PEDIA SURGERY RECALLMIDTERMS BATCH 2016

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BE A PART OF YOUR REVIEW.

Upon examination of the inguino scrotal area of the above patient, a deep reddish swollen scrotum is
noted with distention of the abdomen. This boy probably has:
A. Incarcerated hernia
B. Testicular tortion
C. Testicular tumor
D. Strangulated hernia

With above impression, he is best managed with :

A. Direct transport of the patient to OR for emergency herniotomy and to salvage trapped bowels
B. Trial manual reduction of incarcerated hernia with strict observance
C. Hydration, serum electrolytes..
D. Ice pack over the mass and observe for improvement before surgery

Testicular descent
a. Independent of the development of procesus vaginalis
b. Explains the higher incidence in prematures
c. It’s a dynamic process
d. Descent stops at birth
**EXCEPT A

2 year boy with hydrocele with scrotal enlargement,soft and decreases in size upon gentle squeeze.
What type of hydrocoele?
A. communicating type
B. non-communicating
C.
D.

Typical radiographic picture of malrotation

A. Distended small bowels with small flecks of gas distally
B. paucity of colonic gas
C. double bubble sign
D. Birds beak

In the surgical management of Malrotation, timing of intervention is of essence because of the

possibility of complication
A. Electrolyte imbalance
B. Dehydration
C. Hindgut volvulus
D. Intestinal ischemia

A 3 y/o patient was brought to the ER due to repeated vomiting,light green in color,epidosic abdominal
pain of 5 days in duration. On examination,the patient is severely dehydated ,doubling up every now
and then with recent onset of scanty bloody stools. Abdomen is distended with hyperactive bowel
sounds. Impression is.
A. Idiopathic intussusception
PEDIA SURGERY RECALLMIDTERMS BATCH 2016
B. Intussusception due to Merkel's
C. Intestinal volvulus
D.late onset malrotataion

Clinical manifestation of Hirschsprung disease

A. May present in varied but most common patient does not pass meconium in 1st 24 hours of life
B. Always present as obstruction right after birth
C. Manifest as chronic constipation in older children
D. Should primarily be considered on children with early chronic constipation

Chromosome evidence of possible genetic cause of Hirschprung's dse

A. Deletion of Long arm chromosome 10 locus 11.2 -21.2
B. Deletion of Short arm chromosome 10 locus 11.2 -21.2
C.MEN II
D. RET Oncogene

Electrolyte loss in pyloric stenosis

A. Potassium
B. Chloride
C. Bicarnonate
D. Sodium

Important aspect in diagnosis of pyloric stenosis

A. Hx and pe
B. Xray
C. Ultrasound
D. UGIS

True about inguinal hernia in children

A. Very seldom seen at birth
B. 60% will incarcerate in infancy
C. Not aggravated by increased abdominal pressure
D. MC presentation is obstruction

3 year old boy with no palpable scrotum, diagnosed with undescended testis. What is the management
of choice?
A. Observation
B. Orchidoplexy-ANS
C. Herniotomy
D.?

Plain xray findings in intestinal atresia:

A. paucity of colonic gas
B. multiple loops
C. double bubble sign

Type of intestinal atresia with familial association

A. Type I
PEDIA SURGERY RECALLMIDTERMS BATCH 2016
B. Type II
C. Type 3B
D. Type 3A

Contraindication for ESWL except:

A. pregnancy
B. bleeding
C. aneurysm
D. staghorn calculi

A newborn with upper abdominal distention & non bilous vomiting with Down’s facie & prominent
stomach on x-ray.
A. Pyloric stenosis
B. Malrotation
C. Pyloric atresia
D. Duodenal atresia

In malrotation, the location of cecum is

A. RLQ
B. LLQ
C. Side by side with the duodenum.
D. Mobile

Intestinal atresia usually associated with short bowel syndrome

A. web
B. Sausage
C.inverted v
D. Apple peel

A 1 y/o male, down syndrome, presenting with sudden onset of intermittent abdominal pain with
vomitting. Several hours later passed bloody stools. PE showed a healthy non cooperative infant with
abdominal pain and voluntary muscle guarding. most likely dignosis? INTUSSUSCEPTION

in older children with malrotation, the usual presenting symptom is

a. obesity
b. chronic abdominal pain
c. recurrent bilious vomiting
d. frequent stooling

Cause of post prandial pain- malrotation

Genetic evidence of hirscprung:

A. Familial association in all cases
B. Higher mode of transmission in male than female
C.female has 360x more transmission than male
D. The longer the aganglionosis lesser chance of transmission

The symptoms of Malrotation is related to

PEDIA SURGERY RECALLMIDTERMS BATCH 2016
A. Extraluminal obstruction by pancreas
B. Extraluminal obstruction by ladd's membrane
C. Duodenal compression by SMV
D. Volvulus of the sigmoid

Pedia most common cause of intussusception in children

A. meckels diverticulum
B.__
C. primary / idiopathic
D. lymphatic hypertrophy

Practical way to detect undescended testis?

A. Ultrasound
B. CT scan
C. Laparoscopy

Most common site of aganglionosis?

a. Rectosigmoid
b. Ascending colon
C. Descending Colon

2yo boy brought to ER, with irreducible right scrotal mass 3 days duration. Patient carried by mom,
covered with blanket, sunken eyeballs, cold to touch, greenish vomitus on mom’s sweater. Primary
assessment?
A. newborn, bilous vomit, malnutrition, down's
B. dehydrated by recurrent loose stools
C. dehydrated, fatigue, hypotonic
D. needs surgery immediately

Characteristic of pyloric stenosis:

a. bilous vomiting
b. progressive projectile non bilous vomiting
c. abdominal distension
d. usually septic

Definitive treatment of Hirschprung's disease

A. Anoplasty
B. Colostomy
C. Pull through
D. Laparoscopy
Clinical Manifestation of Malrotation-
(No choices)
Possible answers:
-bilous vomiting- most prominent clinical manifestation
- paucity of the bowel sound- presence of air in stomach and duodenum
- negative abdominal dustention and positive upper abdominal fullness