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GI Flashcards

(105 cards)

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1
Q

externalized intestines, not in a pouch

A

gastroschesis

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2
Q

Complications of gastrochesis

A

infection
hypothermia
necrosis of the intestines

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3
Q

immediate tx of gastrochesis

A

sterile saline and gauze to wrap intestines

wrap saran warp to keep moisture and heat in

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4
Q

problems that has sx without pathologic correlation. Lab tests/ work up are negative

A

Functional

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5
Q

sx caused by an distinct pathological entity.

A

organic problem

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6
Q

what does a Chem 7 look at?

A

basic electrolytes

kidney function

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7
Q

what can strep throat depend on?

A

Headache and stomachache

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8
Q

Most common sources of acute abdominal pain in young children?

A

Malrotation
intussusception
incarcerated hernia
congential anomalies

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9
Q

Most common source of acute abdominal pain in older children

A

Appendicitis

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10
Q

pouch on the wall of the lower part of the intestine that is present at birth

A

Merckel’s diverticulum

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11
Q

what are 2 function chronic abdominal pains

A

constipation

IBS

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12
Q

common organic problems of abdominal pain

A

gastritis/ ulcer
lactose intolerance
parasites
gallbaldder dz

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13
Q

bloating, transitioning b/w constipation and diarrhea.

A

IBS

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14
Q

tx for functional abdominal pain

A

reassurance and explanation of functional pain (fluids, diet, activity, sleep, emotions)

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15
Q

most common cause of vomiting in childhood?

A

Viral gastroenteritis

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16
Q

what can forceful or projectile vomiting indicate?

A

Pyloric stenosis, obstruction

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17
Q

what causes billious (green/yellow) vomiting?

A

Beyond ampulla of vater (means there is a problem beyond that point)

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18
Q

what can cause bloody vomiting?

A

mallory weis tear
gastric
peptic ulcer

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19
Q

problems associated with projectile vomiting in neonates

A

obstruction
duodenal atresia/ stenosis
malrotation/ volvulus
pyloric stenosis

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20
Q

What is forceful vomiting that is non-billious and forceful and projectile. Will present with FTT

A

Pyloric stenosis

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21
Q

Most common cause of vomiting in older children?

A

Viral illness

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22
Q

Vomiting first thing in the morning associated with headaches. Not associated w/ nausea or abdominal pain.

A

CNS problem

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23
Q

what is the origin of acute diarrhea usually?

