PEDIATRIC

Question 1

What is Marasmus?

Answer 1

Related to “total calorie” malnutrition. Hungry.
Subtype of PEM (protein-energy malnutrition) associated with:
- severe muscle wasting
- loss of body fat
- lack of edema (anasarca)

Question 2

What is Kwashiorkor?

Answer 2

Subtype of PEM (protein-energy malnutrition) associated with:

• muscle wasting + normal weight
• anasarca/edema
• anorexia, apathy

Question 3

Soave technique

Answer 3

For Hirschsprung - “pull-through” technique

• endorectal mucosal dissection within aganglionic distal rectum
• normally ganglionated colon then pulled through remnant muscular cuff + coloanal anastomosis is formed

Question 4

What is Swenson procedure

Answer 4

For Hirschsprung - “pull-through” technique

• removal of all agnaglionic colon
• end-to-end anastomosis above anal sphincter

Question 5

What is Duhamel procedure

Answer 5

For Hirschsprung - “pull-through” technique

• involves bringing normal colon down through rectorectal space
• decreased rate of anastomotic stricture with less extensive pelvic dissection compared to Swenson/Soave (other pull-through techniques)

Question 6

What is Martin procedure (For Hirschsprung)

Answer 6

Side-to-side anastomosis between normally innervated small bowel and aganglionic left colon

Question 7

What is Kimora procedure (For Hirschsprung)

Answer 7

• staged procedure in which right colon is anastomoses side-to-side to ileum

Question 8

Benefit of pull-through procedures for Hirschsprung

Answer 8

(Swenson, Duhamel, Soave) effective in treating short segment Hirschsprung

Question 9

Incisional approach for testicular torsion

Answer 9

Midline scrotal incision

Question 10

Laparoscopic port placement for pyloromyotomy

Answer 10

Left and right upper quadrants

Question 11

Factors that increase risk of hepatoblastoma in children

Answer 11

• Beckwith-Wiedemann syndrome
• fetal alcohol syndrome
• TPN

Question 12

Presentation of hepatoblasmtoma

Answer 12

• asymptomatic abdominal mass (may have pain from acute hemorrhage or GI obstruction)
• nontender, firm mass that moves with respiration

Question 13

MC solid organ tumor in peds population

Answer 13

neuroblastoma

Question 14

Presentation of neuroblastoma

Answer 14

• palp flank mass
• diarrhea, HTN, ataxia
• elevated catecholamines, metanephrines, dx by CT

Question 15

Factors associated with poor prognosis neuroblastoma

Answer 15

• age >1yo

- elevation in neuron specific enolase (NSE), LDH, and N-myc amplification