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Flashcards in ABD problems Deck (64):
1

Bilious emesis is sign of

neonate sign of interstinal obstruction require immediate workup

2

Newborn with obstruction, on xray you see pneumoperitoneum; next step?

emergent surgery

3

Newborn w/ obstruction, x-ray shows dilated loops and no feces in rectum, next step?

water soluble contrast enema
can be therapeutic (breaks up feces)

4

meconium ileus is assoc with

Cystic fibrosis

5

Recurrent UTI in infants and children should ring a bell for?

Congenital UT anomaly
Vesicoureteral reflux

6

Vesicoureteral reflux causes

dilation of ureters (hydroureter)
and kidneys (hydonephrosis)

7

DX VUR
screen w/

voiding cystourethrogram
screen: USG

8

Chronic pyelonephritis appears

blunting of calices (calyceal clubbing)
focal parenchymal scarring

9

How to evaluate renal scarring?

Scinigraphy w/ Dimercaptosuccinic acid

10

MCC of chronic renal insufficiency/failure in kids

Posterior urethral valves

11

Increased AFP and bowel free in amniotic fluid

Gastroschisis

12

Complications due to amniotic fluid inflammation/edema in gastroschisis

necrotizing enterocolitis
short bowel syndrome
Dysmotility: prolonged reliance of TPN

13

Gastroschisis is an isolated defect _% of the time

90

14

Rx of Gastroschisis

After delivery cover in sterile saline and plastic wrap (minimizes insensible heat and fluid loss)
place NG tube
Start Antiobiotics
Prompt surgical repair

15

Omphalocele infants typically have 50% chance of

other major malformations:
cardiac disease
NT defects
Trisomy

16

Constipation in kids is exacerbated by

excessive milk consumption
toilet training
adjustment to day care or transitional events

17

Complications of constipation in kids

anal fissures
hemorrhoids
encopresis
enuresis/UTI
Vomiting

18

Rx constipation in kids

Increase dietary fiber
limit cows milk intake to

19

MCC of UT Obstruction in newborn?

Posterior urethral valves

20

Potters Syndrome

Pulmonary hypoplasia
Oligohydramnios
Twisted skin
Twisted face (facial abnormalities: flat facies)
Extremities (limb defects)
Renal agenesis
Sonogram: PUV= hydroureters, hydronephrosis

21

MC renal malignancy in kids

Nephroblastoma: Wilms tumor
mc age 2-5

22

Indications for renal and bladder USG during UTI?

kid

23

USG sees some hydronephrosis and scarring; next step?

VCUG

24

IDIOT: kid eats his moms iron tablets, antidote?

IV fluids
Deferoxamine

25

Iron poisoning causes

free radical production and lipid peroxidation which imparis various cell processes= systemic manifestation
ABD pain
hematemesis
Hypovolemic shock
M. Acidosis

26

Lead poisoning C/f in kids?

Irritability
poor appetitie
Headaches
ABD pain/anemia
Rx: Calcium EDTA, Succimer

27

Kid with blious emesis, given NG tube decompression and IV fluids, ABD xray shows no air in interstine, next step?

Upper GI series
possible malrotation (ligament of treitz on R side of abd)

28

Procedure called for fixing a volvulus?

Ladd procedure:
fixing the bowel in a non-rotated position to minimize recurrent volvulus risk

29

Classic triad of Biliary cyst

Pain, jaundice and palpable mass
Usually present

30

Dx and Rx biliary cyst

DX: USG and ERCP
Rx: Surgical resection to relieve obstruction and prevent malignant transformation

31

recurrent cystitis c/f

suprapubic pain
dysuria
pyuria
bacteriuria
toddlers: constripation

32

henoch schonlein purpura c/f

Typically follows infection
Palpable purpura
arthitis/arthralgia
abd pain, inussusceptions
renal disease similar to IgA nephropathy

