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Leeds MBCHB Year 4 Peads > Gastroenterology > Flashcards

Gastroenterology Flashcards

(89 cards)

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1
Q

“Redcurrant jelly stools” dx

A

Intussusception

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2
Q

Persistent abdo pain and anaemia -> dx

A

Coeliacs or IBD

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3
Q

Raised focal calprotectin -> dx

A

IBD

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4
Q

Abdominal migraine presentation

A

central abdo pain LASTING LESS THAN 1 HOUR

Can have aura, photophobia or headaches

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5
Q

Management of abdominal migraine

A

Same as normal

Dark room, paracetamol, NSAIDs, sumatriptan

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6
Q

Prevention of abdominal migraines

A

Pizotifen - serotonin agonist

If stopped must be done slowly as causes depression

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7
Q

3 common (ish) secondary causes of constipation

A

Hypothyroidism, CF, Hirschsprungs disease

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8
Q

Term for feacal incontinence

A

Encopresis

Pathological at 4 years

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9
Q

“ribbon stool” dx

A

Anal stenosis

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10
Q

1st line management of constipation in kids

A

Movicol

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11
Q

Most common age for GORD in children

A

Under 1 years

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12
Q

Presentation of GORD in infants

A

Chronic cough, hoarse cry, reluctancy to feed, pneumonia, poor weight gain

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13
Q

Likely cause of “projectile vomiting”

A

Pyloric stenosis

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14
Q

Cause of “bile stained” vomiting

A

Internal obstruction

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15
Q

Likely cause of vomiting child with “blood in stools”

A

Cows milk allergy/ NEC

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16
Q

3 secondary causes of constipation

A

Hirschsprungs disease, CF, hypothyroidism

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17
Q

1st line management of GORD

2nd and 3rd

A

Advice/ thickened fluids
Gaviscon
Omeprazole

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18
Q

What is Sandifers syndrome

A

Abnormal movements associated with GORD

Torticollis (forceful neck muscle contraction causing neck twisting) and dystonia (abnormal twisting movements of back)

Improves when reflux is treated

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19
Q

Cause of pyloric stenosis

A

Hypertrophy -> narrowing of pylorus

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20
Q

Other than projectile vomiting how else can pyloric stenosis present

A

Failure to thrive

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21
Q

What may be found on examination in pyloric stenosis

A

“olive” like mass in abdomen

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22
Q

Blood gas analysis in pyloric stenosis

A

Hypochloric metabolic alkalosis

HCl is removed from stomach

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23
Q

How to diagnoses pyloric stenosis

A

Abdo USS

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24
Q

Treatment for pyloric stenosis

A

Laparoscopic pyloromyotomy (Ramstedt’s operation)

