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GI Flashcards

1
Q

sx w/out pathologic correlation

A

FUNCTIONAL

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2
Q

sx caused by a distinct pathological entity

A

ORGANIC

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3
Q

most common sources of acute abdomen in young children

A

Malrotation, intussusception, incarcerated hernia, congenital anomalies

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4
Q

most common sources of acute abdomen in older children

A

appendicitis

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5
Q

chronic abdominal pain in children

A

FUNCTIONAL 70-90% of the time- constipation, IBS

ORGANIC 10-30%- gastritis/ulcer, lactose intolerance, parasites, gall bladder disease

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6
Q

treat functional abdominal pain

A

reassurance and explanation of functional pain

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7
Q

Often have diarrhea as infants, then constipation as older children
Abdominal pain in early school years
Often stress-associated, risk of school avoidance
Rarely, if ever, awakens at night

A

IBS

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8
Q

most common cause of vomiting in childhood

A 
viral gastroenteritis
(obstructions, acute or chronic inflam of the gi tract, CNS inflam, metabolic derangements)
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9
Q

projectile vomiting means…

A

high obstruction, ie pyloric stenosis

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10
Q

bilious vomiting means…

A

OBSTRUCTION
Beyond ampulla of vater … duodenal, jejunal, ileal, colonic
** Malrotation

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11
Q

bloody vomiting means…

A

Mallory Weis tear (less common in peds)
Gastritis
Peptic ulcer?

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12
Q

neonatal vomiting common causes

A 
OBSTRUCTION
Duodenal atresia and stenosis
Malrotation / volvulus
Pyloric stenosis- forceful, nonbilious
METABOLIC ACIDOSIS
Sepsis
Metabolic disorders / Inborn errors of metabolism
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13
Q

chronic vomiting in older children may mean

A

CNS (vomiting 1st thing in the morning associated w HA, no nausea, no abd pain)

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14
Q

Acute diarrhea in children- common cause

A

INFECTIOUS

viral- ROTAVIRUS, enterovirus, norovirus

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15
Q

management of acute diarrhea in children

A

supportivefluids, Na, K
Oral rehydration, starvation prolongs diarrhea
Avoiding lactose is helpful

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16
Q

should you give antidiarrheal meds?

A

NO. ineffective, possible can cause worsening illness

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17
Q

Bacterial diarrhea causes

A

Campylobacter, Salmonella, Shigella, E. coli, Yersinia, C diff

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18
Q

Bacterial diarrhea presentation

A

blood in stool, foreign travel, high fever

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19
Q

Functional causes of chronic diarrhea

A

IBS, toddler’s diarrhea

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20
Q

organic causes of chronic diarrhea

A 
Food allergies
Malnutrition / Malabsorption syndromes 
Impaction
Inflammatory bowel disease
Hirschsprung’s disease
Immune deficiency syndromes
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21
Q