33

rx HSP

Supportive: hydration and NSAIDS
Severe: hospitilization and steroids

34

Nephrotic syndrome assoc w/ HBV

membranous nephropathy
also: sle, drugs, infections

35

Nephrotic syndrome assoc w/ HIV

FSGS
also: heroin, CKD, Sickle cell

36

infantile hypertrophic pyloric stenosis r/f

first born boy
formula feeding: gradual hypertrophy of pylorus
onset around 3-5 wks

37

acid base disturbance in pyloric stenosis

hypochloremic m. alkalosis
(from vomiting)

38

milk protein allergy c/f

vomiting
poor weight gain
bloody stools

39

asian newborn with jaundice have decreased

hepatic UGT activity

40

physio jaundice pathophys (3 reasons)

At bith high HCT w/ short life span= high Hb turnover
Decreased UGT activity until 2 wks of age
Sterile newborn gut= inc enterohepatic recycling (cant breakdown bilirubin to urobilinogen)

41

Reye syndrome labs

Hyperammonemia
n/inc: bilirubin, ALP
Increased PTT
hypoglycemia
elevated AST,ALT, LDH

42

Biopsy of Liver in Reye syndrome

Microvesicular steatosis

43

Breastfeeding failure jaundice is

exaggerated unconjugated hyperbilirubinemia inf FIRST week of life that is caused by lactation failure

44

normal infant stool

Normally pass dark sticky meconium during first 2 days of life
then should transition to yellowish or green stool in ingesting adequate milk

45

breast milk jaundice time frame

starts age 3-5 days peaks at 2 weeks

46

breast milk jaundice is what

High levels of B-glucuronidase in breast milke deconjugate intestinal bilirubin and increase enterohepatic circulation
Normal exam and adequate breastfeeding
Indirect (unconjugated) hyperbilirubinemia up to 10-30 mg/dl

47

Rx breastfeeding failure jaundice

increase frequency and duration of feeds to stimulate milk production, adequate hydration and promote bilirubin excretion

48

Neonates and breast feeding times?

8-12 times a day (every 2-3 hrs)
for 10-20 mins per breast for 1st month of life

49

ingestion of chemical management

Secure ABCs
Remove contaminated clothing and visible chemical: irrigate exposed skin
Chest xray if resp symptoms
Endoscopy w/in 24 hrs

50

Gut immaturity, exposure to bacteria from enteral feeds,, leads to cascade of inflammation and damage to bowel wall; Dx?

Necrotizing enterocolitis (NEC)

51

Decreased rates of NEC in premature infants when fed?

breast milk instead of formula

52

Xray of NEC?

Air visible in bowel wall= pneumatosis intestinalis
portal venous air
severe intestinal necrosis can cause perforation and pneumoperitoneum

53

Meckels diverticulum c/f

Asymptomatic incidental finding
painless hematochezia (melena stools)
intussception
intestinal obstruction
volvulus

54

Dx meckels?

Technetium 99m pertechnetate scan

55

meckels is what

incomplete obliteration of fetal vitelline (omphalomesenteric) duct

56

In 1-8 wks a kid develops, Jaundice, acholic stools or dark urine, Hepatomegaly, Conjugated hyperbilirubinemia, Mildly elevated transaminases; Dx?

Biliary atresia

57

Dx biliary atresia

USG: absent or abnor Gallbladder
Hepatobiliary scintigraphy: failure of tracer to excretion
Intraoperative cholangiogram(gold standard): biliary obstruction

58

Rx biliary atresia

Hepatoportenterostomy (Kasai procedure)
LIver transplant

59

Intussusception r/f (6)

Viral illness or rotavirus vaccine
Meckels
HSP
Celiac disease
Intestinal tumor
Polyps

60

Wilms tumor arises from what embryologic precursor

Metanephros: renal parenchyma

61

Embryologic structures of mesonephros

Seminal vesicles
epididymis
ejaculatory ducts
ductus deferens

62

Paramesonephron gives rise to

fallopian tubes
uterus
part of vagina

63

Risk factors for jejunal atresia

vasoconstrictive meds
cocaine
tobacco
not assoc w/ chromosomal abnormalities

64

Jejunal atresia presents how

bilious vomiting
abd distention
Abd xray: triple bubble sign