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Pediatrics > GI > Flashcards

GI Flashcards

0
Q

Associated anomalies in TEF?

A

VACTERL

vertebral anal cardiac tracheoesoph renal limb anomalies

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1
Q

Most common type of TEF?

A

Upper esophagus ends in blind pouch

TEF to distal esophagus

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2
Q

Clinical presentation of TEF?

A

Frothing bubbling cyanosis

Immediate regurg after feeding

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3
Q

Diagnostic tool for TEF?

A

Xray to show coiled tube and distended stomach

Cannot pass ogt or ngt

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4
Q

Treatment for TEF?

A

Place baby in prone position

Surgical end to end anastomosis

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5
Q

GERD age range?

A

4-12mos

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6
Q

GERD etiology?

A

LES relaxation

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7
Q

Best test to diagnose GERD?

A

pH monitoring. Should only be <4 for 5-8% of the time

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8
Q

Other dx tools for gerd?

A

Barium esophagogram

Endoscopy

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9
Q

GERD tx?

A

Positioning - prone and upright
First line: H2 blockers
PPI or antacids
Surg: Nissl fundoplication

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10
Q

Kind of necrosis caused by alkali ingestion?

A

Liquefactive

ALkali Liquefactive

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11
Q

Kind of necrosis caused by acidic ingestion?

A

Coagulative

aCidic Coag

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12
Q

True or false. Induce emesis or do gastric lavage for caustic ingestion.

A

FALSE!

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13
Q

Caustic ingestion dx?

A

UGI Endoscopy

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15
Q

Caustic ingestion tx?

A

Dilute with milk or water

Surg resection

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16
Q

Age range of pyloric stenosis?

A

3 weeks to 5 months

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17
Q

Characteristic vomitus of pyloric stenosis?

A

Non-bilious

Projectile

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18
Q

Electrolyte imbalance in pyloric stenosis

A

Hypochloremic hypokalemic metabolic alkalosis

from vomiting

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19
Q

Abdominal finding in pyloric stenosis?

A

Olive shaped palpable movable hard mass>4mm in mid epigastrium

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20
Q

Best dx for pyloric stenosis?

A

Ultrasound

Thickened pylorus

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21
Q

Barium findings in pyloric stenosis?

A

Double tract sign - streaks of barium

Shoulder sign - pylorus into antrum

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22
Q

pyloric stenosis tx?

A

Ramstedt pyloromyotomy

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23
Q

Duodenal atresia age range?

A

Newborns

Usually preterm

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24
Q

Characteristic vomitus of Duodenal atresia?

A

Bilious (obstruction is distal to ampulla)

25
Q

Duodenal atresia associated with what congenital anomaly?

A

Down syndrome

26
Q

xray finding in Duodenal atresia?

A

Double bubble sign vs double tract sign in pyloric stenosis

gas in stomach and prox duod, no gas in distal bowel

27
Q

Duodenal atresia tx?

A

NGT decompression!

Surg: duodenoduodenostomy

28
Q

MC areas of volvulus?

A

CS

Cecum, sigmoid

29
Q

volvulus triad?

A 
SIR (or SIRE)
sudden, severe epig pain
inability to pass NGT
retching
emesis
30
Q

volvulus etiology?

A

incomplete rotation of interstion

SMA acts as axis for rotation

31
Q

UTZ findings in volvulus?

A

CUB or COB
coffee bean sign - mesenteric root
inverted U sign - omega sign
bird beak sign

32
Q

definitive tx for volvulus?

A

lap derotation with resection

50% reccurrence if without resection

33
Q

MC malrotation?

A

Failure of cecum to move into RLQ

34
Q

when should intestinal rotation be completed?

A

3 months AOG

35
Q

malrotation age range?

A

Usually 1 year old with chronic obstruction

36
Q

UTZ findings in malrotation?

A

Cecum in RUQ instead of RLQ
Misplaced lif og Treitz
Inversion of SMA and SMV

37
Q

malrotation tx?

A

surgery!!

38
Q

Meckel’s diverticulum etiology?

A

Omphalomesenteric duct remnant

Lining similar to stomach (acid producing)

39
Q

Meckel’s diverticulum age range?

A

First 2 years of life

40
Q

Classic presentation of Meckel’s diverticulum?

A

Painless rectal bleeding

41
Q

Meckel’s diverticulum dx?

A

Radionuclide scan (Tc 99m pertechnetate)

42
Q

Meckel’s diverticulum tx?

A

surgical excision

43
Q

Meckel’s diverticulum rule of 2’s?

A 
2 years old
2% of population
2 types of tissue
2 cm in size
2 feet from ileocecal valve
44
Q

Hirschsprung disease age range?

A

Presents at birth

Delayed passage of meconium

45
Q

Hirschsprung disease etiology?

A

Absence of ganglion cells in bowell wall

MCC of neonatal bowel obstruction

46
Q

Gold standard dx of Hirschsprung disease?

A

Rectal biopsy

show no ganglion cells

47
Q

Other dx tools for Hirschsprung disease?

A

Manometry - shows IAS failure to relax even with rectal distention

48
Q

Hirschsprung disease tx?

A

Surgery

temporary colostomy until 6-12mos for definitive surgery

49
Q

MC complication of Hirschsprung disease?

A

Enterocolitis

50
Q

MC site of telescoping bowel?

A

Intussusception

MC ileo-colic

51
Q

Classic presentation of Intussusception?

A

PAROXYSMAL colicky crampy abdominal pain
Vomiting
Lethargy, fever, progressive weakness

52
Q

Intussusception usually preceded by?

A

Adenovirus or rotavirus infection

53
Q

Characteristic stool of Intussusception?

Abdominal PE finding?

A

Currant jelly stools

Sausage shaped mass RUQ

54
Q

UTZ finding of Intussusception?

A

Doughnut or target sign

55
Q

Barium finding of Intussusception?

A

Coiled spring sign

56
Q

Intussusception tx?

A

Resection with end to end anastomosis

57
Q

Small volume, acidic stool, stops with fasting, (+) reducing substances?

A

Osmotic diarrhea

Lactase deficiency

58
Q

watery voluminous alkaline pH, continues even with fasting?

A

Secretory diarhea

Cholera, E.coli, Clostridium difficile

59
Q

Causes of bloody diarrhea?

A 
CASES
Campylobacter
Amoeba (Entamoeba)
Shigella
E.coli
Salmonella

Pediatrics (2 decks)

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