GI

Question 1

Acute inflammation of gastric causing abdominal pain, nausea, vomiting, diarrhea, increased bowel sounds, sick feeling

Answer 1

Gastroenteritis

Question 2

What is the most common cause of gastroenteritis

Answer 2

Viral

Question 3

What are viral pathogens that cause

gastroenteritis

Answer 3

Rotavirus 50%
Adenovirus
Norovirus

Question 4

This virus can cause gastroenteritis year-round and is more commonly in older children and adults

Answer 4

Norovirus

Caused by fecal oral route through contaminated food or water

Question 5

This virus can cause gastroenteritis is seen in children 2 to 4 years old

Answer 5

Adenovirus

Question 6

Rotavirus

Answer 6

50% of cases of gastroenteritis
Acute fever, emesis, watery no blood diarrhea

less than five years

Last 3 to 8 days, highly contagious
Fecal oral spread

Question 7

Bacterial causes of gastroenteritis

Answer 7

Salmonella
Shigella
Campylobacter
E.coli

Question 8

Common parasitic cause of gastroenteritis

Answer 8

Giardia lambia

Question 9

What stool is associated with Campylobacter bacterial gastroenteritis

Answer 9

Odorous

Question 10

What symptoms are associated with Shigella bacterial gastroenteritis

Answer 10

Fever spikes, bloody stool, febrile seizures

6m-3yrs

Question 11

E.Coli has what type of stool associated in bacterial gastroenteritis

Answer 11

Mild loose stool

Question 12

Giardia lambia

Answer 12

Flagellate protozoan parasitic causes of gastroenteritis
Found in contaminated food and water
Abdominal pain, flatulence, bloating, watery greasy foul smelling stool

Intermittent symptoms or a asymptomatic 1-4 week

Need stool culture to identify

Question 13

Giardia lambia parasitic gastroenteritis treatment?

Answer 13

Albendazole, metronidazole

X7-10 days

Question 14

When are diagnostic test done for gastroenteritis

Answer 14

Symptoms greater than 72 hours or presence of bloody stool

Stool guaiac + bacterial
Culture
Stool wbc
Ova and parasites

Question 15

What pathogens of gastroenteritis are excluded from school

Answer 15

Rotavirus, E. coli, shigella

Question 16

E. coli and shigella need what to return to school

Answer 16

Two negative stools

Question 17

Moderate oral rehydration

Answer 17

50 mL / hr

Question 18

Severe oral rehydration

Answer 18

100 mL/hr

Question 19

When her antibiotics given in gastroenteritis

Answer 19

If 72 hours or labs are done

Or 8-10 stools /day

Question 20

Antibiotic management for gastroenteritis

Answer 20

Bactrim (trimethoprim/sulfamethoxazole) x5 days

Azithromycin 2nd line

Not given in salmonella

Question 21

Early sign of dehydration

Answer 21

Normal vital signs decreased output

Question 22

Blood pressure, heart rate, cap Refill, turgor, fontanel normal
Urine decrease slightly, normal mentation

Answer 22

Mild dehydration 3 to 5%

Question 23

Moderate dehydration percentage & symptoms

Answer 23

6-9% 
Normal blood pressure, cap Refill
Heart rate increased
Turgor decreased
Urine <1mL/kg/h
Sunken fontanel

Question 24

Severe dehydration percentage and symptoms

Answer 24

> 10%

BP normal/decreased
HR decreased 
>3s cap Refill 
Turgor decreased 
Fontanel decreased 
Cool mottled 
Normal to lethargic to comatose mentation

Question 25

Affects anywhere in the G.I. tract chronic inflammation of the intestine triggered by pathogen

Answer 25

Crohn’s disease Large uncontrolled inflammatory response wants a free radicals proteases, platelet activating factor causing tissue destruction is released

Question 26

Cobblestone appearance of the G.I. tract

Answer 26

Crohn’s disease | Scattered areas of the affected ileum colon or G.I. tract

Question 27

Symptoms of crohns

Answer 27

``` Diarrhea Bloody stool Malabsorption Pain with no diarrhea Decreased wt Pain RLQ Food related pain Cobblestone intestinal tract ``` Family hx increases

Question 28

Severe frequent diarrhea with blood pain in left lower quadrant

Answer 28

Symptoms of ulcerative colitis More diarrhea because decrease H2O absorption of the large intestine which is the main goal of that organ

Question 29

Inflammation of the colon or large intestine

Answer 29

Ulcerative colitis

Question 30

Ulcer created along the lumen of the large intestine spots in the mucosa tissue is eroded away, circumferential and continuous

Answer 30

UC

Question 31

Causes of ulcerative colitis

Answer 31

Diet/stress is a secondary cause Auto immune origin —-T cells destroy lining Family history plus environmental >females teens to 30s Whites/Eastern European Jews

Question 32

Diagnostics for IBD

Answer 32

Stool-cal protein neutrophils in poop show inflammation in the intestinal lining Upper G.I. shows IBD changes in extent Endoscopy/colonoscopy with biopsy is the gold standard CBC w/diff microcytic anemia; increase white blood cells, ESR, CRP

Question 33

Treatment for IBD

Answer 33

Referral to G.I. Nutritional therapy to increase growth Anti-inflammatory agents Sulfasalazine,mesalamine Immunosuppressant Corticosteroids, cyclosporine,azathroprine Biologics Inflixamab,adalimimab Surgery Ileocecectomy/ ostomy=CD Coloectomy=UC

Question 34

Episodic/continuous abdominal pain occurs at least weekly ,at least x2 a month With no other cars

Answer 34

Functional abdominal pain, chronic abdominal pain, recurrent abdominal pain

Question 35

What age group is most common to have functional abdominal pain

Answer 35

School aged 8 to 15 years | 13 to 17%

Question 36

Functional abdominal pain risk factors

Answer 36

School-aged Male Certain personality traits: maladaptive coping, protective parents, common absence from school due to pain

Question 37

Management of functional abdominal pain

Answer 37

Pain is real even with no organic cause reinforce normal behavior, decrease hectic lifestyle and hurried meals, identify stress, pain diary , no medication as needed

Question 38

Symptoms of functional abdominal pain

Answer 38

``` Cranky dull pain No radiation Peri umbilical No relief Not related to food No nighttime awakenings Normal weight Interferes with activity Diffuse tenderness No guarding ```

Question 39

How to calculate dehydration Weight 7kg Now 6.5 kg

Answer 39

Pre-illness Weight - illness weight / pre-illness weight x100 7 kg-6.5 =500 g 0.5/7=0.07x 100=7%

Question 40

Most common symptom of a pinworm infection

Answer 40

Anal itching

Question 41

Pinworms transmission

Answer 41

I don’t worm lives in rectum comes out at night to lay eggs on the perianal skin and dies causing itching; scratching and then finger to mouth contact transfers eggs into the intestines because children swallow them and then once they reach the duodenum they develop into mature worms and repeat the cycle Easily float in air can be swallowed by others

Question 42

Worm like thread seen on toilet or underwear

Answer 42

Pinworms | Enterobius vermicularis

Question 43

Medication for pinworm

Answer 43

Pyrantel pamoate 11 mg/kg one dose Albendazole 400mg POx1 repeat in 2 weeks

Question 44

Tight anal canal with no stool in vault

Answer 44

Hirschsprung’s disease

Question 45

Impacted stool with fissure and large dilated rectum

Answer 45

Constipation