Alterations In Digestive Function (Children Pt 1 & 2)

Question 1

Most alterations in the digestive function of children are congenital anomalies of the …

Answer 1

Intestinal Tract, disorders of digestion, absorption, nutrition, and liver disease

Question 2

Define Cleft lip (harelip) and cleft palate

Answer 2

Failure of the bony plate to fuse in the midline due to multiple gene-environment, interactions, and deficiency of vitamin B vitamins

Question 3

Cleft Lip

Answer 3

Is caused by the incomplete fusion of the nasomedial or intermaxillary process during the fourth week of development

Question 4

Cleft Palate

Answer 4

Results from the incomplete fusion of the primary palatal shelves during the third month of gestation.

Question 5

Esophageal Atresia

Answer 5

Esophagus ends in a blind pouch

Question 6

Tracheoesophageal fistula

Answer 6

Abnormal connection between the trachea and esophagus; incomplete closure of the laryngtracheal tube

Question 7

Esophageal atresia causes drooling or aspiration during feeding. T or F

Answer 7

True

Question 8

Esophageal Malformation patho

Answer 8

Post viral, environmental, & genetic

Question 9

Define Pyloric Stenosis

Answer 9

Obstruction of the pyloric sphincter is caused by hypertrophy/hyperplasia of CIRCULAR sphincter muscle. More common in male infants.

Question 10

Obstructions of the Duodenum, Jejunum, and Ileum

Answer 10

• Are caused by intrinsic malformations (atresia or stenosis)
• Obstructions may be partial or complete
• stenosis: narrowing down the lumen

Question 11

Intestinal Malrotation

Answer 11

Failure for of the colon to rotate during fetal development; Twisting is volvulus (twisting on the bowel on itself)

Question 12

What is the most common malformation of the GI tract for neonates?

Answer 12

Outpouching of all layers of the small intestinal wall called MECONIUM (meckel diverticulum)

Question 13

Meconium Ileus

Answer 13

Condition in the newborn in which intestinal secretions and amniotic waste products produce a thick TARRY plug that obstructs the intestine (usually from a lack of digestive enzymes).

Question 14

Distal Intestinal Obstruction Syndrome

Answer 14

Formerly called meconium ileus equivalent; Occurs when intestinal contents become abnormally THICK and obstruct the LUMEN

Question 15

Name 4 disorders that can cause obstructions in the small intestine (duodenal, jenjunal, and ileal)?

Answer 15

Meconium ileus: thicker than usual ileum causing bowel obstruction
Atresia: underdevelopment of an orfice (opening)
Peritoneal bands
Acquired obstructive disorders

Question 16

Meckel diverticulum is an ________ of all layers of the _____ intestine caused by a failure if the fibrous band that connects the small intestine to the umbilicus.

Answer 16

Outpouching; small intestine

Question 17

Congenital aganglionic megacolon (Hirschsprung disease) is cause by:

Answer 17

An absence of enteric ganglia and malformation of the PNS system in a segment of the colon, resulting in adequate colon motility and functional obstruction.

Question 18

Hirschsprung disease

Answer 18

Birth defect in which nerves are missing from parts of the intestine (obstruction of the colon).

Question 19

What is the most common cause of colon obstruction?

Answer 19

Hirschsprung disease

Question 20

Anorectal Malformations

Answer 20

Anal or rectal agenesis (no rectal orfice), atresia (underdevelopment of opening), & fistula (abnormal connection new two body parts)

Question 21

Deformities that cause complete obstruction are called

Answer 21

Imperforate anus

Question 22

Malformations of the anus and rectum range from mild congenital ________ of the anus to complex deformities, all of which are classified as __________ anus.

Answer 22

Stenosis; imperforate

Question 23

Meconium is

Answer 23

A substance that fills the intestine before birth

Question 24

Meconium plug syndrome

Answer 24

Benign bowel obstruction

Question 25

Meconium aspiration syndrome

Answer 25

Gasping respirations that cause meconium aspiration

Question 26

Meconium ileus

Answer 26

Abnormally sticky meconium causes intestinal obstruction

Question 27

In new borns GERD is normal. T or F

Answer 27

True; sphincter is not fully developed.

Question 28

Eosinophilic esophagitis is differentiated from GERD, it’s a separate disease that can occur in children called _____ _____.

