Gastroenterology Flashcards
(99 cards)
1
Q
What are GI causes of vomiting?
A
Appendicitis
Intussusception
Gastroenteritis
Obstruction
2
Q
GU causes for vomiting in children?
A
UTI
3
Q
What are the 2 categories for vomiting?
A
forcefulness
color
4
Q
What are the 2 categories for forcefulness?
A
non projectile
projectile
5
Q
What are the 2 categories for color?
A
bilious
nonbilious
6
Q
What is non projectile d/t?
A
reflex
usually normal
7
Q
What is projectile d/t?
A
obstruction
8
Q
What color is pathologic?
A
green
9
Q
What is bilious color d/t?
A
obstruction
10
Q
What are the causes of non bilious vomit?
A
overfeeding
GER
GERD
pyloric stenosis
11
Q
How does overfeeding cause non bilious vomit?
A
new parents think baby is crying b/c s/he is hungry
12
Q
How many cal is recommended for babies?
A
100-120 kcal/kg/day
13
Q
What is GER?
A
just spit up
NOT a pathological finding
usually d/t weak lower esophageal muscle
14
Q
When is GER most common?
A
3-4 mo
15
Q
GER-tx?
A
reassurance
sit up after feeds
change formula
16
Q
GERD?
A
pathological changes take place
17
Q
GERD-sx?
A
projectile vomit
fussy
wt loss
18
Q
What is pyloric stenosis?
A
non bilious vomit BUT obstructive
the pylorus muscle becomes super big (hypertrophy) causing the stenosis to get narrow –> baby throws up
19
Q
Pyloric stenosis - commonly seen when?
A
3-5 wks
20
Q
Pyloric stenosis -cx?
A
maybe d/t macrolide that is used to treat chlamydia pneumonia
21
Q
Color of pyloric stenosis vomit?
A
non bilious - coffee ground mix
22
Q
Pyloric stenosis - PE?
A
b/c the pylorus muscle is big –> olive like mass felt on RUQ
23
Q
Pyloric stenosis- labs?
A
b/c baby is throwing up all the time —> metabolic alkalosis (throwing up acid)
24
Q
Pyloric stenosis - tx?
A
surgery
25
Pyloric stenosis - prognosis?
after surgery baby gets fat b/c it was not thriving before
26
What is a type of bilious vomit?
necrotizing enterocolitis
Midgut volvulus
Intussusception
27
What types of babies will you see necrotizing enterocolits?
SGA
| short gestational age (complication d/t premature baby)
28
What is necrotizing enterocolitis?
inflammation of the intestinal wall
29
Necrotizing enterocolitis - labs?
KUB: dilated bowel and PNEUMATOSIS OF INTESTINE (gas cysts in wall)
30
Necrotizing etnerocolotis - tx?
surgery is required
31
What is Midgut volvulus?
bilious vomit
twisting of the intestine - Ladd's bands narrows the mesenteric base causing a twist/malrotation of the small bowel --> small bowel becomes ischemic
32
Midgut volvulus - labs?
CT: corkscrew of the upper GI
33
Midgut volvulus- sx?
SUDDEN GI pain
34
Midgut volvus - onset of age?
any age
35
What is Intussusception?
the Si protrudes into the large intestine causing a "telescoping" of the intestines
36
Intussusception - onset of age?
<2yo
37
Intussusception - sx?
baby cries with legs curled up to chest
38
Intussusception - PE?
RUQ mass
39
What Gi has RUQ mass?
Intussusception
| Midgut volvolus
40
What is a late finding of Intussusception?
RED CURRANT JELLY STOOL
41
WHat is the CLASSIC sx of Intussusception?
vomit
RUQ mass
stomach pain
42
How can you tell the difference between Midgut volvuls and Intussusception?
midgut: corkscrew finding
Intussusception: target sign which is telescoping
43
Intussusception - tx?
first line: enema to push it out
second line: detelescoping via surgery
GOA: TO CATCH IT EARLY TO PREVENT SURGICAL REPAIR
44
What is the main cause of Intussusception?
meckel's diverticulum
45
What is meckel's diverticulum?
outpoutching of the small intestine
46
Meckels diverticulum - sx?
PAINLESS BLEEDING of the rectal
47
What are the rules of 2's in meckels diverticulum?
2feet off the ileocecal valve
2in outpocketing
2yo
48
What dz can cx bilious vomiting in premies?
NEC
49
What dz can cause bilious vomiting in infants?
malrotation - midgut volvulus
| Intussusception
50
What ere the PE for appendix?
```
Rosving sign
psoas sign
mcburneys' point
guarding
appy waddle
obturator sign
rebound tenderness
```
51
What labs would you order to check for abdominal pain?