A

Infectious

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24
Q

Tx for acute diarrhea

A

Fluids, Na, K

oral rehydration

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25
what part of the GI system does rotavirus affect?
Small intestine
26
what presents with volumous watery diarrhea without leukocytes or blood. Will first have vomiting then followed by a low fever.
Rotavirus
27
what age groups is roatvirus common in?
3-15 months, peak in winter
28
who are enteroviruses more common in
Toddlers and school aged
29
What is a potential cause of traveler's diarrhea?
Norovirus (winter vomiting syndrome)
30
How do you tx diarrhea?
No antidiarrheal medications because they are ineffective and possibly worsen the illness
31
What should you suspect if there is blood in the stool?
Colitis, bacterial cause
32
Patients with shigella often also have what?
a high fever
33
when can abx be harmful with diarrhea?
Shigella, can cause hemolytic uremic syndrome
34
what are the only indications for abx in bacterial diarrhea
C. Diff or | salmonella or campylobacter with risk of further infection
35
What conditions can cause malabsorption diarrhea?
Lactose inteolerance celiac disease cystic fibrosis steatorrhea
36
Pt. presents with fever, tenesmus, abdominal pain with diarrhea and hx of being on abx.
pseudomembranous colitis by C. Diff
37
what causes toddler's diarrhea
too much fat, not enough protein
38
most common reason for constipation in children.
Functional
39
Think of with a constipated infant. Stool isn't moving due to lack of innervation.
Hirschsprung disease
40
causes of organic constipation
cystic fibrosis hypothyroidism anorectal malformation
41
Chronic constipation with dilatation of rectal ampulla and fecal soiling
Encopresis
42
Tx for consptiation
increase fiber, avoid dairy increased fluids | toilet training exercising after eating
43
Signs of an organic cause of constpation
``` No massage of meconium w/i 2 days of birth hard, infrequent stooling poor growth/ development distended abdomen abnormally placed anus ```
44
Medical tx for constipation
osmotic laxative- polyethylene glycol
45
Causes of signifiant GI bleeding in kids
PUD Meckel's diverticulum colitis intussusception
46
Causes of minor GI bleeding in kids
Anal fissure mallory-Weiss tear swallowed nasopharyngeal blood
47
outpouching of the small intestines
Meckel's diverticulum
48
most common cause of rectal bleeding in infants
colitis from allergies (milk allergy) or anal fissue
49
common causes of GI bleeding in odler children
IBS | meckel's diverticulum
50
tx you can do for Mecke's diverticulum
Meckel scan (nuclear med test)
51
Is a paralytic ileus functional or organic?
Functional
52
Is disordered peristalsis functional or organic?
Functional
53
Is a septic ileus functional or organic?
Functional
54
For an ______ you have pain that is out of proportion to the physical exam. will hear hypertympanic bowel sounds.
obstruction
55
sill be sitting still
peritonitis
56
if pain is increasing in frequency or severity what does it suggest
Ischemia
57
what is the major cause of small bowel obstruction
surgery (due to surgery)
58
what can show an obstruction
x-ray (KUB) do supine and upright to look for air/fluid levels
59
A Blueish hue in infants can indiacte what?
Perforation
60
what does increased bowel sounds indicate (high pitched)?
obstruction | gastroenteritis
61
what usually cause decreased bowel sounds?
paralytic ileus obstruction ischemia
62
exposure of the esophagus to gastric contents. It is a physiologic problem
GE reflux
63
Casues of reflux
Increased frequency of sphincter relaxation Decreased lower esophageal sphincter resting tone Poor esophageal clearance of refluxed material Slow gastric emptying
64
when is spitting up a problem
Pain FTT aversion to eating
65
Pulmonary complications of reflux
Aspiration pneumonia Broncho-pulmonary disease Asthma/reactive airway disease Apnea and bradycardia
66
irritation of the esophagus
Esophagitis
67
meds for GERD in kids
``` H2 antagonists (zantac, pepcid) PPIs (prilosec, prevacid, nexium) ```
68
what is a surgery that tightens the esophagus and is for severe reflux.
Nissen fundoplication
69
will present with copious oral secretions,choking aspiration,
tracheoesophageal fistula
70
What is tracheoesophageal fistula associated with?
``` VACTREL Vertebral Anaal atresia Cardiac TE_F renal Limb abnormalities ```
71
Hernia presents at birth, repair if present after first few years of life.
Umbilical hernia
72
Hernia more common in males, rarely incarcerated. corrected by surgeon
Inguinal hernia
73
big concern with pyloric stenosis
FTT
74
what abx given in neonatal period has been associated w/ higher incidence of pyloric stenosis in infants (<30 days)
erythromycin
75
In childhood most are secondary to underlying illness, toxins, or drugs causing a breakdown in mucosal defenses.
PUD
76
Most accurate study for PUD
endoscopy
77
best test for H. Pylori
Usually the stool, because serum testing is for the antibody
78
End result is obstruction with dilated bowel proximally, small disused bowel distally
Intestinal atresia
79
double bubble sign refers to what type of obstruction
small intestine
80
tx for duodenal atresia
surgery – duodenoduodenoscopy (bipass stenosis)
81
Due to abnormal movement of intestine around the superior mesenteric artery as intestine reenters abdominal cavity at ~10 weeks
Malrotation
82
where does midgut malrotation appear
duodenojejunal junction-
83
presents with pain, bilious vomiting, distention.
Malrotation
84
Tx for malrotation
Surgical emergency
85
Herniation through cord | Associated with anomalies
omphacele
86
what is gastroschisis associated w/?
spina bifida
87
Tx for congenital diaphragmatic hernia
NPO, NG for gastric decompression, Surgery
88
Can present in toddlerhood with worsening respiratory distress and failure to thrive.
Congential diaphragmatic hernia
89
Outpouching of ileum in mid to distal ileum
Meckel diverticulum
90
tx for meckel diverticulum
surgery
91
Telescoping of bowel that causes progressive edema and ischemia
Intussusception
92
Present with ~20 minute cycles of intermittent pain, vomiting Heme positive stools (95% of the time.)
Intussusception
93
Is Meckel diverticulum painful?
No usually painless
94
what does meckel diverticulum usually present with?
bloody stools
95
what condition with have ribbon like stools?
Hirschsprung dz
96
Major compilation from hirschsprung dz
toxic megacolon
97
usually around 18 months-3 years old, intermittent episodes. Will bring knees to chest. Currant jelly stools.
Intussusception
98
tx for intussusception
contrast enema
99
most common cause of obstruction in first couple years of life
intussusception
100
most common cause of acute abdomen in older children
acute appendicitis
101
``` Abdominal pain Diarrhea, constipation Gassiness, distention, bloating Anorexia Poor weight gain, FTT (but can be obese) Irritability, lethargy ```
Celiac dz
102
will see distended belly and then wasting.
Celiac's dz
103
tx for celiacs
avoid gluten
104
Gold standard for celiac dx
small bowel biopsy
105
bile ducts aren't complete. Will have bile reflux back to liver. can cause jaundice after first few years of life.
biliary atresia

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