P year‎ > ‎Paediatrics‎ > ‎

12.09.05 Teaching notes

Key Surgical Conditions
  • Undescended testes
  • Inguinal hernia
  • Hydrocoele
  • Circumcision
  • Umbilical hernia
  • Tongue tie
  • Pyloric stenosis
  • Intususception
  • Causes of bowel obstruction
    • Malrotation volvulus
    • Intestinal atresia
    • Meconium ileus
    • Hirschprung's


Acid-base Tutorial

  • SBE vs BE
    • Base excess is the quantity required to return the plasma in-vitro to a normal pH
    • Standard base excess is the quantity required to fix the whole ECF
    • In practice they're quite similar, since the plasma does most of the buffering
  • Anion gap
    • = Na - (HCO3- + Cl-)
    • Should be around 12
    • Good measure of ketones, lactate
      • Not used much now, as lactate is measured directly
  • Chloride rise
    • Chloride "displaces" HCO3- and so causes a metabolic acidosis
    • This is "hyperchloraemic acidosis" and doesn't change the anion gap
  • Other causes of metabolic acidosis cause an isolated HCO3- fall and thus a fall in the anion gap
  • TPN contains acetate which is converted to HCO3- and causes a metabolic alkalosis


Retinopathy of prematurity (ROP)

  • Previously known as retrolental fibroplasia (RLF)
  • Caused by disorganized growth of retinal blood vessels
  • May result in scarring and retinal detachment
  • All preterm babies are at risk for ROP
    • Very low birth weight is an additional risk factor
  • Both oxygen toxicity and relative hypoxia can contribute to the development of ROP


VACTERL

  • Vertebral anomalies
  • Ano-rectal malformation
  • Cardiac anomalies
  • Tracheo-oesophageal fistulae
    • Most have NO patant oesophagus
    • End of oesophagus joins into trachea
    • Causes mucousy-bubbly-frothy mouth
  • Renal anomalies
  • Limb anomalies


Notes

  • Paediatric history
    • Developmental history
      • Scans
      • Milestones
    • Birth history
    • Neonatal history
    • Allergies
      • Pets, carpets, cigarettes
  • Babies breathe through their NOSE
  • Babies need FLUIDS and GLUCOSE but can survive without other stuff for quite a while
  • Umbilical arteries and vein remain patent for weeks
    • Can be used for venous/arterial access
  • Threshold for admission to NNU = 1.8 kg
  • ROP
Comments