Common surgical problems north

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18.2 (18.3)
Averil Tam
Flashcards by Averil Tam, updated more than 1 year ago
Averil Tam
Created by Averil Tam almost 6 years ago
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Question Answer
1. TRUE/FALSE? a) Dermoid cysts are a common midline neck lump in children. True
1. TRUE/FALSE? b) There is an association between the presence of tongue tie in an infant and an increase in dental caries later in life. True. Tongue tie in an infant does have a correlation with increased dental caries. Tongue tie can run in families. If correctional surgery is required, it is usually done at around 1 year of age.
1. TRUE/FALSE? c) A lateral neck lymph node in an 18 month old child is very likely neoplastic. False. An enlarged cervical lymph node in a child of 18 months to 2 years is very unlikely to be neoplastic. It is much more likely to be reactive (secondary to recent infection) or acutely inflamed.
1. TRUE/FALSE? d) The diagnosis of a thyroglossal cyst may be assisted by asking the child to poke out their tongue. True. A thyroglossal cyst will move upwards with protrusion of the tongue. If the child is too young to follow instructions, observe while feeding/swallowing.
2. TRUE/FALSE? a) The major risk of a lymphatic malformation of the neck is airway compromise. True. Lymphatic malformations of the neck (formerly referred to as Cystic Hygromas) can lead to airway compromise, especially if infected and enlarged.
2. TRUE/FALSE? b) Pre-auricular sinuses are rarely seen in children of South East Asian descent. False. They often occur bilaterally.
2. TRUE/FALSE? c) A branchial sinus or fistula occurs in the midline. False. Branchial remnants (sinus, fistula or cyst) occur as lateral structures.
2. TRUE/FALSE? d) A 12 year old boy presenting with a lateral neck lump must have neoplasia considered in the diagnosis. True. Although it remains uncommon, the risk of neoplasia starts to rise as children enter the teenage years. Hence these children must be carefully assessed to exclude the diagnosis of a neoplastic process. In this age group, it is less common to see reactive lymph nodes (ie. secondary to infection).
3. TRUE/FALSE - pyloric stenosis: a) Pyloric stenosis occurs more commonly in boys. True. The incidence of pyloric stenosis is 4:1 boys to girls. It is familial with an incidence of 1:20 if the boy’s father had PS and 1:5 if his mother had it. It is more prevalent in children of Anglo Celtic descent.
3. TRUE/FALSE - pyloric stenosis: b) The peak age at presentation is 6 months. False. Presentation is usually at around 4 weeks of age; onset of vomiting is at 2-3 weeks, and very unusual beyond 8 weeks.
3. TRUE/FALSE - pyloric stenosis: c) Projectile vomiting is a feature. True. Projectile vomiting is a feature of PS. It is usually milky, non-bilious and occurs 30-60 minutes after a feed. Peristaltic waves and an olive shaped mass are signs to elicit.
3. TRUE/FALSE - pyloric stenosis: d) The infant with pyloric stenosis may become acidotic due to vomiting. False. The child with PS usually develops hypochloraemic alkalosis due to vomiting, and severe dehydration if untreated.
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