Exam 2 - GI

Question 1

when is the GI system formed during embryonic development

Answer 1

first 4 weeks

Question 2

the GI tract arises from the ___ layer

Answer 2

endoderm

Question 3

can an infant still breastfeed with a cleft lip

Answer 3

yes but depends on the severity

Question 4

when is a cleft lip repair

Answer 4

1-2 months and again at 4-5 years

you want complete closure by 6-24 months

Question 5

cleft lip puts children at higher risk for ___ ___ and ___ ___

Answer 5

ear infection; hearing loss

Question 6

what is esophageal atresia

Answer 6

congenital malformation where the esophagus terminates before reaching the stomach

Question 7

3 C’s for esophageal atresia

Answer 7

coughing
choking
cyanotic

Question 8

HOB should be at least __ degrees for esophageal atresia

Answer 8

30

Question 9

how often to suction with esophageal atresia

Answer 9

q5-10 minutes

Question 10

what 2 meds need to be administered ASAP d/t aspiration risk

Answer 10

IVF
abx

Question 11

what are the 4 motility disorders

Answer 11

GERD
constipation, encopresis
recurrent abdominal pain
IBS

Question 12

s/sx of physiological GERD

Answer 12

painless emesis after meals
rarely occurs during sleep
weight gain
no aspiration
will outgrow by 1-2 y/o

Question 13

s/sx of pathologic GERD

Answer 13

FTT
aspiration PNS and/or asthma
apnea
coughing, choking
frequent emesis with abdominal pain, crying
risk for aspiration, ear infection
meds and/or sx for treatment

Question 14

GERD management

Answer 14

diet
positioning
meds
tx acute bleeding
surgery (fundoplication)

Question 15

constipation/encopresis management

Answer 15

overcoming withholding
diet changes
change retention habits
emotional support
home care
evaluation
toileting schedule
keep a change of clothes on hand

Question 16

IBD management

Answer 16

corticosteroids
immune suppressants (MTX)
abx
low fat, low fiber diet
high protein diet

Question 17

appendicitis s/sx develop slowly over __ hour period

Answer 17

12

Question 18

s/sx of appendicitis

Answer 18

pain
anorexia
N/V
fever

pain proceeding vomiting, appendicitis is likely

Question 19

possible position of child with appendicitis

Answer 19

knee-chest

Question 20

what are the 4 obstructive disorders

Answer 20

hypertrophic pyloric stenosis
intussusception
volvulus
Hirschsprung’s disease

Question 21

when does hypertrophic pyloric stenosis occur

Answer 21

within the first few weeks after birth

Question 22

cause of hypertrophic pyloric stenosis

Answer 22

unknown but can be genetic predisposition

Question 23

what to assess with hypertrophic pyloric stenosis

Answer 23

frequency, consistency and amount

Question 24

concern with hypertrophic pyloric stenosis

Answer 24

dehydration
weight loss

Question 25

where may there be a palpable mass with hypertrophic pyloric stenosis

Answer 25

R of the umbilicus

Question 26

preop: hypertrophic pyloric stenosis

Answer 26

NPO IVF NGT elevate HOB

Question 27

postop: hypertrophic stenosis

Answer 27

elevate HOB PO rehydrating solution (when bowel sounds return) formula started if PO hydration is tolerated x24 hours I&Os (weigh diapers, daily weight)

Question 28

when does intussusception occur

Answer 28

5 months to 3 years

Question 29

s/sx of intussusception

Answer 29

abdominal pain mass in RUQ red, currant jelly like stools vomiting fever lethargy

Question 30

intussusception treatment

Answer 30

NPO until active bowel sounds radiographic air enema saline enema NGT sx is LAST resorT

Question 31

what must always be documented with intussusception

Answer 31

see and document all characteristics of BM

Question 32

Hirschsprung disease is commonly seen in individuals with ___ ___

Answer 32

Down Syndrome strong heredity

Question 33

Hirschsprung disease is d/t ___ ___ in 1 part of the GI tract

Answer 33

inadequate immobility

Question 34

s/sx of Hirschsprung disease

Answer 34

delayed meconium passage chronic constipation first month of life abdominal pain, distention FTT ribbon like stools

Question 35

Hirschsprung disease can lead to a ___ ___

Answer 35

permanent colostomy

Question 36

Hirschsprung pre op

Answer 36

NPO abx monitor abdominal circumference monitor electrolytes

Question 37

Hirschsprung post op

Answer 37

bowel sounds s/sx infection BM anal dilators

Question 38

most common malabsorption disorder

Answer 38

lactose intolerance

Question 39

what are the 4 types of lactose intolerance

Answer 39

primary secondary congenital developmental

Question 40

primary vs. secondary vs. congenital vs. developmental lactose intolerance

Answer 40

P: around 5 y/o S: secondary to illness or injury C: rare, hereditary D: seen in premature babies, gets better over time

Question 41

where is tropical sprue Celiac disease seen mostly

Answer 41

Caribbean India SE Asia

Question 42

what is short bowel syndrome

Answer 42

congenital malformation 50% less bowel than normal individual

Question 43

lactose intolerance is more common in ___ and ___ ___

Answer 43

Asians Native Americans

Question 44

how to dx lactose intolerance

Answer 44

stool test

Question 45

where is gluten seen

Answer 45

protein seen in wheat, barely, rye, and oats

Question 46

how to Dx Celiac

Answer 46

Bx jejunum IgA blood work

Question 47

which form of hepatitis is most prevalent in children

Answer 47

hepatitis A

Question 48

what is biliary atresia

Answer 48

inflammation, obstruction of the bile duct hard time with fats and bile salts

Question 49

#1 indication for liver transplant in children

Answer 49

biliary atresia

Question 50

treatment for cirrhosis of the liver in children

Answer 50

no treatment, supportive measures