presentation functional chronic diarrhea

A

healthy appearing, 5-8 stools per day for an infant

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22
Q

presentation organic chronic diarrhea

A

weight loss, growth failure, ill-appearing

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23
Q

treatment of pseudomembranous colitis

A

oral metronidazole or vanco

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24
Q

most common causes of abx related c diff

A

clindamycin, cephalosporins, ampicillin

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25
2nd most common cause of referrals to peds GI
constipation
26
chronic constipation
``` 2 or more for at least 2 months: < 3 BM/Wk > 1 episode of encoporesis/wk impaction of rectum with stool stool that plugs toilet retentive posturing and fecal withholding pain with defecation ```
27
most common childhood constipation is...
FUNCTIONAL (withholding or IBS)
28
Organic causes of constipation
Hirschsprung's disease
29
Absence of Meissner and Auerbach plexi | Sympathetic hyperactivity leading to tonic contraction (doesn’t relax)
Hirschsprung's disease
30
Chronic constipation with dilatation of rectal ampulla and fecal soiling
encoporesis
31
treat encoporesis
Requires stool evacuation followed by chronic management to avoid reaccumulation of stool. Stool softeners are important
32
treatment of diarrhea
Lifestyle: diet, behavioral modifications, biofeedback?
33
Signs that would suggest organic constipation
No passage of meconium within 2 days of birth Hard, infrequent stooling since birth, especially if breast fed Poor growth/ development Distended abdomen Abnormally placed anus, commonly anteriorly
34
Medical treatment for constipation
laxatives, usually osmotic (PEG 3350 common. Also can use lactuolose, magnesium hydroxide, mag citrate)
35
Most common source of significant GI bleed in kids
Peptic ulcer disease Meckel’s diverticulum Colitis Intussusception
36
a true congenital diverticulum... a slight bulge in the small intestine present at birth
Meckel's diverticulum
37
minor GI bleeding in kids causes
Anal fissures Mallory-Weiss tear Swallowed nasopharyngeal blood
38
rectal bleeding in infants common causes
colitis, anal fissure, milk protein allergy
39
rectal bleeding in older children common causes
Inflammatory Bowel Disease, Meckel’s diverticulum
40
causes of functional obstruction
disordered peristalsis, paralytic ileus, septic ileus, dysmotility
41
causes of mechanical obstruction
narrowing of the lumen, malrotation, intraluminal obstruction, meconium plug/CF
42
nonbilious vomiting
proximal to the ampulla of Vater
43
bilious vomiting
distal to the ampulla of Vater
44
infant has not passed stool in 24 hours. what do you think?
Hirschsprungs
45
Maternal hx polyhydramnios, what do you think about baby?
high obstruction | esophageal atresia, duodenal atresia
46
increased BS
obstruction | gastroienteritis
47
decreased BS
ileus, obstruction, ischemia
48
surgery pyloric stenosis
myotomy
49
surgery imperforate anus/Hirschsprungs
temporary colostomy
50
surgery intestinal atresias/webs
primary anastomosis
51
surgery malrotations/adhesions
lysis of adhesions and resection of nonviable intestine
52
surgery meconium ileus
theraputic enema
53
complications of pathologic reflux (GERD)
pain, which causes behaviors (crying, arching) growth failure (FTT) pulmonary complications (asp pneumo, asthma, apnea) esophagitis
54
medical therapy GERD
H2, PPI
55
very severe GERD, meds don't work, what can you do
surgical procedures: Nissen fundoplication
56
kid has copious oral secretions, choking aspiration, and you are unable to pass an NG tube. What do you think>
esophageal atresia | tracheoesophageal fistula
57
EA and TF associated with what
VACTERL
58
neonate took oral erythromycin and now comes in with projectile, nonbilious vomiting, constipation, dehydration, and weight loss
pyloric stenosis
59
gold standard diagnostic pyloric stenosis
US
60
most accurate test for PUD
endoscopy
61
kid comes in, abd pain several hours after meals that awakens him at night
PUD
62
treatment PUD
Acid suppression or neutralization PPI , healing in 4-6 weeks H pylori eradication if indicated PPI + antibiotic regimen 1-2 weeks
63
most common site of intestinal atresia and stenosis
jejunum (duod second)
64
kid comes in polyhydramnios,bilious emesis, abdominal distension within hours of birth. he passes his meconium normally
duodenal atresia
65
duodenal atresia on x ray
double bubble sign
66
where does midgut volvulus usually occur
duodenojejunal junction
67
treatment of malrotation
Absolute Surgical Emergency .. Bowel ischemia and necrosis
68
kid born with guts out and no sac covering them
gastroschisis
69
herniation through the umbilical cord
omphalocele
70
Abdominal contents in chest due to failure in diaphragm formation at 8-10wk gestation
congenital diaphragmatic hernia
71
kid has persistent painless bloody stools
meckel diverticulum
72
common location for hirschprung
rectosigmoid colon
73
neonate fails to pass meconium by 24h what do you think
Hirschsprung
74
older child passing foul-smelling, ribbon like stools and has abd distention with prominent veins
Hirschs
75
major complication of hirschsprung
enterocolitis, colonic rupture
76
Translocation of Bacteria to bowel wall
NEC
77
Telescoping of bowel that causes progressive edema and ischemia
intussusception
78
usual location intussusception
Just proximal to ileocecal valve extending for varying distances into the colon
79
currant jelly stool
intussusception
80
most common cause of obs in first 2 years of life
intussusception
81
Most common indication for emergency abdominal surgery in childhood
acute appendicitis
82
greatest risk factor for IBD
family history
83
common trigger in Celiac disease
environmental agent-gliadin component of gluten
84
treatment Celiac
gluten free diet lifelong
85
gold standart celiac
SB biopsy
86
kid appears well but is jaundiced
biliary atresia
87
95% of the cause of pancreatic dysfunction in childhood
CF

Pediatrics (15 decks)

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