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Paediatrics RIA > Abdominal pain > Flashcards

Abdominal pain Flashcards

(62 cards)

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1
Q

loose, frequent stools with blood and mucus, passing stools overnight, weight loss, family hx

A

IBD

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2
Q

what intolerance can last following an infectious gastroenteritis + how can it be managed

A

Lactose intolerance

Lactose exclusion diet for up to 6-8 weeks

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3
Q

what can cause blood on the outside of a hard stool

A

constipation

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4
Q

Coeliac screen

A

IgA anti tissue transglutaminase

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5
Q

protein biomarker present in faeces when intestinal inflammation present

A

Faecal Calprotectin

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6
Q

what investigation can be used in place of Barium studies

A
  • Small bowel MR enterography
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7
Q

patchy inflammation/skip lesions

A

chrons disease

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8
Q

continuous inflammation in large bowel

A

ulcerative colitis

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9
Q

pattern seen in chrons

A

cobblestoning pattern

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10
Q

inflammation affects which layers in chrons and UC

A

chrons: transmural involvement

UC: limited to mucosa

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11
Q

trx coeliac disease

A

lifelong gluten free diet

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12
Q

symptoms/features coeliac disease (7)

A
  • abdo pain
  • faltering growth
  • iron deficiency (microcytic anaemia)
  • stool: freq, bulky, pale
  • weight loss
  • fatigue
  • pallor
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13
Q

cause of Haemolytic uremic syndrome

A

E coli 0169

commonly from poorly processed meat

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14
Q

where is bacillus cereus found

A

reheated rice

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15
Q

features of HUS

A
  • diarrhoea becomes bloody
  • thromocytopenia
  • anaemia
  • haematuria
  • Creatine levels raise
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16
Q

protein low in pancreatic involvement of CF

A

faecal elastase

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17
Q

inflammatory causes of abdominal pain

A
  • gastroenteritis
  • UTI
  • Hepatitis
  • IBD
  • appendicitis
  • pancreatitis
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18
Q

what is intussception

A

when a segment of the intestine invaginates into adjoining intestinal lumen

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19
Q

risk factors to ask about in a history of abdominal pain

A
  • history of recent foreign travel
  • infectious contact
  • contacts with similar symptoms
  • eaten foods out of ordinary
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20
Q

what is recurrent abdo pain defined as

A

at least 1 episode per month for at least 3 consecutive months, which is severe enough to interfere with routine functioning

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21
Q

vomiting red flags

A
  • haematemesis
  • abdo tenderness/distension
  • blood in stools
  • bulging fontanelle
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22
Q

presentation of proximal intestinal obstruction

A
  • billous vomiting
  • abdo pain
  • abdo distension
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23
Q

risks of rapid weight loss

A
  • refeeding syndrome
  • hypoglycaemia
  • infection
  • cardiac arrhythmia
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24
Q