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25
2 most common causes of viral gastroenteritis
rotavirus and norovirus
26
What toxin does E Coli produce
Shiga
27
What can an E Coli 0157 infection lead to
Haemolytic uraemia syndrome (increased risk with ABX)
28
Child with abdominal cramps, bloody diarrhoea and vomitting
E coli 0157 infection (HUS)
29
Haemolytic uraemia syndrome triad:
Low platelets, low RBC and AKI
30
Most common cause of travellers diarrhoea and bacterial gastroenteritis
Campylobactor jejuni
31
Campylobacter jejuni gram stain
Negative
32
Abx for Campylobacter jejuni treatment
Azithromycin
33
Abdo cramping after eating left over rice
Bacillus Cereus *gram positive*
34
Bacillus Cereus incubation and recovery time
Vomiting within 5 hours, diarrhoea within 8 Resolves after 24 hours
35
Undercooked pork gram negative infection
Yersinia enterocolitica
36
Yersinia enterocolitica symptoms
Bloody diarrhoea, abdopain, fever and lymphadenopathy Can mimic appendicitis (mesenteric lymphadenitis)
37
Giardiasis treatment
Metronidazole
38
Giardiasis symtoms
None or chronic diarrhoea
39
How long off school do children need to remain after gastroenteritis
48 hours after symptoms resolve
40
Post gastroenteritis complications
IBS, lactose intolerance, reactive arthritis, Guillian Barre
41
Rash in coeliac disease
Dermatitis herpetiforms
42
3 neuro symptoms in coeliac
Peripheral neuropathy, cerebellar ataxia, epilepsy
43
What other condition is strongly associated with coeliacs
T1DM (test everyone) [anaemia/ b12 deficiency]
44
Most common genetic association with coeliac
HLA DQ2
45
3 auto antibodies in coelias
TTG, EMAs, DGP (test total IgA as TTG and DGP are IgA
46
What two features will a coeliacs biopsy show
Crypt hypertrophy | Villous atrophy
47
Acronym for Crohns
Crows Nest ``` No blood or mucus Entire GI tract Skip lesions Terminal ileum most affected AND Transmural Smoking is a risk factor ```
48
Acronym for UC
UC - CLOSE UP ``` Continuous inflammation Limited to colon and rectum Only superficial mucosa Smoking is protective Excrete blood and mucus ``` Use aminosalicylates Psc
49
Screening test for IBD
Faecal calprotectin
50
Management of crohns to induce remission
1: Steroids 2: enteral nutrition (mix of amino acids and pro biome nutrients)
51
Drugs used in crohns to maintain remission
Azothioprine or Mercaptopurine
52
When would surgery be used in Crohns
When it only affects the distal ileum
53
What does the drug choice in inducing remission depend on in UC
Mild to moderate: aminosalicytlale | Severe: steroids
54
Drug used to maintain remission in UC
Aminosalicylate
55
Two types of surgical choices in patients with UC
ileostomy ileo anal anastomosis (j pouch)
56
How does biliary atresia present
Persistent jaundice (lasting more than 14 days) in newborn
57
Bilirubin analysis results in biliary atresia
High conjugated As liver still working
58
Management of biliary atresia
Surgery Kasai portoenterostomy
59
Can a patient with intestinal obstruction pass wind
No
60
Vomiting type in obstruction
Green/ bilious
61
Bowel sounds in obstruction
Tinkling/ high pitched Absent later
62
Initial investigation for ?obstruction
Abdominal xray
63
What will an abdominal X-ray show in an obstructed patient
Dilated loops Absence of air in rectum
64
Treatment of obstruction
Drip and suck NGT/rhyls IV fluids DO NOT GIVE METOCLOPRAMIDE
65
Cause of Hirschsprung's disease
Nerve cells of mesenteric plexus/ auerbachs plexus not present in bowel and rectum No peristalsis
66
Word meaning lack of plexus in Hirschsprung's disease in whole colon
Total aganglionic
67
4 condition Hirschsprung's disease is associated with
T21 Neurofibromatosis Waardenburg syndrome MEN 2
68
Presentation of Hirschsprung's disease
Delay in passing meconium Chronic constipation Abdominal pain, distention, vomiting Failure to thrive
69
Main complication of Hirschsprung's disease (other than constipation)
Hirschsprung's associated entrocolitis 2-4 weeks after birth, fever, distention and sepsis which can lead to toxic megacolon and perforation
70
How to diagnose Hirschsprung's disease
Rectal biopsy Can also do abdo X-ray to check for HAEC
71
Definitive management of Hirschsprung's disease
Removal of ganglionic bowel
72
5 association with intussusception
``` Concurrent viral illness HSP CF Polyps Meckel diverticulum ```
73
Classic symptoms of intussusception
Redcurrant jelly stool Sausage shaped mass in RUQ Severe colicky abdominal pain (viral illness proceeding)
74
intussusception diagnosis is by?
USS or contract enema
75
Management of intussusception
Therapeutic enemas to push bowel back Surgical reduction
76
4 complication of intussusception
Obstruction Gangrenous bowel Perforation Death
77
Peak age for appendicitis
10-20 years
78
4 key appendicitis ddx
Ectopic pregnancy Ovarian cysts (particularly with rupture and torsion) Meckels diverticulum - malformation of distal ileum that can bleed, become inflamed and rupture Mesenteric adenitis
79
Rovsings sign
Palpation of LIF causes pain in RIF
80
How is appendicitis dx made
Clinical history and raised inflmataory markers CT can help USS can exclude female pathology
81
What is a appendix mass
Omentum sticks to inflamed appendix forming a mass ABX and fluids Remove later
82
Management of appendicitis
laparoscopic appendicectomy
83
What antibody mediates CMPA
IgE But can be non IgE and occur over several days
84
Usual age of presentation of CMPA
Under 1 year
85
CMPA symptoms
Bloating, wind, abdominal pain, D&V General allergic symptoms: rash, swelling, cough, sneezing
86
When do most children outgrow CMPA
3 years
87
Management and testing of CMPA
No testing available STOP MUM CONSUMING DAIRY IF BREAST FEEDING Hydrolysed cow milk
88
Can breastfed babies get CMPA
YES
89
When should children be weaned
6 months If baby is high risk allergic, try allergens at 4 months

Leeds MBCHB Year 4 Peads (21 decks)

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