GI

Question 1

Hyperbilirubinemia

Answer 1

Conjugated:

• ALWAYS PATHOLOGIC
• biliary atresia tx tplant
• Dubin-Johnson
• galactosemia

Unconj:

• benign (physiologic peaks 2-3 days, breast milk 3-5 days peaks 2 weeks)
• breastfeeding failure (1st wk, dehydration)
• hemolysis if high in first 24 h
• Gilbert
• Crigler-Najjar

Question 2

Pyloric stenosis

Answer 2

First born boys 1-2 mo erythromycin
Nonbilious vom
Dx abd us
Tx myotomy

Question 3

Intussusception

Answer 3

<2 peyer patches
>2 meckels (dx tec99 ectopic gastric mucosa, 
Painless hematochezia)
Dx us target sign
Tx air enema

Question 4

Volvulus

Answer 4

Malrotation, bilious emesis
Unstable go to surg
Stable 1) Ng decomp —> 2) IVF —> 3) XR r/o pneumoperitoneum gasless abdomen —> 4) upper GI series=barium swallow corkscrew, then surg
Ligament of treitz on the R

Question 5

Choanal atresia

Answer 5

Cyanosis better w crying worse w feeding

CHARGE = coloboma (hole in the eye) Heart atresia retardation growth/dev ear

Question 6

Vitamin deficiencies

Answer 6

B1 thiamine beri beri (heart wet muscle weakness dry) wernicke
B2 riboflavin derm glossitis chelosis stomatitis normocytic anemia
B3 niacin pellagra derm PHOTOSENSITIVE RASH dementia/depression, diarrhea, death
B6 pyridoxine RARE like B2 + personality changes
B9 folate
B12 cobalamin
C scurvy
A eye probs, rash ext surfaces
D rickets

Question 7

Milk protein allergy

Answer 7

2-8w
Eczema
Hematochezia
Usually resolved by 1y

Question 8

Necrotizing enterocolitis

Answer 8

XR air in bowel wall, hep portal vein, preemies, congenital heart defects/hypotension (poor perfusion)

Question 9

Too high Tbili

Answer 9

> 17, phototherapy, if it doesn’t work transfusion

HEARING LOSS

Question 10

Galactosemia

Answer 10

First few days of life before NBS results, jaundice, vomiting, hepatomegaly