Systems: Paediatrics AB > Surgery > Flashcards

Surgery Flashcards

(44 cards)

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1
Q

How do you calculate children’s weight?

A

2 x (age + 4)

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2
Q

How do you calculate children’s blood volume?

A

80mls/kg

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3
Q

How do you calculate children’s urine output?

A

0.5-1mls/kg/hours

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4
Q

How do you calculate children’s insensible fluid loss?

A

20ml/kg/day

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5
Q

How do you calculate children’s systolic BP?

A

80 + (2 x age)

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6
Q

What are the normal vitals of a child < 1?

A
  • RR 30-40
  • HR 110-160
  • SBP 70-90
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7
Q

What are the normal vitals of a child 2-5?

A
  • RR 25-30
  • HR 95-140
  • SBP 80-100
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8
Q

What are the normal vitals of a child 5-10?

A
  • RR 20-25
  • HR 80-120
  • SBP 90-110
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9
Q

What are the normal vitals of a child >10?

A
  • RR 15-20
  • HR 80-120
  • SBP 100-120
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10
Q

What are the big differences between children and adults?

A
  • Communication
  • Signs
  • Disease processes
  • Physiological parameters
  • Expectations
  • STRESS
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11
Q

What is the WHO pain ladder?

A
  • Paracetmol
  • NSAIDs
  • Weak opioid
  • Strong opioid
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12
Q

What sentinel signs occur in children?

A
  • Feed refusal
  • Bile vomits
  • Colour
  • Tone
  • Temperature
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13
Q

What history may be obtained from a child with abdominal pain?

A

Pain

  • Closer to umbilicus less chance of pathology
  • Colic vs constant
  • Movement (speed bump test)

Vomiting

  • Increases significant
  • Bile is important
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14
Q

What colour is bile vomit?

A

Green

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15
Q

What investigations should be carried out for abdominal pain?

A
  • Urine
  • FBC if diagnostic doubt
  • Electrolytes if sick or dry
  • Rarel x-rays
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16
Q

What is the basis of management?

A
  • Does this child need a surgical opinion?

- Does this child need an operation?

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17
Q

What is the incidence of classical appendicitis?

A
  • Unusual >4 years
  • Can be difficult diagnosis
  • 20% of admissions
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18
Q

How does classical appendicitis present?

Study These Flashcards
A
  • Murphy’s triad (pain, vomiting, fever)

- Tenderness over Mcburney’s point

19
Q

What clues point to classical appendicitis?

Study These Flashcards
A
  • Moderate temperature with vomiting

- Child looks unwell;

20
Q

What are the possible complications of classical appendicitis?

Study These Flashcards
A
  • Abscess
  • Mass
  • Peritonitis
21
Q

What is the incidence of non-specific abdominal pain?

Study These Flashcards
A
  • F>M
  • 45% of admissions
  • Often recurrent
22
Q

What are the features of non-specific abdominal pain?

Study These Flashcards
A
  • Short duration
  • Central
  • Constant
  • Not made worse by movement
  • No GIT disturbance
  • No temperature
  • Site and severity of tenderness vary
23
Q

What can non-specific abdominal pain mimic?

24
Q

What would suggest non-specific abdominal pain was due to mesenteric adenitis?

Study These Flashcards
A
  • High temperature
  • URTI often
  • Not unwell
25
What would suggest on-specific abdominal pain was due to pneumonia?
- Child sicker than the abdominal signs | - Usually RLL
26
What is the incidence of pyloric stenosis?
- M:F 5:1 | - Often have FMH
27
How does pyloric stenosis present?
- 4-16/52 history - Non bilious projectile vomiting - Weight loss
28
What would you find on capillary gases of pyloric stenosis?
- Alkalosis - Hypochloraemia - Hypokalaemia
29
How is pyloric stenosis investigated?
- Test feed | - US
30
How is pyloric stenosis treated?
- IV fluids with saline /dextrose with KCl | - Periumbilical pyloromyotomy
31
How does malrotation present?
Young baby with bile green vomiting
32
How is malrotation investigated?
Upper GI contrast study ASAP
33
How is malrotation managed?
Laparotomy ASAP
34
How does intussusception present?
- Baby (6-12 months) - Short history of viral illness - Intermittent colic - Dying spells - Bilious vomit - Delayed cap refill - Bloody mucous PR
35
How is intussusception investigated?
-USS abdomen (target sign)
36
How is intussusception managed?
- Pneumostatic reduction (air enema) | - Laparotomy
37
What is gastroschisis?
Abdominal wall defect where gut is eviscerated and exposed
38
What is gastroschisis sometimes associated with?
Atresia
39
How is gastroschisis managed?
-Primary or delayed closure
40
What are the survival prospects of gastroschisis?
- 90%+ | - Short gut
41
What is exomphalos?
Umbilical defect with covered viscera
42
What are the associated anomalies of exomphalos?
- 25% cardia - 25% chromosomal - 15% renal, neurological - Beckwith-Weideman syndrome
43
How is exomphalos managed?
Primary or delayed closure
44
What is the prognosis for exomphalos?
Post natal mortality is 25%
Systems: Paediatrics AB
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