Answer 28

Atopic disease

Question 29

Atopic disease

Answer 29

Immediate & delayed hypersensitivity reactions to food ingestion

Question 30

The most common cause of acquired intestinal obstruction in infants is called

Answer 30

INTUSSUSCEPTION

Question 31

Intussuception means

Answer 31

One portion of the bowel telescopes or invaginates into another.

Question 32

Clinical manifestations of Intussuception

Answer 32

Currant jelly stools (dark and gelatinous)

Question 33

Define Cystic Fibrosis: “Classic Triad”

Answer 33

- Inherited disease - pathophysiologic triad: 1) pancreatic enzyme deficiency (causes maldigestion ) 2) Increased mucus production in the resp. Tract 3) elevated chloride and sodium concentrations in sweat

Question 34

Cystic Fibrosis causes pancreatic insufficiency. T or F

Answer 34

True

Question 35

Pancreatic damage (secondary to CF) can eventually affect the beta cells resulting in diabetes mellitus. T or F

Answer 35

True

Question 36

Clinical Manifestations of CF

Answer 36

Growth failure, glucose intolerance, chronic lung infections

Question 37

Define Celiac Disease “Gluten intolerance” aka “gluten sensitive enteropathy”

Answer 37

Auto/Immune mediated lifelong disease of the small intestinal villous epithelium in the presence of a gluten containing diet. (T cell mediated, antibody, complement activation)

Question 38

Gluten

Answer 38

Protein component in cereal grains (wheat , rye, barley, oats, malt)

Question 39

A person with celiac disease loses _____ epithelium in the intestinal tract.

Answer 39

Villous

Question 40

Clinical Manifestations of Celiac disease

Answer 40

Stools: pale, bulky, foul smelling Child: failure to thrive

Question 41

Celiac disease: Primary vs Secondary Effects

Answer 41

Primary: Villus and atrophy, inflammation Secondary: mucosal damage (proximal bowel); decreased pancreatic function

Question 42

Kwashiorkor

Answer 42

Severe deficiency of protein; occurs in children ages 1-4 who have been weaned of breast milk

Question 43

Marasmus

Answer 43

Is a deficiency of all nutrients; common in children younger than 1 year old (lack of protein and carbs)

Question 44

Kwashiorkor & Marasmus causes ______mental and physical development.

Answer 44

Stunted

Question 45

Failure to thrive falls below the ____ percentile on the growth curve or shows stagnation in length or width.

Answer 45

Third

Question 46

Necrotizing Entercolitis is a disorder in neonates, particularly low birth weight or premature which is a result of:

Answer 46

- low birth weight - stress/anoxia from an immature bowel wall - Bacteria invade the mucosa and can result in colitis, necrosis, intestinal perforation, sepsis, and death. - causes death if left untreated

Question 47

Clinical manifestations of necrotizing enterocolitis

Answer 47

- Bloody stools after 8-10 days of age - Elevated wbc count - bradycardia - apnea

Question 48

Acute Diarrhea

Answer 48

Is associated with acute viral or bacterial gastroenteritis, contaminated food / water

Question 49

Chronic Diarrhea

Answer 49

Prolonged diarrhea; Very dangerous with children since they have lower fluid reserves than adults.

Question 50

Rotavirus

Answer 50

Is the leading cause of severe diarrhea in infants & young children worldwide.

Question 51

Primary Lactose Intolerance

Answer 51

Inability to digest milk sugar (lactose) results in osmotic diarrhea with ingestion of lactose-containing dairy products

Question 52

Physiologic jaundice of the Newborn

Answer 52

Mild hyperbilirubinemia; subsides 1-2 weeks (can cause brain damage called kernicterus)

Question 53

Billary Atresia

Answer 53

Congenital malformation of the bile duct that obstructs bile flow. Most common reason for liver transplantation in children.

Question 54

Hepatitis A Virus

Answer 54

Most common forms of chronic liver disease

Question 55

Portal Hypertension in children usually caused by extrahepatic obstruction. ______ of the portal vein is the most common cause of portal hypertension in children.

Answer 55

Thrombosis (splenomegaly is the most common sign)

Question 56

What are the three most common metabolic disorders that cause liver damage in children?

Answer 56

Galactosemia, fructosemia, and Wilson disease

Question 57

Wilson Disease

Answer 57

Defective cooper uptake and metabolism; accumulates in the kidneys, liver, and brain.

Question 58

Clinical Manifestations of Wilson Disease

Answer 58

Kayser - Fleischer rings : accumulation of copper in the limbus of the cornea causing a greenish yellow ring