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laughing your way peds > GI > Flashcards

GI Flashcards

1
Q

How does functional dyspepsia present

A

Recurrent pain in the upper abdomen or periumbilical area that cannot be relieved with change in stool patterns and there is no organic cause

Symptoms must be present once a week for at least 2 months

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2
Q

Tx for functional dyspepsia

A

Eliminate nsaid, spicy foods and soda

Meds - h2 blockers or PPI also low dose antidepressants

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3
Q

How does IBS present

A

Abdominal discomfort improved with defecation, changes in stool frequency or changes in stool consistency

Could also have bowel urgency with feeling of incomplete evacuation. Passage of mucus, bloating, and abdominal distention.

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4
Q

Tx for IBS

A

Dietary changes (reduce sorbitol, fructose and gas forming foods) and address psychological issues

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5
Q

What should you consider in a pt that presents with recurrent abdominal pain and urinary retention, tachycardia, blurred vision, dry mouth

A

Anticholinergic meds that were inappropriately prescribed

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6
Q

What should be the diet for a child who has moderate to severe dehydration due to diarrhea

A

Avoid fatty foods and foods high in simple sugars

Oral rehydration solution should be 2% glucose and 90meq of sodium chloride

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7
Q

What are the different ecoli that cause diarrhea and which ones cause bloody stools

A

Enteropathogenic - non bloody (neonates and kids < 2)

Enterotoxigenic - non- bloody (travelers diarrhea)

Shiga toxin producing/enterohemorrhagic - bloody after 3-4 days (can cause HUS antibiotics contraindicated)

Enteroaggregative - non bloody

Enteroinvasive - bloody with tenesmus

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8
Q

XRAY findings for volvulus

A

Gastric and duodenal dilatation

Decreased intestinal air and cork screw appearance of the duodenum

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9
Q

Lab findings in pyloric stenosis

A

Hypochloremic metabolic alkalosis with severe hypokalemia

Elevated indirect bill

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10
Q

Diagnostic criteria on ultrasound for pyloric stenosis

A

Pyloric length > 14mm

Pyloric muscle thickness > 4mm

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11
Q

How does ectodermal hypoplasia present and how is it diagnosed

A

Absent teeth. X linked

Diagnosed by skin biopsy which shows lack of sweat pores

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12
Q

How does hallermann Strieff syndrome present

A

Underdeveloped small teeth

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13
Q

What are risk factors for h. Pylori

A

Low socioeconomic status and immigration from a developing country

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14
Q

Next step if h. Pylori serologic testing is positive

A

Another study to confirm such as fecal antigen or urea breath test

Limit testing to those at risk

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15
Q

Tx for h. Pylori

A

PPI + 2 antibiotics

Clarithromycin and amox or clarithromycin and metronidazole

7-14 day course

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16
Q

How do you diagnose celiac disease

A

Biopsy

Antibodies are only for screening

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17
Q

Tx for irritable bowel syndrome

A

High fiber diet, attention to emotional factors. Amitryptyline.

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18
Q

How does gardners syndrome present

A

Extra teeth, polyps (premalignant), ostromas

Autosomal dominant

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19
Q

How does peutz-jeghers syndrome present

A

Pigmentation of lips and gums along with a lot of colonic polyps (premalignant)

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20
Q

Tx for UC when disease is a medical emergency

A

Fluids, blood transfusion and steroids

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21
Q

Tx for UC when infection

A

Metronidazole

22
Q

First line medical tx for UC

A

5 ASA (aminosalycylate)

23
Q

Second line medical tx for UC

A

Corticosteroids, 6 mercaptopurine or azarhioprine or methotrexate, cyclosporine or tacrolimus

24
Q

Descriptions for chron’s

A

Skip lesions on XRAY, cobblestone appearance on endoscopy. Transmural lesions and noncaseating granulomas

25
Q

What should you rule out in a child older than 6 that presents with intussusception

A

Lymphosarcoma

26
Q

Tx for intussusception

A

Air contrast enema as it’s diagnostic and therapeutic

27
Q

Dx and tx for hirschsprung disease

A

Rectal biopsy / surgical excision

Proximal aganglionic segment is distended with stool

28
Q

Tx of peptic ulcer disease

A

H2 blocker, sucralfate, prostaglandin analogues (misoprostol), PPI

29
Q

What are the rules of 2 for meckel diverticulum

A

Presents around the age of 2 or bf

2 types of tissue (gastric and intestinal)

2 feet from ileocecal valve

2 inch in length

2% of newborns affected

(Painless rectal bleeding)

30
Q

How does cholestatic jaundice present

Stasis!

A

Elevated direct bili and elevated alkaline phosphatase and elevated GGT

Liver dz vs anatomic/obstructive hepatobiliary scintigraphy first step for dx

Most common cause is TPN

31
Q

How does biliary atresia present

A

Elevated direct bili in newborn usually at 3 wks of age and less than 2 months old

Clay colored stools

32
Q

How does choledochal cyst present

A

Neonatal jaundice, fever, acholic stool, RUQ pain, palpable mass

Dx with ultrasound

33
Q

What is the deficiency in GILBERT syndrome

A

Glucuronyl transferase deficiency

34
Q

Presentation of GILBERT syndrome

A

Teenager who is jaundiced after a URI or fasting!

Intermittently elevated unconjugated bili w illness or other stressors. Recognized after puberty.

Familial condition

35
Q

Lab findings in GILBERT syndrome

A

Elevated indirect bili and normal LFTs

36
Q

Lab findings in Wilson disease

A

Low serum Cooper and ceruloplasmin level

Elevated tissue Cooper (liver) and urine

37
Q

Tx of Wilson disease

A

D-Penicillamine

38
Q

Lab finding in liver failure

A

Elevated serum ammonia level and mental status change

Think of reye when you give aspirin to someone with varicella or flu

39
Q

Most specific test in diagnosing pancreatitis

A

Abdominal ultrasound

40
Q

What can pancreatitis be associated with

A

Pulmonary edema and pleural effusion

41
Q

Causes of recurrent or chronic pancreatitis

A

Familial dyslipidemia

Hypercalcemia (hx of hyperparathyroidism or kidney stones)

Infection, autoimmune, inherited conditions, medications

42
Q

Presentation of cholecystitis

A

fever, pain radiating to the right scapula, palpable mass in the right upper quadrant

Jaundice not common

43
Q

Conditions that predispose kids to cholecystitis

A

Hemolytic disease, TPN, small intestinal disease, obesity, pregnancy

44
Q

Risk factors for gallstones

A

CF, ileal resection, treatment with ceftriaxone, TPN

45
Q

Presentation of cholelithiasis

A

Jaundice, hepatosplenomegaly

46
Q

How do you dx biliary atresia

A

Biopsy!

First test is ultrasound followed by HIDA ultimately a biopsy

47
Q

Tx for biliary atresia

A

Kasai procedure to act as a bile duct. Where you join liver to intestines

48
Q

What markers will you see during acute Hep b infection

A

HBsAg
HBeAg
HBV-DNA

49
Q

What markers are present during recovery of Hep b

A

Anti-HBs
Anti- HBc
Anti- HBe

50
Q

What is Hep C associated with

A

Hepatocellular carcinoma and cirrhosis

51
Q

Most common cause of chronic viral hepatitis

A

Hep C

laughing your way peds (26 decks)

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