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Pediatrics > GI > Flashcards

GI Flashcards

1
Q

Sandifer syndrome

A

spasmodic tordional dystonia; opsthotonic posturing, mainly involving the neck, back and upper extremities, associated with GERD

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2
Q

Diagnosis of reflux/aspiration

A

video barium swallow

milk scan (less specific, more sensitive)

Salivagram (if likely upper airway secretion aspiration)

BAL (lipid-laden macrophage = aspiration)

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3
Q

evaluation of elevated LFTs in obese child

A

Don’t forget hepatitis B and C
PSC
autoimmune hepatitis

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4
Q

Tx of hospitalized patients with acute severe colitis

A

IV steroids
Infliximab
Colectomy if no response 10-12 days after initiation

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5
Q

Fecal lactoferrin

A

iron-binding protein found inside neutrophils
Sensitive and specific for detecting IBD (but can be positive for any intestinal inflammation)

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6
Q

Appendicitis tx

A

surgery here in US
Abx only ok in europe

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7
Q

Ddx of infant who is not able to swallow solids

A

congenital esophageal stricture
Vascular ring

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8
Q

What is the Apt-Downey test and what is the oldest age to test it on

A

detects fetal hemoglobin
+ means it’s from the baby
- means its maternal

8 week old

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9
Q

How does secondary lactose intolerance happen in celiac disease?

A

atropy of lactase-containing vili

will resolve when celiac is treated (gluten-free diet)

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10
Q

How do you diagnose lactose intolerance

A

lactose breath testing
intestinal biopsy (less commonly done)

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11
Q

Chronic vs. acute recurrent vs. acute pancreatitis

A

Acute (2/3):
1. abd pain epigastric
2. serum amylase/lipase 3x ULN
3. Imaging finding consistent with pancreatitis

Acute recurrent:
At least 2 episodes of AP and 1 of the following
- Complete resolution of pain between AP episodes
- complete normalization of pancreatic enzyme measurements between AP episodes

Chronic (any below)
- Abd pain consistent with pancreatitis
- evidence of exocrine pancreatic insufficiency
- evidence of endocrine pancreatic insufficiency
- biopsy

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12
Q

Causes of Acute recurrent pancreatitis or chronic pancreatitis

A

CF
Pancreas divisum, annular pancreas
HLD, medications (VPA or 6-MP)
autoimmune pancreatitis
Primary sclerosing cholangitis

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13
Q

What is rectal suction biopsy used to detect?

A

Hirschsprung

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14
Q

What neonatal diseases is AFP elevated in

A

omphalocele, gastrocschisis, neural tube defects

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15
Q

High bHCG in early pregnancy ddx

A

trisomy 21
placental tumor
molar pregnancy

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16
Q

Celiac lab findings

A

normal pancreatic elastase and elevated fecal fat from fat malabsorption

17
Q

Syndrome associated with exocrine pancreatic insufficiency

A

Shwachman Diamond syndrome

18
Q

Juvenile polyp, signs symptoms, age onset, treatment

A

1-7 yo
Painless, intermittent rectal bleeding
Polyp in distal colon

Tx: resection. No further follow up for colonoscopy is indicated

UNLESS there is >5 polyps. Then Juvenile polyposis syndrome. Need colonoscopy q1-3y

19
Q

Villous atrophy and intraepithelial lymphocytosis. dx?

A

celiac

20
Q

Common causes of cholestasis in first few months of life. Labs to get

A

biliary atresia
idiopathic neonatal cholestasis
parenteral nutrition-associated cholestasis (TPN)
Obstruction (bile stone, choledochal cyst)
CF
Metabolic/endocrine disorder (e.g. tyrosinemia)
Panhypopituitarism
Alagille syndrome

Labs: alpha1 antitrypsin lvl, TFT, Abd US, review newborn screen

21
Q

Liber biopsy for those with biliatry atresia would show

A

evidence of fibrosis
bile duct plugging
bile ductal proliferation

22
Q

Tx of biliary atresia

A

Kasai hepatoportoenterostomy (HPE) – re-establish bile flow before age 90 days

May need liver transplant (cirrhosis, portal htn)

23
Q

Ddx of rectal prolapse, when to be concerned

A

<4yo due to normal anatomy
If >4yo, usually abnormal

Usual etiology:
constipation, severe chronic cough.
Rectal poplyp
Hirschsprung

24
Q

Causes of dysphagia in young people (teen and young adult)

A

EoE

need EGD

25
Q

Tx of EoE

A

3-6 food elimination
topical steroids (fluticasone or oral viscous budesonide)
PPI

If doesnt respond, may need elemental formula

26
Q

When does biliary atresia present?

A

After the first few weeks of life

27
Q

Crigler-Najjar. Problem is conjugated or unconjugated hyperbilirubinemia?

A

unconjugated

28
Q

Gilbert syndrome, conjugated or unconjugated problem hyperbilirubinemia?

A

unconjugated

29
Q

Physiologic neonatal jaundice is caused by what immature enzyme?

A

bilirubin uridine diphosphate-glucoronosyltransferase BUGT

Also increased enterohepatic circulation of unconjugated bilirubin, and increased bilirubin from hemolysis of RBCs

30
Q

Physiologic neonatal jaundice is caused by what immature enzyme?

A

bilirubin uridine diphosphate-glucoronosyltransferase BUGT

Also increased enterohepatic circulation of unconjugated bilirubin, and increased bilirubin from hemolysis of RBCs

31
Q

Dx of functional constipation

A

2 or less defacations in the toilet per week
At least 1 episode of fecal incontinence per week, history of stool retention, hx of painful/hard bowel movements, rectal fecal mass, large-diameter stools that may obstruct the toilet

32
Q

CF in infants, signs/symptoms

A

hepatomegaly
steatorrhea
severe diaper dermatitis
malnutrition

33
Q

Superior Mesenteric artery syndrome sx

A

significant weight loss followed by bilious emesis

34
Q

Causes of emesis you should not forget about

A

malrotation
volvulus (corkscrew)
duodenal atresia (double bubble)
EoE
abdominal migraine
pyloric stenosis

35
Q

How does hypophosphatemia occur in refeeding syndrome?

A

increased phosphate use in production of ATP

36
Q

Other electrolyte abnormalities in refeeding sd besides hypophos

A
  • hypomag
  • hypo K (increased insulin from sudden hyperglycemia)
  • hypo-thiamine

Pediatrics (26 decks)

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