what is refeeding syndrome

A

a metabolic disturbance associated with malnourishment

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25
causes of rapid weight loss in adolescents
- coeliac disease - IBD - anorexia - malignancy - achalasia - addisons disease - juvenile arthritis - T1DM - hyperthyroidism
26
investigations for rapid weight loss
- phosphate - ECG - U+E - blood glucose - calcium - magnesium - LFTs - CRP - TFT - coeliac screen - ESR - WCC
27
DSM 5 criteria for anorexia nervosa
- restriction of energy intake relative to requirements leading to a sig low body weight - intense fear of gaining weight despite being underweight - disturbance in the way in which ones body image is experienced
28
physiological abnormalities of anorexia nervosa
- low: oestrogen, testosterone, FSH, LH - raised: cortisol + GH - high cholesterol - hypercarotinaemia - impaired glucose tolerance - low T3
29
3 main types of eating disorders
- anorexia nervosa - bulimia nervosa - EDNOS
30
behavioural and psychological features of anorexia (4)
- feeling fat - disturbed body image - wont eat in front of others - compulsive exercise
31
clinical features of anorexia
- low weight for height - amenorrhoea - headaches, dizziness, fainting - constipation - dry skin - cool peripheries - hair loss - hypotensive, tachycardia, hypothermia - peripheral oedema - enlarged salivary glands
32
short term management for anorexia nervosa
- physical stabilisation | - if < 75% weight to height ratio then start: thiamine, vit b complex, multivitamins
33
medium term management of anorexia nervosa
MDT package in community
34
long term management of anorexia nervosa
- prevention | - BEAT charity
35
how can CBT help those with anorexia
help to build self esteem, cope with social pressure, identify certain thought patterns
36
complications of anorexia nervosa
starvation causing muscle loss including heart and diaphragm resulting in difficulty breathing and cardiac failure GI tract - constipation, nausea, bloating osteoporosis brain atrophy halitosis from repeated vomiting
37
What is lanugo
soft hair covering body which develops as a response of loss of insulating effect of fat
38
2 support organisations for anorexia nervosa
BEAT charity FEAST
39
what is a marker of refeeding syndrome
drop in phosphate level
40
what is refeeding syndrome
when refeeding stimulates insulin secretion resulting in cells taking in K+ and Mg2+ and phosphate --> leaving low levels in serum --> cardiac arrhythmias + death
41
what is bulimia
type of eating disorder characterised by episodes of binge eating, followed by intentional vomiting or other purgative behaviours
42
name 4 purgative behaviours
- laxatives - diuretics - exercising - vomiting
43
durance of bulimia symptoms for diagnosis
- at least once a week for 3 months
44
side effects of repeated vomiting
- eroded enamel - sialadenosis - halitosis - russel sign - mallory weiss tears - dehydration - electrolyte depletion
45
long term effects of laxative use
- loss of bowel motility - worsening constipation - rectal prolapse w/ slow healing
46
4 surgical causes of abdominal pain
1) Testicular torsion 2) appendicitis 3) Bowel obstruction 4) Intussception
47
not passing meconium within 48 hours of birth - possible causes (2)
- Hirschsprung’s disease | - Cystic fibrosis
48
what is 1st line laxative for chronic constipation?
movicol
49
why does GORD occur in babies?
in babies their is immaturity of the lower oesopahgeal sphincter, allowing stomach contents to easily reflux
50
metabolic disturbance seen in pyloric stenosis
hypocholoraemic, hypokalaemic metabolic alkalosis
51
diagnostic invx for pyloric stenosis
albomdinal USS
52
derm symptom in Coeliac disease
Dermatitis herpetiformis is an itchy blistering skin rash
53
Endoscopy and intestinal biopsy findings in coeliac disease
- villous atrophy | - crypt hypertrophy
54
causes of intestinal obstruction
- Intussception - Meconium ileus - Imperforate anus - Strangulated hernia - Oesophageal/duodenal atresia
55
AXR finidngs in bowel obstruction
dilated loops of bowel - haustra indicate large bowel - valvulae conniventes indicate small bowel (complete circle around width of bowel)
56
pathophysiology of Hirschprungs disaease?
absent nerve cells in the myenteric plexus (auerbach plexus) in the distal bowel & rectum absence of parasympathetic ganglion cells
57
3 conditions associated with Hirschprungs disease?
Downs syndsome Neurofibromatosis MEN Type 2
58
presentation of hirscprungs disease
- failure to pass meconium - chronic constipaton - abdominal distension & vomiitng - failure to thrive & poor weight gain
59
typical presenting age of Intussception
6 months to 2 years
60
3 differentials for appendicitis
- ectopic pregnancy - ovarian cysts - Meckel's diverticulum
61
a cause of prolonged jaundice (lasting longer than 14 days)
Biliary atresia
62
what is biliary atresia?
progressive destruction of the extrahepatic biliary system

Paediatrics RIA (12 decks)

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