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PEDS UWORLD > ABD problems > Flashcards

ABD problems Flashcards

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1
Q

Bilious emesis is sign of

A

neonate sign of interstinal obstruction require immediate workup

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2
Q

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

A

emergent surgery

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3
Q

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

A

water soluble contrast enema

can be therapeutic (breaks up feces)

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4
Q

meconium ileus is assoc with

A

Cystic fibrosis

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5
Q

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

A

Congenital UT anomaly

Vesicoureteral reflux

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6
Q

Vesicoureteral reflux causes

A 
dilation of ureters (hydroureter)
and kidneys (hydonephrosis)
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7
Q

DX VUR

screen w/

A

voiding cystourethrogram

screen: USG

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8
Q

Chronic pyelonephritis appears

A

blunting of calices (calyceal clubbing)

focal parenchymal scarring

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9
Q

How to evaluate renal scarring?

A

Scinigraphy w/ Dimercaptosuccinic acid

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10
Q

MCC of chronic renal insufficiency/failure in kids

A

Posterior urethral valves

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11
Q

Increased AFP and bowel free in amniotic fluid

A

Gastroschisis

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12
Q

Complications due to amniotic fluid inflammation/edema in gastroschisis

A

necrotizing enterocolitis
short bowel syndrome
Dysmotility: prolonged reliance of TPN

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13
Q

Gastroschisis is an isolated defect _% of the time

A

90

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14
Q

Rx of Gastroschisis

A

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

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15
Q

Omphalocele infants typically have 50% chance of

A

other major malformations:
cardiac disease
NT defects
Trisomy

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16
Q

Constipation in kids is exacerbated by

A

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

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17
Q

Complications of constipation in kids

A 
anal fissures
hemorrhoids
encopresis
enuresis/UTI
Vomiting
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18
Q

Rx constipation in kids

A

Increase dietary fiber

limit cows milk intake to

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19
Q

MCC of UT Obstruction in newborn?

A

Posterior urethral valves

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20
Q

Potters Syndrome

A

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

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21
Q

MC renal malignancy in kids

A

Nephroblastoma: Wilms tumor

mc age 2-5

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22
Q

Indications for renal and bladder USG during UTI?

A

kid

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23
Q

USG sees some hydronephrosis and scarring; next step?

A

VCUG

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24
Q

IDIOT: kid eats his moms iron tablets, antidote?

A

IV fluids

Deferoxamine

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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

PEDS UWORLD (9 decks)

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