persistence of the vitelline duct?

  • Pancreatitis
  • Meckel's diverticulum (correct)
  • Appendicitis
  • Gastric ulcer

What is the treatment for a toddler presenting with unilateral earache, rhinorrhea, or wheezing due to a foreign body?

<p>Appropriate endoscopy and removal (C)</p> Signup and view all the answers

What is the recommended tube size for endotracheal intubation in children aged under 10 years?

<p>Width of patient's pinky nail bed (C)</p> Signup and view all the answers

What type of solution is usually preferred as trauma bolus for younger children to prevent hyponatremia?

<p>Normal saline (C)</p> Signup and view all the answers

Which type of cyst is most likely to connect with the external auditory canal?

<p>First branchial cleft cyst (C)</p> Signup and view all the answers

Where is the most common location for a second branchial cleft cyst?

<p>Anterior border of mid-SCM muscle (D)</p> Signup and view all the answers

Which condition is characterized by a soft, mass-like lesion usually found in the base of the lateral neck?

<p>Cystic hygroma (B)</p> Signup and view all the answers

From what does a thyroglossal duct cyst arise?

<p>Abnormal descent of the thyroid gland from the foramen cecum (B)</p> Signup and view all the answers

Which tumor is known to appear at birth or shortly after and typically grows rapidly during the first 6–12 months of life?

<p>Hemangioma (C)</p> Signup and view all the answers

What is the most common area for a hemangioma to appear?

<p>Head and neck (D)</p> Signup and view all the answers

Which tumor usually presents as an asymptomatic mass and may be associated with secretory diarrhea, raccoon eyes, and hypertension?

<p>Neuroblastoma (A)</p> Signup and view all the answers

What is the #1 solid abdominal malignancy in children?

<p>Neuroblastoma (A)</p> Signup and view all the answers

What is the mean age at diagnosis for Wilms tumor?

<p>3 years (B)</p> Signup and view all the answers

What syndrome is associated with Wilms tumor, Aniridia, Genitourinary malformations, and mental Retardation?

<p>WAGR syndrome (C)</p> Signup and view all the answers

What condition is characterized by being found on the antimesenteric border of small bowel and represents a persistent vitelline duct?

<p>Meckel's diverticulum (D)</p> Signup and view all the answers

What are the rule of 2s for Meckel's diverticulum?

<p>2 feet from ileocecal valve, 2% population, male predominance, symptomatic in 50% (C)</p> Signup and view all the answers

Which procedure is most likely to be indicated for an incarcerated inguinal hernia?

<p>High ligation of the hernia sac (A)</p> Signup and view all the answers

What is the most common cause of neonatal jaundice requiring surgery?

<p>Biliary atresia (D)</p> Signup and view all the answers

What surgical procedure is indicated for sacrococcygeal teratomas in neonates?

<p>Excision (A)</p> Signup and view all the answers

What is the most common cause of airway obstruction in infants?

<p>Laryngomalacia (A)</p> Signup and view all the answers

What is the main surgical indication for tracheomalacia?

<p>Dying spell (D)</p> Signup and view all the answers

What is the surgical correction indicated for choanal atresia?

<p>Surgical correction (A)</p> Signup and view all the answers

What is the most common tumor of the pediatric larynx?

<p>Laryngeal papillomatosis (B)</p> Signup and view all the answers

1

<p>Vas deferens blood supply will collateralize to testicles (C)</p> Signup and view all the answers

Which condition presents with a risk factor of TE fistula?

<p>Tracheomalacia (C)</p> Signup and view all the answers

What is the diagnostic study to confirm Hirschsprung's disease?

<p>Contrast enema (A)</p> Signup and view all the answers

What surgical procedure is indicated for cystic fibrosis in infants?

<p>Resect cyst (C)</p> Signup and view all the answers

Which imaging study is most appropriate if a Meckel's diverticulum is suspected and the location is difficult to locate?

<p>Meckel's scan (pertechnetate) (B)</p> Signup and view all the answers

What procedure is indicated for the treatment of pyloric stenosis with symptoms, suspicion of gastric mucosa, narrow neck, or complication such as perforation?

<p>Pyloromyotomy (B)</p> Signup and view all the answers

What is the typical age range for presentation of pyloric stenosis?

