ABS Pediatric Surgery flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Congenital diaphragmatic hernia prognosis

In congenital diaphragmatic hernia, prenatal liver herniation and a low lung-to-head ratio predict poorer survival; fetal tracheal occlusion may be considered for severe cases under specialized protocols.

Myelomeningocele prenatal repair

Prenatal myelomeningocele repair before 26 weeks' gestation reduces shunt dependence and improves motor outcomes, but increases preterm birth and uterine dehiscence risk compared with postnatal repair.

Macrocystic lung malformation treatment

A macrocystic congenital lung malformation with hydrops may be decompressed by thoracoamniotic shunting; microcystic lesions with hydrops may require fetal surgical intervention or maternal steroid therapy.

Gastroschisis versus omphalocele

Gastroschisis presents as bowel evisceration through a right paraumbilical defect without a membrane, whereas omphalocele is covered by membranes and often associated with chromosomal and cardiac anomalies.

Necrotizing enterocolitis perforation

In necrotizing enterocolitis, pneumoperitoneum indicates intestinal perforation and requires urgent surgical consultation; unstable preterm infants may be treated with primary peritoneal drainage rather than immediate laparotomy.

Duodenal atresia double bubble

Duodenal atresia classically produces a double-bubble sign on abdominal radiograph with no distal gas; it is associated with Down syndrome and requires duodenoduodenostomy after stabilization.

Malrotation with volvulus

Bilious vomiting in a neonate suggests malrotation with volvulus; urgent upper gastrointestinal contrast study and prompt Ladd procedure are needed to prevent intestinal necrosis.

Pyloric stenosis metabolic alkalosis

Hypertrophic pyloric stenosis causes nonbilious projectile vomiting and hypochloremic, hypokalemic metabolic alkalosis; pyloromyotomy is performed after correcting dehydration and electrolyte abnormalities.

Biliary atresia Kasai timing

Biliary atresia causes conjugated hyperbilirubinemia and acholic stools; Kasai portoenterostomy performed before 60 days of life improves native liver survival, with transplantation reserved for failure.

Intussusception enema reduction

Ileocolic intussusception in a stable child without peritonitis can be reduced by air or contrast enema; ultrasound shows a target sign, and surgery is reserved for failed reduction or perforation.

Meckel diverticulum bleeding

Meckel diverticulum may cause painless lower gastrointestinal bleeding from ectopic gastric mucosa; a technetium-99m pertechnetate scan can confirm it, and symptomatic lesions are resected.

Choledochal cyst malignancy risk

Choledochal cysts carry an increased risk of cholangiocarcinoma and require complete excision with hepaticojejunostomy rather than simple drainage.

Wilms tumor initial management

Wilms tumor is typically managed with nephrectomy and chemotherapy; biopsy is avoided when the diagnosis is classic, and tumor spillage affects staging and therapy.

Neuroblastoma MYCN amplification

MYCN amplification in neuroblastoma predicts aggressive behavior and poor prognosis; treatment combines surgery, chemotherapy, and radiation, with intensity guided by age, stage, and biology.

Hepatoblastoma PRETEXT staging

Hepatoblastoma staging uses the PRETEXT system, which describes liver tumor involvement; elevated alpha-fetoprotein supports diagnosis, and cisplatin-based chemotherapy plus resection is standard.

Rhabdomyosarcoma biopsy principle

Suspected rhabdomyosarcoma requires adequate diagnostic biopsy before chemotherapy; treatment combines surgery, radiation, and chemotherapy, with site and histology determining risk.

Pediatric hypotension formula

For children aged 1 to 10 years, hypotension is defined as systolic blood pressure below 70 mm Hg plus twice the age in years; infants under 1 year use below 70 mm Hg.

Pediatric fluid bolus

In pediatric shock, an initial crystalloid bolus is 20 mL/kg; reassess after each bolus because over-resuscitation can worsen outcomes, and blood products are used for hemorrhagic shock.

Splenic injury nonoperative

Hemodynamically stable children with splenic injury can usually be managed nonoperatively with monitoring; surgery or angioembolization is reserved for ongoing bleeding or instability.

Burn resuscitation Parkland

The Parkland formula gives 4 mL/kg per percent total body surface area of lactated Ringer solution in the first 24 hours, with half given in the first 8 hours; children also need maintenance fluids.

Esophageal atresia with fistula

Esophageal atresia with distal tracheoesophageal fistula is the most common type; a coiled nasogastric tube and absent gastric air help diagnosis, and primary repair follows stabilization.

Pectus excavatum Nuss repair

Pectus excavatum with a Haller index above 3.25 and cardiopulmonary or cosmetic concerns may be repaired by the Nuss procedure, which uses a curved bar without sternal resection.

Empyema management children

Pediatric empyema is treated with antibiotics and chest tube drainage; intrapleural fibrinolytics or video-assisted thoracoscopic surgery may be used for complex collections.

Congenital lung lesion resection

Asymptomatic congenital lung malformations may be observed or electively resected; surgery is indicated for symptoms, rapid growth, or concern for malignancy, often via thoracoscopy.

Posterior urethral valves diagnosis

Posterior urethral valves cause prenatal hydronephrosis, a keyhole bladder, and oligohydramnios; voiding cystourethrography confirms the diagnosis, and endoscopic valve ablation relieves obstruction.

Cryptorchidism orchiopexy timing

Undescended testes should be corrected by orchiopexy by 12 to 18 months of age to reduce infertility and malignancy risk; earlier surgery may be considered for clearly nonpalpable testes.

Hypospadias circumcision caution

In hypospadias, circumcision should be deferred because the foreskin may be needed for urethral reconstruction; repair is usually performed between 6 and 18 months of age.

Anorectal malformation staged repair

Imperforate anus is managed initially with a diverting colostomy when a fistula is present or the neonate is unstable; posterior sagittal anorectoplasty restores continuity later.

Thyroglossal duct cyst

A thyroglossal duct cyst is a midline neck mass that moves with tongue protrusion; treatment is Sistrunk procedure, which removes the cyst and central hyoid bone to reduce recurrence.

Infantile hemangioma propranolol

Infantile hemangiomas that are large, ulcerated, or threaten vision or airway are treated with oral propranolol; it reduces proliferation and is generally started after cardiopulmonary assessment.

Branchial cleft cyst

A lateral neck mass in a child may be a branchial cleft cyst; definitive treatment is complete surgical excision to prevent recurrent infection, often after imaging and infection control.

Thyroid nodule child biopsy

A pediatric thyroid nodule requires ultrasound and fine-needle aspiration because malignancy risk is higher than in adults; papillary carcinoma is the most common type.