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  1. Admin

    weekly question 13/7/2025

    Correct answer a transfer the patient directly to the operating room at your hospital. The treatment priority with testicular torsion is expedient operative detorsion. A 2024 APSA TEC Talk pointed out that delays in definitive care are mostly due to pre-hospital delays due to deficits in...
  2. Admin

    weekly question 13/7/2025

    You are called by a physician at a local urgent care facility about a 12-year-old boy with 8 hours of right scrotal pain. A scrotal ultrasound shows twisting of the right spermatic cord and there is an absence of testicular blood flow on color doppler. The most appropriate plan is to a transfer...
  3. Admin

    chart Nutcracker syndrome

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  4. Admin

    weekly question 6/7/2025

    A three-kg term infant with prenatally identified congenital diaphragmatic hernia (CDH) is on high frequency oscillation ventilation. Persistent pulmonary hypertension and evidence of left ventricular dysfunction is noted on echocardiogram. Addition of which of the following pharmacologic agents...
  5. Admin

    weekly question 29/6/2025

    A 27-week neonate weighing 950g is born at an outside hospital. The neonate is in respiratory distress. The airway is secured after three attempts, There are also several attempts to pass an NG tube each of which meets resistance at 8 cm.The infant has stabilized after intubation and an...
  6. Admin

    weekly question 22/6/2025

    Correct answer d Observation with ultrasound surveillance at 6 and 12 months This patient has a breast mass less than 5 cm in diameter with benign sonographic features and no high-risk history. Current guidelines recommend observation and serial imaging for low-risk fibroadenoma-like lesions of...
  7. Admin

    weekly question 22/6/2025

    A 14-year-old girl presents to your clinic with a palpable, non-tender right breast mass noted for the past 3 weeks. She denies trauma, fever, or nipple discharge. On exam, the mass is firm, mobile, and measures approximately 4 cm in diameter. An ultrasound shows a solid, well-circumscribed...
  8. Admin

    video Necrotizing enterocolitis stoma creation

    see video link in second post
  9. Admin

    weekly question 15/6/2025

    An 11-year-old girl presents to your clinic with a history of chronic constipation. She underwent a Duhamel procedure for Hirschsprung disease when she was a newborn. Previous transition zone was identified in the proximal-descending colon based upon review of medical records. She is markedly...
  10. Admin

    weekly question 8/6/2025

    A 13-year old girl presents with mild epigastric pain. Laboratory studies include an AST 135 IU/L, ALT 173 IU/L, total bilirubin 1.9 mg/dL, direct bilirubin 1.4 mg/dL, amylase of 400 u/L, lipase of 500 u/L. Right upper quadrant ultrasound shows small stones in the gallbladder with a 7-mm...
  11. Admin

    a clinical pearl In diagnosis of Gynecomastia

    Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "The breast tissue present in gynecomastia is most often tender, firm, and subareolar. One third of boys will present with unilateral gynecomastia. A mass in the breast that is not subareolar and is...
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