<p>3 months-3 years (C)</p> Signup and view all the answers

What is the recommended management for severe dehydration in infants with pyloric stenosis?

<p>Fluid resuscitation with normal saline boluses until making urine, then switch to D5 normal saline with potassium maintenance (D)</p> Signup and view all the answers

What is the primary diagnostic modality for intussusception?

<p>Ultrasound of the abdomen (D)</p> Signup and view all the answers

What is the initial management approach for severe dehydration in infants with intussusception?

<p>Normal saline boluses until making urine, then switch to D5 normal saline with potassium maintenance (A)</p> Signup and view all the answers

What is the most common lead point for intussusception in children?

<p>Enlarged Peyer's patches (D)</p> Signup and view all the answers

What is the recommended treatment for reduction of intussusception with air-contrast enema?

<p>80 (B)</p> Signup and view all the answers

What is the typical recurrence rate after reduction of intussusception?

<p>15% (C)</p> Signup and view all the answers

What is the most common cause of duodenal obstruction in newborns under 1 week?

<p>Duodenal atresia (A)</p> Signup and view all the answers

What is the recommended initial diagnostic study for malrotation in a child presenting with sudden onset of bilious vomiting?

<p>Upper gastrointestinal series (D)</p> Signup and view all the answers

What percentage of children with malrotation present within the first month after birth?

<p>90% (B)</p> Signup and view all the answers

What is the most common sign of Hirschsprung's disease in infants?

<p>Failure to pass meconium in the first 24 hours (A)</p> Signup and view all the answers

What is the initial treatment for gastroschisis?

<p>Initially place saline-soaked gauzes and resuscitate the patient (B)</p> Signup and view all the answers

What procedure may be needed for a giant omphalocele?

<p>Silastic chimney or silo for temporary coverage (B)</p> Signup and view all the answers

Which condition is associated with the absence of ganglion cells in the myenteric plexus?

<p>Hirschsprung’s disease (A)</p> Signup and view all the answers

What is the classic presentation of necrotizing enterocolitis in premature neonates?

<p>Pneumatosis intestinalis on abdominal x-ray (C)</p> Signup and view all the answers

What may be observed on abdominal x-ray in meconium ileus?

<p>Dilated loops of small bowel without air-fluid levels (B)</p> Signup and view all the answers

What is the primary treatment for imperforate anus that is high (above levators)?

<p>Colostomy, later anal reconstruction with posterior sagittal anoplasty (B)</p> Signup and view all the answers

What surgical intervention is indicated for congenital vascular malformation causing hemorrhage or ischemia?

<p>&quot;Embolization and/or resection&quot; (C)</p> Signup and view all the answers

"Failure of embryonal development" is characteristic of which condition?

<p>&quot;Omphalocele&quot; (D)</p> Signup and view all the answers

What is the most likely finding on abdominal x-ray in gastroschisis?

<p>No abnormal findings on abdominal x-ray (B)</p> Signup and view all the answers

What is a common risk factor for necrotizing enterocolitis?

<p>Prematurity (B)</p> Signup and view all the answers

Which anatomical anomaly presents with stiff bowel from exposure to amniotic fluid?

<p>Gastroschisis (B)</p> Signup and view all the answers

In children, what is the marker of adequate resuscitation?

<p>Urine output of 1 cc/kg/hr for age &gt; 1 (D)</p> Signup and view all the answers

What is the preferred intravenous fluid for maintenance in children?

<p>D5 normal saline (B)</p> Signup and view all the answers

What is the most common type of mediastinal mass in children?

<p>Neurogenic tumors (B)</p> Signup and view all the answers

Which congenital lung condition presents with anomalous systemic arterial supply and may have respiratory compromise or abnormal CXR?

<p>Pulmonary sequestration (B)</p> Signup and view all the answers

What is the surgical treatment for choledochal cyst type III?

<p>Transduodenal excision (A)</p> Signup and view all the answers

What is the most common type of congenital diaphragmatic defect located on the left side and posteriorly?

<p>Bochdalek's hernia (D)</p> Signup and view all the answers

What is the survival rate for diaphragmatic hernias and chest wall defects overall?

<p>~50% (A)</p> Signup and view all the answers

What is the most likely symptom associated with cystic hygroma (lymphangioma) in children?

<p>Respiratory distress (D)</p> Signup and view all the answers

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