Gastroenterology Flashcards Preview

Paediatrics > Gastroenterology > Flashcards

Flashcards in Gastroenterology Deck (75)
Loading flashcards...
1

Blood in vomit

Oesophagitis, peptic ulceration, oral/nasal bleeding

2

Projectile vomiting in first few weeks of life

Pyloric stenosis

3

Vomiting at the end of paroxysmal coughing

Whooping cough

4

Abdominal distension

Intestinal obstruction, including strangulated inguinal hernia

5

Blood in stool

Intussusception or gastroenteritis

6

Failure to thrive

GORD, coeliac disease and other chronic GIT conditions

7

What is posseting?

Is the return of small amounts of milk with the return of swallowed air - occurs in nearly all babies from time to time

8

What sort of infections can be associated with vomiting in infants

Gastroenteritis but also with UTI and CNS infections

9

When does GORD usually resolve by?

Usually resolves spontaneously by 12 months of age - due to maturation of lower oesophageal sphincter, assumption of upright posture and more solids in diet (liquid diet, lying down and immature sphincter are reasons for GORD)

10

Complications of GORD

Failure to thrive
Oesophagitis
Recurrent pulmonary aspiration
Dystonic neck posturing (sandifer syndrome)

11

Management of uncomplicated GORD

Adding inert thickening agents to feeds and positioning in head up 30degree position after feeding

12

Management of more severe GORD

Acid suppression with h2 receptor antagonists (ranitidine) or proton pump inhibitors (omeprazole)
Surgery if don't respond to medication or have oesophageal stricture

13

What is pyloric stenosis

Hypertrophy of pyloric muscle causing gastric outlet obstruction
Presents between 2-7 weeks of age

14

Which infants is pyloric stenosis more common in

More common in boys 4:1
Particularly in first borns and may have a family history especially on maternal side

15

Type of vomiting in pyloric stenosis

Increases in frequency and forcefulness over time until it becomes projectile
Hunger after vomiting until dehydration causes loss of interest in eating

16

Diagnosis of pyloric stenosis

Feed test - gastric peralstasis wave moving across abdomen and pyloric mass (like olive) usually palpable in RUQ - ultrasound can be helpful

17

Management of pyloric stenosis

IV fluids to correct any fluid and electrolyte imbalance
Treatment by pyloromyotomy - Ramsteadt - division of muscle - quick recovery

18

Green vomit in child

Obstruction

19

What is colic?

Paroxysmal, inconsolable crying or screaming often accompanied by drawing up of the knees and passage of flatus several times a day - particularly in the evening

20

Incidence and period of colic

Occurs in first few weeks of life and resolved by 4 months of life and occurs in up to 40% of babies
Benign condition but can be worrying for parents

21

What can severe and persistent colic be due to?

Milk protein allergy or GORD

22

Causes of acute abdomen pain? x8

Appendicitis , hernia, hip joints and testes need to be checked
Lower lobe pneumonia
Primary peritonitis with nephrotic syndrome or liver disease
DKA
UTI and acute pyelonephritis

23

In what age is acute appendicitis uncommon in?

Uncommon in children under 3 years

24

Symptoms of acute appendicitis? x3

Anorexia
Vomiting (usually only a few times)
Abdominal pain, initially central and colicky and then localising to RIF

25

Signs in acute appendicitis?

Flushed face with oral fetor
Low grade fever
Abdominal pain aggravated by movement
Persistent tenderness with guarding in RIF

26

Why does diagnosis of acute appendicitis need to be made quickly in preschool children?

Perforation may be rapid - omentum is less developed

27

What might be identified in urine of acute appendicitis

White blood cells or organisms as inflamed appendix may be adjacent to ureter or bladder

28

What is intusseception?

Invagination of proximal bowel into a distal segment - most commonly the ileum passes into the caecum through the ileocaecal valve

29

At what age does intusseception commonly occur?

May occur at any age but peak age is between 3 months and 2 years

30

Most serious complication of intusseception

Constriction of mesentery therefore venous obstruction and engorgement, bleeding from mucosa, fluid loss and bowel necrosis