Brainscape's Knowledge GenomeTM

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


See full index

Paediatrics > Gastroenterology and Nutrition > Flashcards

Gastroenterology and Nutrition Flashcards

1
Q

What are the causes of vomiting in an infant?

A
  • Reflux/GORD
  • Overfeeding (common in bottle fed infants)
  • Pyloric stenosis
  • Infection, e.g. gastroenteritis, UTI, meningitis
  • Intestinal obstruction
  • Cow’s milk protein allergy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the epidemiology of gastro-oesophageal reflux

When does this typically resolve for most infants?

A

Extremely common in first year of life

Usually resolves by 1 year in vast majority of cases

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

Describe the investigation of gastro-oesophageal reflux

A

Diagnosis is usually clinical, therefore investigations are not usually required

If investigations are required:

  • 24 hour oesophageal pH monitoring
  • Endoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the management of gastro-oesophageal reflux and GORD (conservative, medical and surgical)

A

Conservative:

  • Smaller, more frequent feeds
  • Feed thickening agents

Medical:
- Acid suppression, either with H2 receptor antagonist (e.g. ranitidine) or PPI (e.g. omeprazole)

Surgical:
- Very rarely, surgical intervention is required (fundoplication)

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

Give 2 examples of complications of GORD in infants/children

A
  • Faltering growth

- Recurrent chest infections

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

Describe the pathophysiology of pyloric stenosis

A

Hypertrophy of the pyloric muscle causing gastric outlet obstruction

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

When does pyloric stenosis usually present?

A

2-8 weeks

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

What is the main symptom of pyloric stenosis?

A

Projectile vomiting

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

a) Describe the initial investigation of pyloric stenosis
b) What may bloods show?
c) What type of imaging is used to confirm the diagnosis?

A

a) Test feed = visible peristalsis and “olive” shaped mass in RUQ
b) Hypochloraemic, hypokalaemic metabolic alkalosis
c) USS to confirm diagnosis

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

Describe the definitive management of pyloric stenosis

A

Surgery (pyloromyotomy)

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

What is faltering growth?

A
  • Sub-optimal weight gain

- Sustained drop down 2 centile spaces

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

How are the causes of faltering growth classified?

A
  1. Inadequate intake
  2. Inadequate retention, e.g. GORD
  3. Malabsorption, e.g. coeliac
  4. Increased requirements, e.g. congenital heart disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In most cases, the cause of faltering growth is…

A

Inadequate intake of food

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

Describe the vomiting in an infant with suspected intestinal obstruction

A

Bilious (green) vomit = intestinal obstruction until proven otherwise

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

What are the causes of intestinal obstruction in infants/children?

A
  • Intussusception
  • Malrotation
  • Meckel’s diverticulum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the pathophysiology of intussusception

A

Most commonly involves the ileum passing into the caecum through the ileocaecal valve (invagination of the bowel)

17
Q

What are the textbook signs of intussusception?

A
  • ‘Sausage’ shaped mass on abdominal exam

- ‘Redcurrant jelly’ stool

18
Q

In intussusception, what may be visible on imaging?

A
  • USS may show characteristic ‘target’/’donut’ sign

- XR may shows signs of obstruction, e.g. distended small bowel

19
Q

Describe the definitive management of intussusception

A

Rectal air insufflation (unless there are signs of peritonitis, in which case surgery is required)

20
Q

Describe the pathophysiology of malrotation

When does this usually present?

A

Abnormality of midgut rotation during embryological development

Usually presents in first few days of life

21
Q

Describe the investigation of suspected malrotation

A

Urgent upper GI contrast study

22
Q

Describe the management of malrotation

A

Surgery

23
Q

Describe the pathophysiology of appendicitis

A

Appendix becomes obstructed, allowing bacteria to multiply

24
Q

What are the clinical features of appendicitis

A
  • Acute abdominal pain (tenderness +/- guarding) starting generalised then localising to RIF
  • Fever
  • Vomiting
25
Q

Describe the investigation of appendicitis

A

Abdominal USS

26
Q

Describe the management of appendicitis

A

Appendicectomy

27
Q

Describe the epidemiology of constipation in infants/children

A

Very common

28
Q

What are the causes of constipation in infants/children?

A
  • Usually caused by dehydration/lack of fibre

- Can be caused by other conditions, e.g. hypothyroidism, cystic fibrosis, Hirschsprung disease (rare)

29
Q

What may happen in children when there is long-standing constipation?

A

Overflow soiling

30
Q

Describe the management of constipation (conservative/medical)

A

Conservative:

  • Adequate fluid/fibre intake
  • Encourage good toileting habits

Medical:

  • Mild/moderate = osmotic laxatives, e.g. movicol
  • Severe cases = disimpaction regimen required (osmotic + stimulant laxative, e.g. sodium picosulphate or senna)
31
Q

Describe the pathophysiology of Hirchsprung disease

When does it usually present?

A

Congenital disorder in which there is an absence of ganglion cells in part of the bowel, which prevents peristalsis in that section of bowel (usually affects rectum and sigmoid colon)

Usually presents in neonatal period, with failure to pass meconium within 48 hours of life

32
Q

Which test is done to confirm a diagnosis of Hirschprung disease?

A

Rectal biopsy

33
Q

Describe the management of Hirschprung disease

A

Surgical (anorectal pull-through)

34
Q

Describe the textbook sign of Meckel’s diverticulum

A

Massive rectal bleeding

35
Q

Describe the definitive management of Meckel’s diverticulum

A

Surgery

36
Q

How much formula should bottle fed infants be having in a day?

A

150ml/kg per day

37
Q

What are the common causes of gastroenteritis?

A
  • Norovirus

- Roatvirus

38
Q

What is the main concern in a child presenting with gastroenteritis?

A

Dehydration

39
Q

Post-gastroenteritis, patients may develop…

A

Transient lactose intolerance

Paediatrics (17 decks)

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