GASTROENTEROLOGY Flashcards
(92 cards)
An exclusively breastfed infant has not stooled
for 5 days with no other symptoms. The stool is
soft with no rectal bleeding. The infant is gaining weight
Reassurance (breastfed infants may go several
days or even a week between bowel movements)
A 1-week-old child with frequent spit-ups,
otherwise doing well
Reassurance (newborn reflux is normal)
A 3-week-old first newborn boy presents with
nonbilious projectile vomiting, hypochloremic,
hypokalemic metabolic alkalosis, and dehydration
Pyloric stenosis
What are the upper GI series useful for?
To rule out anatomic or motility problems. Does
not diagnose reflux
What is the next best step in cases with suspected pyloric stenosis?
Abdominal US (pylorus)
Weight loss, abdominal pain, nausea, effortless
postprandial regurgitation after at least 1 meal
daily for 1 month, regurgitated food occasionally reswallowed, rechewed, or spit out
Rumination syndrome
Child with no known health problem woke up
suddenly vomiting blood. The child is stable and
acting normal. What is the most likely cause?
Epistaxis (nose bleeding is the most common
source in healthy children)
Nausea and vomiting every 1–2 months, each
episode lasts for few hours, otherwise healthy, no symptoms in-between episodes, positive family history of migraine
Cyclic vomiting syndrome
A 7-year-old healthy child, with periumbilical
abdominal pain worse in the morning prior to
school, improves during weekends with normal
growth parameters
Reassurance (functional abdominal pain)
Adolescent presents with recurrent episodes of
abdominal pain, diarrhea, and sometimes
constipation in the previous 3 months. No weight loss and all labs are normal. What is the best treatment?
Peppermint oil, diet modifications, cognitive
behavioral therapy
High achieving adolescent complains of crampy
abdominal pain, diarrhea, and at other times,
constipation; pain is relieved with stooling
Irritable bowel syndrome
A mother brought her toddler with a diaper full of undigested food, the child is holding a large bottle of apple juice
Toddler diarrhea
What is the major concern of using antimotility
drugs such as Loperamide?
May induce ileus
The best management of toddler’s diarrhea
Juice restriction and allow normal dietary fat
Child with a low-grade fever, 6 episodes of
diarrhea, otherwise reassuring medical exam.
What is the treatment of choice?
Oral rehydration therapy (avoid anti-diarrheal
agents)
An infant presents with bright red blood stool,
poor weight gain, diarrhea, and fussiness; the
infant is breastfeeding, supplemented with
standard infant formula; stool guaiac test is
positive
Cow milk protein intolerance
Child with dysphagia, recurrent food impaction;
biopsy shows an increased eosinophil?
Eosinophilic esophagitis
Child accidentally swallowed caustic liquid 6 h
ago, presents with dysphagia, oral pain, chest
pain, nausea, and vomiting
Endoscopy in 12–24 h after ingestion
Adolescent with recurrent headaches takes
ibuprofen as needed, presents with dysphagia and chest discomfort (does not like to drink water with medicine)
Pill-induced esophagitis
4 weeks passed and the coin still in the stomach
with no symptoms
If the coin does not pass through the stomach by 4 weeks or if the patient is symptomatic, removal by endoscopy should be considered
Swallowed a coin, no symptoms, and radiograph showed the coin still in the esophagus
Observe for 12–24 h, removal of the coin if it
does not pass to the stomach or if the patient
became symptomatic
Swallowed a coin, no symptoms, and radiograph showed the coin in the stomach
Checking the stool for passage for 4 weeks, with
weekly radiographs, if indicated
Swallowed a button battery (BB), and passed to
the stomach with symptoms
Immediate removal
Swallowed a coin, excessive drooling, and chest
pain, and radiograph showed the coin still in the
esophagus
Immediate removal
