Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 Paeds CCs > 7. GI minor > Flashcards

7. GI minor Flashcards

1
Q

What are red flag symptoms associated with abdominal pain?

A

-Peritonitis
-Rigid abdomen
-Guarding
-Signs of shock
-Bilious vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can cause acute abdominal pain in children?

A

GI:
-Gastroenteritis
-Peptic ulcer
-Acute appendicitis
-Mesenteric adenitis
-IBD
-Constipation
-Diabetes
-Necrotising enterocolitis
-Malrotation with volvulus
-Intussusception
-Intestinal obstruction
Non-GI:
-UTI
-Diabetes
-Lower lobe pneumonia
-Renal calculi
-Henoch-Schonlein purpura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is mesenteric adenitis?

A

-Swollen lymph glands in the stomach
-Occurs after recent viral infection
-Can mimic appendicitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Henoch-Schonlein purpura?

A

-Disease causing inflammation of small blood vessels - skin, intestines, kidneys, joints
-Purpuric rash seen on legs + joint pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is malrotation with volvulus?

A

-Torsion of intestine causing compromised blood flow and closed loop obstruction
-A surgical emergency occurring in the first month of life
-Causes bilious vomiting, peritonitis, haemodynamic instability, difficulty feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is intussusception?

A

-Part of the intestine folds into the section next to it
-Causes colic, shock, jelly stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some red flags associated with recurrent abdominal pain?

A

-Weight loss
-Diarrhoea
-Blood PR
-Joint symptoms
-Rashes
-FHx of coeliac / IBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some gynae causes of recurrent abdo pain?

A

-Dysmenorrhoea
-PID
-Ovarian cyst
-Haematocolpos (= vagina fills with menstrual blood due to imperforate hymen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes appendicitis?

A

-Appendix becomes blocked by stool, foreign body, tumour, infection
–Appendix can swell in response to any infection in the body
-Uncommon in children <4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the components of McBurney’s triad?

A

-Pain in RIF
-Low grade fever
-N+V (usually only once or twice)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What signs would you expect to find with appendicitis?

A

-Pain on movement
-Tenderness in RIF
-Decreased bowel sounds
-Tachycardia
-Rovsing’s sign (= pain in RIF on palpation of LIF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the pathophysiology of coeliac disease?

A

-Repeated exposure to gluten causes villous atrophy in the intestine
-Causing malabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What investigations can be done to diagnose coeliac disease?

A

-TTG (=tissue transglutaminase) antibodies
-FBC, folate (iron deficiency anaemia)
-Jejunal biopsy (crypt hyperplasia, subtotal villous atrophy)
-TFTs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What complications can arise from coeliac disease?

A

-Iron-deficiency anaemia
-Hyposplenism
-Osteoporosis
-Lactose intolerance
-Subfertility
-Enteropathy-associated T-cell lymphoma of small intestine, rarely other malignancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the mainstay of treatment for coeliac disease?

A

-Gluten free diet + re-challenge after 2 years
-Also give pneuomoccocal vaccine due to functional hyposplenism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What can cause feeding problems in children?

A

-Cleft palate
-CNS disorders
-Prematurity / LBW
-Airway problems
-Head + neck problems including muscle weakness
-Autism
-Parent-child issues

17
Q

What issues with food can cause feeding techniques?

A

-Quantity of food
-Kind of food eg early mixed feeding
-Feeding technique

18
Q

What does WHO recommend for weaning children from 6 months?

A

-Combine food with milk to ensure getting nutrients until 8 months before cutting down
-One taste at a time
-Blend at first, gradually do so less to get child used to new textures
-Once weaned, move from being fed with a spoon –> finger feeding –> feeding themselves
-Avoid low fat, high sugar + salt foods, soya + soft cheeses
-No honey or cow’s milk until 12 months

19
Q

What is an inguinal hernia?

A

-Protrusion of abdominal cavity contents through the inguinal canal
-Indirect >common than direct
-More common in boys, prom babies and on the right side due to later descent of the right testis
-Due to patent processus vaginalis
-Usually asymptomatic, increases in size on crying

20
Q

How is an indirect inguinal hernia confirmed on examination?

