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</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</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</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</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</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</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</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</p> Signup and view all the answers

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

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

    What is the #1 solid abdominal malignancy in children?

    <p>Neuroblastoma</p> Signup and view all the answers

    What is the mean age at diagnosis for Wilms tumor?

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

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

    <p>WAGR syndrome</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</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%</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</p> Signup and view all the answers

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

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

    What surgical procedure is indicated for sacrococcygeal teratomas in neonates?

    <p>Excision</p> Signup and view all the answers

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

    <p>Laryngomalacia</p> Signup and view all the answers

    What is the main surgical indication for tracheomalacia?

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

    What is the surgical correction indicated for choanal atresia?

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

    What is the most common tumor of the pediatric larynx?

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

    1

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

    Which condition presents with a risk factor of TE fistula?

    <p>Tracheomalacia</p> Signup and view all the answers

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

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

    What surgical procedure is indicated for cystic fibrosis in infants?

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

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

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

    What is the primary diagnostic modality for intussusception?

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

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

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

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

    <p>80</p> Signup and view all the answers

    What is the typical recurrence rate after reduction of intussusception?

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

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

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

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

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

    What is the initial treatment for gastroschisis?

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

    What procedure may be needed for a giant omphalocele?

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

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

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

    What is a common risk factor for necrotizing enterocolitis?

    <p>Prematurity</p> Signup and view all the answers

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

    <p>Gastroschisis</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</p> Signup and view all the answers

    What is the preferred intravenous fluid for maintenance in children?

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

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

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

    What is the surgical treatment for choledochal cyst type III?

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

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

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

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

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

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