EXAM #2: VOMITING IN INFANTS & CHILDREN Flashcards Preview

Gastrointestinal System > EXAM #2: VOMITING IN INFANTS & CHILDREN > Flashcards

Flashcards in EXAM #2: VOMITING IN INFANTS & CHILDREN Deck (28):
1

What is the definition of apnea in infants?

Apnea lasting longer than 20 seconds

2

What is GER?

Gastroesophageal Reflux--passage of gastric contents into the esophagus

*Normal process

3

What is regurgitation?

Effortless spitting up of gastric contents

4

Is pea-soup emesis worrisome? Why?

Yes--bilious emesis

5

Is projectile vomiting worriesome? Why?

Yes--pyloric stenosis

6

What are the red flags of emesis in the pediatric population?

- Bilious emesis
- GI Bleeding
- Failure to thrive
- Forceful projectile emesis
- Emesis after 6 months (should be getting better)
- Lethargy
- Bulging fontanelle

7

Where is the emetic center located?

Reticular formation of the medulla

8

Where is the chemoreceptor trigger zone?

Floor of the 4th ventricle

9

What are the signs of Gastroenteritis?

- History of ill contacts
- Fever
- Abdominal pain i.e. irritability in kids
- Diarrhea
- Nausea vomiting
- Acute onset

10

What are the common viral causes of Gastroenteritis in the pediatric population?

Rotavirus
- Adenovirus
- Norwalk virus
- Astrovirus
- Calcivirus

11

What viral cause of gastroenteritis has a vaccine?

Rotavirus

12

How is Gastroenteritis treated?

1) Hydration
2) Fever control
3) Tincture of Time

13

What are the signs of meningitis?

- Fever (high)
- Irritability
- Lethargy
- Headache
- Vomiting
- Petechia

14

What is the common viral cause of meningitis in kids?

Enterovirus

15

How does meningitis cause vomiting?

- Meningeal inflammation
- Increased ICP

16

What is the definition of GERD?

- Passage of gastric contents into the esophagus
- + symptoms

17

What are the signs of GERD in infants?

1) Feeding difficulty
2) Hematemesis
3) Failure to thrive
4) Wheezing--aspiration, lower
5) Stridor--aspiration, lower
6) Apnea

18

Why does GERD cause apnea?

Laryngospasm--airway protection mechanism

19

What is Sandifer Syndrome?

Reflux resulting in a seizure-like presentation
- Pain
- Rhythmic tensing/ alternating head movements

*This puts GERD in the differential for infantile seizures*

20

How should you begin to work-up of GERD for a child?

1) History and physical
2) Review growth chart

21

What is the initial diagnostic study for GERD?

Upper GI Series to rule out anatomic anomaly

22

What is a secondary study to perform in the initial work-up GERD?

Esophageal pH probe

23

What lifestyle modifications can be made to treat GERD in infants?

1) Increase caloric density and decrease volume
2) Thicken feeding with rice cereal
3) Use formula with rice starch or carob bean that THICKENS IN THE STOMACH

24

What medications can be used to treat GERD?

1) Antacids
2) PPI
3) H2 blockers
4) Prokinetic agents

25

What is the utility of a PPI in the diagnosis and treatment of GERD?

4 week trial can be used for diagnosis and treatment

26

What is the surgical intervention for GERD?

Nissen Fundoplication

27

What is a Nissen Fundoplication?

- Upper stomach sutured around the esophagus
- Increases the tone of the LES

28

What are the complications can occur with a Nissen Fundoplication?

1) 10% have issues with procedure
2) 10% require revision