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Paeds AM > Constipation and diarrhoea > Flashcards

Constipation and diarrhoea Flashcards

1
Q

What are the types of cause of cnstipation?

A

Social

Pathological

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2
Q

What are some pathological causes of constipation in babies?

A 
Impaction
MEconium ileus
Volvulus 
Bowel obstruction
Hirschsprung's disease
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3
Q

What is the management of faecal impaction?

A

Empty impacted rectum and colon

Maintain regular stool passage- Movicol- with slow weaning off treatment

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4
Q

What is meconium ileus?

A

Meconium becomes thick and congested in intestines and fails to pass

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5
Q

What is meconium ileus a red flag for?

A

CF

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6
Q

What is the presentation of meconium ileus?

A

Within first 48 hours
Bilious vomiting
Abdo distension
No passage of meconium, constipation

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7
Q

What is the investigation of meconium ileus?

A

AXR- fluid levels

Investigate for CF

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8
Q

What s the management of meconium ileus?

A

Surgical decompression

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9
Q

What are the risk factors for volvulus?

A

Malrotation

Hirschsprung’s

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10
Q

What is the presentation of volvulus?

A

Bowel obstruction
Peritoneal signs
Haemodynamic instability

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11
Q

What is the management of volvulus?

A

Emergency surgery

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12
Q

What causes bowel obstruction in newborns?

A

Imperforate anus
Congenital atresia/stenosis
Volvulus
Meconium uleus

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13
Q

What is the most common cause of bowel obstruction in 2-3 months?

A

Strangulated hernia

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14
Q

What is the most common cause of bowel obstruction in 3-18 months?

A

Intususseption

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15
Q

What is Hirschsprung’s disease?

A

Absence of ganglion cells from myenteric and submucosal plexuses causing chronic constipation

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16
Q

What is the presentation of Hirschsprung’s?

A

Delayed passage of meconium
Chronic constipation
Abdo distension

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17
Q

What is the management of Hirschsprung’s?

A

Anorectal pull through

18
Q

What is the most common cause of gastroenteritis?

A

Rotavirus

19
Q

What is the presentation of gastroenteritis?

A

Fever, vomiting and diarrhoea

20
Q

What are the types of cows milk protein allergy?

A

Immediate IgE related- 45% remain intolerant

Delayed non IgE mediated- majority tolerant by age 3

21
Q

What s the presentation of CMPA?

A

Regurgitation, vomiting
Diarrhoea
Irritability, crying
Failure to thrive

22
Q

How is CMPA diagnosed?

A

Clinically via removal of cow’s milk protein

23
Q

What is the management of CMPA in breastfeeding?

A

Maternal avoidance of cow’s milk protein

24
Q

What is the management of CMPA in formula feeding?

A

1st line= extensive hydrolysed formula

2nd= amino acid based formula

25
Q

When does IBD normally present?

A

Adolescence

26
Q

What is the histology of Crohn’s?

A

Inflammation of all layers at any level

Skip lesions, non caseating granulomas, crypt abscesses

27
Q

What is the presentation of Crohn’s?

A

Non bloody diarrhoea
Prominent weight loss
Abdo pain

28
Q

What is the histology of UC?

A

Lesions start at rectum and move proximally

Continuous mucosal inflammation with pseudo polyps

29
Q

What is the presentation of UC?

A

Bloody diarrhoea

Abdo pain

30
Q

What investigations should eb done for IBD?

A

Bloods- raised CRP, anaemia, low vit D and B12
Faecal calprotectin- increased
MR enterography- gold standard
Endoscopy, colonoscopy and biopsy- diagnostic

31
Q

What is the emergency imaging in IBD?

A

CT abdomen

32
Q

What are some causes of malabsorption?

A

Pancreatic disease- classically CF
Chronic liver disease
Cholestasis

33
Q

What can cause both diarrhoea and constipation?

A

IBS

Coeliac

34
Q

What is coeliac?

A

Autoimmune disease causing sensitivity to gladin fraction of gluten, leading to villous atrophy

35
Q

What are some risk factors for coeliac?

A

FH
Other autoimmune conditions
HLA DQ2 and DQ8

36
Q

What is the presentation of coeliac?

A 
Abdo bloating and pain
Diarrhoea/constipation
Failure to thrive
Tiredness
Dermatitis herpetiformis
37
Q

What investigations are done for coeliac?

A

Coeliac serology and IGA
HLA DQ2 and DG8
Duodenal biopsy

38
Q

What is done on a coeliac serology?

A

Anti tissue transglutaminae TTG
Anti endomysial
Anti-gladin

39
Q

What are the indications to diagnose coeliac without biopsy?

A

Anti TTG >10x upper limit
+ anti E
+ HLA

40
Q

What is the management of coeliac?

A

Gluten free diet

Refractory- steroids

Paeds AM (28 decks)

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