A

-Does not transluminate (whereas a hydrocele would)
-Testis should be palpable and distinct from swelling
-Reduction of swelling should be possible

21
Q

How should an inguinal hernia be managed?

A

-Surgery - within a few weeks of diagnosis due to risk of incarceration
-Urgent if irreducible, hard, tender, vomiting

22
Q

What causes a hydrocele?

A

-Forms instead of a hernia when connection with processus vaginalis is small
-Swelling is painless, transluminates and cannot be reduced
-Spontaneous resolution by 12 months

23
Q

What is the pathophysiology of intussusception?

A

-Telescoping of proximal bowel into distal bowel
-Usually ileum –> caecum
-In infants 6-18m, usually caused by Peyer’s patch (= lymph tissue in bowel wall) becoming slightly inflamed after a viral gastroenteritis and gets stuck
-In older children, caused by polyps, Meckel’s diverticulum

24
Q

How should you investigate intussusception?

A

-USS = gold standard - target-like mass seen in RLQ
-Sausage shaped mass may be palpable on abdo exam
-Red-currant jelly stool

25
Q

How should intussusception be managed?

A

-Fluids
-Abx/analgesia
-Urgent reduction via air insufflation under radiological control
–NB not done if peritonitic, perforated, shocked or prolonged - laparotomy done instead

26
Q

What is the pathway of bilirubin conjugation?

A
  1. Haem breakdown in RBC –> bilirubin
  2. Transported to the liver as unconjugated + binds to albumin + conjugated (now water soluble)
  3. Conjugated bilirubin excreted in bile into the duodenum (some is reabsorbed here)
  4. Reabsorbed conj bilirubin is excreted in kidneys as urobilinogen
  5. Rest is excreted in stools as stercobilinogen
27
Q

What causes jaundice?

A

-Build up of bilirubin - serum level >25-30mmol
-Excess haemolysis, impaired conjugation or obstruction can lead to build up

28
Q

What normally causes jaundice in neonates?

A

-Infection - Hep A, EBV, malaria
-Haemolytic disease (if jaundice + pallor)

29
Q

What can cause a build up of unconjugated bilirubin?

A

-Excess bilirubin production
-Impaired liver uptake
-Impaired liver conjugation eg Gilbert’s
-Haemolysis eg sickle cell, thalassaemia, G6PD deficiency

30
Q

What can cause intrahepatic cholestasis?

A

-Infection eg hepatitis, liver abscess, toxoplasmosis
-Toxic eg drugs
-Metabolic eg Wilson’s disease, alpha-1-antitrypsin deficiency, hypothyroidism
-Biliary hypoplasia

31
Q

What can cause cholestatic / obstructive jaundice?

A

-Bile duct obstruction eg CF, biliary atresia, cholecystitis, cholangitis, cysts

32
Q

What is kernicterus?

A

-Unconjugated bilirubin crossing BBB when it reaches high concentrations, deposited in the basal ganglia
-Can cause acute encephalopathy eg irritiability, coma, high-pitched crying

33
Q

What features does mesenteric adenitis have?

A

-Associated with viral symptoms eg fever, headache, pharyngitis
-Enlarged nodes cause acute pain which can mimic appendicitis
-No peritonitis or guarding
-Treat with simple analgesia, may require period of observation to rule out appendicitis

34
Q

What causes pyloric stenosis?

A

-Hypertrophy of pylorus (=muscular valve between stomach and duodenum) causing blockage of passage of food
-Usually develops in first 2-8 weeks of life

35
Q

What signs and symptoms does pyloric stenosis have?

A

-Vomiting that increases in intensity, immediately after feed, projectile + recurrent
-Hungry infant, weight loss
-Dehydration
-Small for age
-Hard mobile mass palpable in RUQ

36
Q

What would be found on investigating pyloric stenosis?

A

-USS - thickened, elongated pylorus
-Low chloride, potassium + sodium
-Metabolic alkalosis

37
Q

How should pyloric stenosis be managed?

A

-Full hydration + electrolyte correction
-Pyloromyotomy (surgery)

Y4 Paeds CCs (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions