Gastrointestinal Flashcards by Serena Arancibia

What are signs of dehydration in children

Low urine output
Weight loss
Dryness (tears and mouth)
Sunken Fontanelle
Increased pulse, decreased VP, skin turgor

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Treatment for dehydration in children

Fluid Bolus 20mL/kg ASAP, followed by maintenance fluids once stable

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What are common causes of Appendicitis

Idiopathic or Fecalith

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Sx of Appendicitis

Periumbilical and RUQ pain
Nausea, Vomiting
Rovsing, Obturator, Psoas, McBurney’s Point Tenderness

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Dx of Appendicitis

CT and US

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Tx of Appendicitis

Appendectomy

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What is Colic

Rule of 3’s: Healthy 3 month old who cries over 3 hours/day for over 3 weeks

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Sx of Colic

Rule of 3’s: Healthy 3 month old who cries over 3 hours/day for over 3 weeks

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Tx of Colic

Reassurance and parent education that baby is not sick. Eliminate cows milk from mother’s diet if breastfeeding

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What is Gastroesophegal Reflux (GER)

Recurrent postprandial emesis that resolves spontaneously and is normal

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What is Gastroesophageal Reflux Disease (GERD)

Persistent sx of GER or esophgeal Inflammation

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Tx for GERD

Acid Suppression via H2 blockers or PPI like Zantac
Smaller more frequent feedings
Thicken milk with rice cereal
Antireflux surgery in severe cases

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What is Chronic Constipation

Must have 2 or more:
Fewer than 3 BM/week
1+ episodes of encopresis (involuntary pooping)
Stool impaction in rectum
Large stools that clog toilet
Fecal Withholding
Pain with Defacation

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Treatment for Constipation

Dietary Fiber and Fluids
Stool Softener: MiriLax
Laxatives: Senokot, Ex Lax

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What is Pyloric Stenosis

Hypertrophy and Hyperplasia of the muscular layer of the pylorus causing a functional outlet obstruction

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Sx of Pyloric Stenosis

Nonbilous vomiting, Regurgitation, Projective Vomiting, Emesis after eating
Usually starts 2-4 wks of age

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What is a Physical exam finding of Pyloric Stenosis

Mobile, firm, non-tender Olive Shape pylorus about 1-2cm in diameter to the right of the umbilicus

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Tx for Pyloric Stenosis

Phyloromyotomy

Cimetidine (acid blocker)

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What is Intussusception

When an intestinal segment invaginates into the adjoining intestinal lumen leading to bowel obstruction

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Where does Intussusception usually happen

Ileocolic junction

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Sx of Intussusception

Vomiting, Abdominal Pain, Currant Jelly Stools (mucous and bloody)
Cyclical crying pattern, Colicky pain

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Dx of Intussusception

Ultrasound

Barium Contrast Enema

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Tx of Intussusception

Air or Barium Enema

IV Fluids, Surgery

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What is Hirschsprung’s Disease

Congenital absence of Meissner’s and Auerbach’s Autonomic plexus

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Where does Hirschsprung's Disease usually occur

Retrosigmoid

Sx of Hirschsprung's Disease

Newborn fails to pass meconium | Constipation, Vomiting, Failure to Thrive

Dx of Hirschsprugn's Disease

Anal Monometry, Rectal Biopsy

Tx of Hirschsprung's Disease

Surgical Resection

Sx of a foreign body

Dysphagia, Odynophagia, Drooling, Regurgitation, Chest/Abdominal Pain, Cough

Tx of foreign body removal

Endoscopic or Miralax

What is Encopresis

Repeated passage of stools in underwear, usually after 4 yrs of age

What causes Encopresis

Constipation

Tx for Encopresis

Support and Education, Establish good bowe habits

What is Acute Bilirubin Encephalopathy

Lethargy, Poor Feeding, Irritable, High Pitched Cry, Arched Neck

What is Kernicterus

Injury to the basal ganglia and brainstem due to severe hyperbilirubinemia

Sx of Kernicterus

Movement disorder, strange gaze, auditory disturbances

What is Gilbert's Syndrome

Persistent jaundice without other abnormalities

What is Breastfeeding Jaundice

Appears within first few weeks of life when baby is not getting adequate milk supply

What is Crigler-Najjar Syndrome

Rare disease that presents a few days after birth and persists

Sx of Crigler-Najjar Syndrome

Problem with UDPGT which makes bilirubin water-soluble for clearance. Jaundice

What is Biliary Atresia

An obstruction of extrahepatic biliary system | Presents from birth-8wks

Sx of Biliary Atresia

Jaundice, dark urine, hepatosplenomegaly, acholic stools

What is Duodenal Atresia

Congenital duodenal obstruction. There is an absence of closure of a portion of duodenum

Sx of Duodenal Atresia

Bilous vomiting within a few hours after birth | Normal meconium

Dx of Duodenal Atresia

X-Ray: Double bubble sign | US: Can see prenatally with polyhydramnios

Tx for Duodenal Atresia

Stomach decompression and electrolyte correction/fluids and surgery

What is a non-communicating Inguinal Hernia

Peritoneal fluid is trapped. The intestine goes through the inguinal ring when the processes vaginallus fails to obliterate.

What is a communicating Inguinal Hernia

When the processus remains open and bowel contents and fluids may be forced inside

What is an Umbilical Hernia

Associated with congential hypothyroidism in neonates. Common in full term infants, African American

Tx for Umbilical Hernia

Surgical Repair when over 4 yrs old. Most regress spontaneously

Where do we get Niacin (B3). A diet rich in what is associated with Niacin Deficiency?

Tryptophans. Diet rich in corn is associated with Niacin deficiency

Niacin Deficiency leads to what disorder

Pellagra: 4 D's | Diarrhea, Dementia, Dermatitis (stocking/glove pattern), Death

What is Vitamin A good for

Vision, Immune Function

Vitamin A Deficiency leads to what

Vision Loss, Night Blindness ,Bitot Spots, Xerophthalmia (dry eye), Squamous Metaplasia

Vitamin C Deficiency leads to what disorder

Scurvy: 3H's | Hyperkeratosis, Hemorrhage (gum, skin, joints), Hematologic (anemia)

Where do we get Vitamin C

Raw Citrus and Green Veggies

Vitamin D Deficiency leads to what disorder

Rickets: Softening of the bones, Bowing deformity, fractures, muscle weakness

**What is the intervention for Foreign Body Ingestion**

80-90% pass spontaneously. Can help move things along with polyethylene glycol solution (Miralax). If dangerous object (battery): Endoscopic removal

**Dx for Intussusception**

Abdominal Ultrasound is #1 | Barium Contrast Enema (can be dx and tx)

**Dx for Hirschsprung Disease**

``` Anal Monometry (no relaxation of sphincter) Rectal Biopsy (no nerves) ```

**Tx for Constipation**

``` Dietary fiber and fluids Osmotic Stool Softeners: Miralax Laxatives: Sneokot or Ex Lax Encorporesis: Disimpaction with phosphate, saline enemas, or mineral oil + regular stool softners Stretch anal sphincter to loosen ```

**Tx for Gastroesophageal Reflux**

GER: Normal GERD: Trial of H2 blockers or PPI Smaller, more frequent meals or thicken formula/milk with rice, rice cereal Keep baby upright Antireflux Surgery (Nissen Fundoplication) for refractory cases

Gastrointestinal Flashcards

(62 cards)