```
CBC
glucose
ANA
CRP
BUN/Cr
LFT
lytes
UA
BC
pregnancy
Stool
```
52
What would you order for imaging?
US
CT
Xray
HIDA
53
What defines diarrhea?
watery stools for more than 3x a day
54
What is chronic diarrhea and acute diarrhea?
chronic: more than 2 wks
| acute; less than 2 wks
55
What are the types of diarrhea?
```
MISO
Motility
Inflammatory
Secretory
Osmotic
```
56
What is motility diarrhea?
when the food passes through too fast and causes the body to NOT absorb anything
57
What is inflammatory diarrhea?
diarrhea that is passed through has protein, blood, and mucus and the body is not able to absorb water and lytes
58
What may causes inflammatory diarrhea?
* EHEC
* E. Coli – undercooked meat
* Salmonella – Poultry
59
What is secretoary?
when the water and lytes are excreted through the lumen
60
What can cause secreatory diarrhea?
cholera
c diff
rotavirus
shigela
61
What can cause osmotic diarrhea?
lactose intolerance
| too much mannitol
62
How to manage diarrhea?
```
remove the agent that is causing the diarrhea
OTC diarrhea does NOT help
rehydrate
abx AFTER finding out organism
give: high fiber and probiotics
```
63
Why is important to find out the organism of the bug for diarrhea?
if it was E.coli (invasive) giving abx will put higher risk for HUS
64
What is toddler's diarrhea?
drinking too much juice!!
normal wt and growth
3+ passage of diarrhea during WAKING hrs
65
What lab test should you do when baby has diarrhea?
SWEAT CL TEST - CF
66
What is constipation?
3 small hard stools/wk
67
What are the different types of constipation?
Functional
Hirschsprung dz
small left colon dz
celiac dz
68
What is functional constipation?
baby experiences painful bowel movement so they voluntarily do NOT pass bowel --> constipate
69
Functional constipation - PE?
anal sphincter dilates and the muscles lose tone
70
Functional constipation - sx?
baby is not eating a lot fiber
baby has social stress
parents find soiled underpants
baby eats well
71
Functional constipation - labs?
TSH for hypothyroidism
| KUB for FOS
72
Functional constipation - tx mild?
fiber
juice (maybe instigate diarrhea)
bowel training
73
Functional constipation - tx severe?
enemas
| NO MINERAL OILS
74
What is Hirschsprung dz?
the colon gets really big d/t the nerve cells not being able to migrate to rectum and anus --> rectum and anus becomes super skinng
75
Hirschsprung dz-PE?
ribbon like stool
| not able to pass meconium during 24hrs of life
76
Hirschsprung dz - tx?
surgical repair
77
How to tell difference between Hirschsprung dz and Small left colon?
bx of the colon
78
Hirschsprung dz - dx?
bx of then colon to find out if the nerve is developed
79
Baby does not pass meconium w/24 hrs of life?
bx of colon - suspecting Hirschsprung dz
80
Baby has pencil/ribbon like stools after 24 hrs of life?
suspect small left sx - do a barium enema
81
Small left sx - tx?
surgery
82
What is the bicarb if baby is dehydrated?
vomit: high bicarb
diarrhea: low bicarb
83
What to check if baby is dehydrated?
tears
| urine output
84
Mild dehydration -tx?
oral fluids
85
Moderate dehydration - tx?
IV bolus
no vomit/diarrhea - home
vomit/diarrhea - ER
86
Severe dehydration - tx?
ER
87
What is marasmus?
no calories, vitamins
88
Marasmus - PE?
SKINNY
brittle hair/nails
hypothermia
89
Kwashiorkor?
has enough calories but NO PROTEIN
90
Kwashiorkor - PE?
edematous
hepatomegaly
poor wound healing
91
Vita A deficiency?
blindness
brittle hair/nail
diarrhea
dry skin
92
Vita D deficiency?
rickets
| ALL BREAT FED BABIES NEED VITA D SUPPLEMENTS
93
Vita E deficiency?
hypoflexia
peripheral: vision, neuropathy
hemolytic anemia
94
Vita K deficiency?
bleeding disorders
95
Thiamine deficiency?
alcoholics
beriberi
arrhythmias, neuropathies, muscle weakness
96
Folate deficiency?
macro anemia
97
Cobalamin deficiency?
pernicious anemia
macro anemia
neuropathies
98
Vita C deficiency?
scurvy
SI dz
irritabilty, bleeding, bony abnormalities
99
Zinc deficiency?
glossitis
photophobia
nail
acrodermatitis enteropathica
