Child Conditions

Question 1

Symptoms of Pyloric Stenosis

Answer 1

PROJECTILE (non-bile stained) vomit

Typically occurs after each meal

Constant hunger

Weight loss

Question 2

Risk factors of Pyloric Stenosis

Answer 2

Boys

First borns

Family history

Question 3

Pyloric Stenosis Ix

Answer 3

Pyloric mass or ‘olive’ palpable in RUQ

Ultrasound

Barium meal

Question 4

Pyloric Mx

Answer 4

IV fluid for resuscitation and to correct electrolytes

Pyloromyotomy (muscle, but not mucosa of pylorus is cut)

Question 5

Gastroenteritis symptoms

Answer 5

-Infective diarrhoea and vomit

Question 6

Causes of Gastroenteritis in kids?

Answer 6

Rotavirus

Adenovirus

Question 7

Causes of bloody diarrhoea?

Answer 7

Bacterial

Campylobacter

Shigella

Intussusception

IBD

Question 8

Toddler diarrhoea classic presentation?

Answer 8

‘Pea and carrots syndrome’ (presence of undigested veg in the stools)

Question 9

Underlying cause of toddler diarrhoea?

Answer 9

Delay in intestinal motility

Question 10

Malabsorption symptoms

Answer 10

Anaemia

Abnormal stools (difficult to flush and very smelly)

Diarrhoea

Abdominal protrusion

Question 11

Coeliac disease symptoms

Answer 11

Dermatitis herpetiformis

Abnormal stools

Abdominal distension

Buttock wasting

Irritable

<2 years

Question 12

Pathology behind coeliac

Answer 12

Villus atrophy –> Flat mucosa

Question 13

Coeliac diagnosis

Answer 13

Jejunal biopsy (will confirm villus atrophy)

Screen for autoantibodies:

IgA, Anti-reticulum, Anti endomysium

Question 14

Coeliac Mx

Answer 14

Gluten free diet

Question 15

Common protein intolerances

Answer 15

Cow’s milk

Soya

Wheat

Fish

Chicken eggs

Question 16

Describe Hirschsprung’s Disease

Answer 16

A condition that affects the large intestine (colon) and causes problems with passing stool.

The condition is present at birth (congenital) as a result of missing nerve cells (parasympathetics) in the muscles of the baby’s colon

Question 17

Symptoms of Hirschspring’s Disease

Answer 17

Failure to pass stool in first 48 hours of life

Abdominal distension

Bile stained vomit

Question 18

Hirschsprung’s Disease Ix

Findings of Ix

Answer 18

PR exam

On withdrawal of finger, a gush of liquid stools and flatus

Question 19

How do you treat Hirschsprung’s Disease?

Answer 19

Surgery

Question 20

Presentation of tracheo-oesophageal fistula?

Answer 20

Chronic cough since birth

Nasal regurgitation

Recurrent aspiration pneumonia

Cough and cyanosis when feeding

Question 21

Child has a history of becoming unwell (i.e with chest infection) and getting mild jaundice which resolves once the infection clears.

What is the most likely diagnosis?

Answer 21

Gilbert’s syndrome

Question 22

Intussception symptoms

Answer 22

Recurrent jelly like stools

Palpable sausage shaped mass

Vomiting (could be bilious)

Episodic colicky abdo pain

Question 23

Is intussception most likely to affect boys or girls

Answer 23

boys

Question 24

Physiology of Intussception

Answer 24

Part of the bowel (usually the ileoceacal valve) has invaded into the next part of the bowel further on

Question 25

Where is the most common site for duodenal atesia to present?

Answer 25

Second part of the duodenum

Question 26

Characteristic appearance of a duodenal atresia on X-ray

Answer 26

Double bubble and no gas in bowel distally

Question 27

How do you treat duodenal atresia?

Answer 27

NG tube IV fluids

Question 28

What is biliary atresia?

Answer 28

Failure of biliary tract to develop Conjugated bilirubin accumulates in blood (it has been produced but it has no way of entering the gut) Causes jaundice & pale stools

Question 29

Ix Biliary atresia

Answer 29

Abdo USS Liver biopsy

Question 30

When would necrotising enterocolitis usually present?

Answer 30

Babies in their first week of life

Question 31

Symptoms of necrotising enetrocolitis

Answer 31

Pass blood Pass mucous Distended abdomen Perforation

Question 32

Ix Necrotising Enterocolitis

Answer 32

Stool cultures Abdominal X-ray

Question 33

Treatment of Necrotising Entercolitis

Answer 33

Stop feeding orally Broad spec antibiotics Parenteral nutrition Surgery

Question 34

Long term complications of necrotising entercolitis?

Answer 34

Malabsoprtion Strictures