GI Flashcards
(69 cards)
1
Q
Abdo pain cx
A
UTI, torsion, mesenteric adenitis, constipation, intussusception, coeliac, IBD, IBS, abdominal migraine, IgA vasculitis, DKA, appendicitis,
2
Q
What are abdominal migraines
A
- Periods where the child cries for no physical reason and then stops
- May develop in kids before they develop traditional migraines.
3
Q
Sx of abdominal migraine
A
- Central abdo pain lasting more than an hour
- Examination will be normal
FH of migraines
4
Q
Mx of abdominal migraines
A
- Acute - NSAIDs
- preventative - Cyproheptadine
- BB
5
Q
What is reflux
A
Reflux from stomach via lower oesophageal sphincter to throat and mouth
- babies have poorly developed sphincter so easy for reflux to occur
6
Q
Sx of reflux in a child
A
- chronic cough, hoarse cry, unsettled, poor feeding, pneumonia, poor weight gain
**resolve within a year of brith
- heartburn, nocturnal cough, bloating
- Begins 0-12 months - very common
7
Q
Mx of reflux in a child
A
- Small frequent meals, burping regularly, upright position
1st line - Feed thickener
2nd line gaviscon and PPI is distressed
8
Q
What is pyloric stenosis
A
- Pyloric canal between stomach and duodenum becomes hypertrophied preventing passage of food
- After feeding increased peristalsis causes powerful ejection causing projectile vomiting
9
Q
Sx of pyloric stenosis
A
- First weeks of life, hungry and hung baby, pale, falling to thrive
- Round mass in upper abdomen - pyloric muscle
- Visible peristalsis in LUQ
10
Q
Ix of pyloric stenosis
A
- US 1st line
- Hypochloric metabolic alkalosis
11
Q
Mx of pyloric stenosis
A
lap pyloromytomy - incision to widen canal
12
Q
Common cx of gastroenteritis
A
viral - easily spread
- Rotavirus or Noravirus
Bacteria - camylobacter jejune - travellers diarrhoea, some strains of E coli
Mx - azithromycin…
13
Q
Sx of gastroenteritis
A
- Nausea and vomiting, diarrhoea, abdopain, cramps
14
Q
Mx of gastroenteritis
A
- Isolate 48hrs
- Replace fluids, dioralyte
15
Q
What is bilary atresia
A
- Congenital condition where bile duct is absent or narrowed
- Prevents bile transport to the bowel casting a build up of conjugated bilirubin
16
Q
Sx of biliary atresia
A
- Significantly jaundice shortly after birth
17
Q
Ix for biliray atresia
A
- Conjugated and unconjugated bilirubin
- Build up of conjugated bilirubin
18
Q
Mx for bilary atresia
A
- Kasai portoenterostomy (attach liver to bowel)
19
Q
What is Hirschprung’s disease
A
- Congenital condition where nerves cells of the myenteric plexus are absent in distal bowel and rectum
- Aganglionc section cannot relax causing it to constrict
Mx - Initial irrigation 1st line
- Fluid resus, AB - if infected
- corrective surgery
20
Q
What conditions are Axs with Hirschprungs disease
A
- Downs syndrome
- Neurofibromatosis
21
Q
Sx of Hirschprungs
A
- Delay in passing meconium (more than 1 day), constipation since brith, abdo pain, vomiting, poor weight gain
- Can lead to inflammation (HAEC) - fever, abdopain, blood in stool, vomiting
22
Q
Complication of Hirschprungs disease
A
Toxic megacolon
23
Q
Ix for Hirschprungs
A
1st line - Abdo X-ray
- rectal biopsy
24
Q
Mx of Hirchsprungs
A
- Initial irrigation
- Fluid resus, AB - if infected
- corrective surgery
25
What is Intussusception
- One part of the bowel telescopes onto another part
26
Sx of Intussusception
- sever colic pain, pale,
- Redcurrant jelly stool,
- RUQ sausage mass, vomiting, obstruction, knees up
27
Ix for Intussusception
- US 1st line
- target sign
28
Mx of Intussusception
- 1st line - non operative Contrast enema under US - air or liquid insuffilation
2nd line or serve pain - Surgical reduction
29
Sx of appendicitis
Sx - central abdo pain radiating to RIF
- Tender at Mcburneys point
Roving's sign
- Rebound tenderness and percussion tenderness (rupture)
30
Ix for appendicitis
- Inflammatory markers
- CT
- US in women
31
Mx of appendicitis
- Diagnostic laproscopyt if investigations are negative
- appendicectomy
32
What is mesenteric adenitis and sx
- Inflammation of abdominal lymph nodes
Sx - abdo pain
33
What triggers mesenteric adenitis
- Tonsillitis or upper resp infection
34
Mx of mesenteric adenitis
- Conservative
35
GS vs Exophalmos
GS - Congenital condition where part of the bowel lies outside of the abdomen not in a peritoneal sac
Mx - newborns to theatre asap
Exomphalos - where bowel lies outside the abdomen in the sac
Mx - C section due to risk of rupture
- staged repair as child grows
36
Infantile colic
- Self limiting condition of unexplained episodes of crying
- First 6 weeks of life
37
Sx of infantile colic
- Excessive crying, pulling legs up to chest then returns to normal
- worse In afternoon/evening, - no abnormal vomitng or diarrhoea
- Feed and grow well
38
Dx criteria of infantile colic
Dx - Rule of 3s
- 3 hours, for 3 days, for 3 weeks
39
Mx fo infantile colic
- Reassurance - 6 months
40
What is a meconium ileus
- impacted meconium in bowel
Sx - bowel obstruction
Ix - X ray - ground glass, dilated loops, no fluid levels
**90% have cystic fibrosis
41
Sx of meconium ileus
- Bowel obstruction
42
Ix for meconium ileus
Ix - X ray - ground glass, dilated loops, no fluid level
43
Conditions axs with mecum ileus
- cystic fibrosis
- often 1st sx
44
Constipation in children mx
- Movicol +electrolytes 1st line
- Add stimulant laxative if not working after 2 weeks^
45
What is oesophageal atresia
- Where the oesophagus does not form properly - cx disruption between upper and lower segments
46
Axs with oesophageal atresia
- tracheo-oesophagal fistula
47
Most common type of OA
- Type C - OA with distal fistula
48
Sx of OA
- Salivation or drooling
- Choking, coughing or cyanosis during feeding
- Abdominal distension - air from fistula
- unable to pass NG
49
Ix and Mx of OA
- CXR showing coiled NG
- Surgery definitive
50
What is duodenal atresia
- Congenital abnormality where part of the duodenum is collapsed so there is no lumen, preventing food moving to the bowel
51
Axs condition with duodenal atresia
- downs
52
Sx of duodenal atresia
- Billious vomitng 24-48hrs after birth
- No distension
- failure to tolerate feeds
53
Ix for duodenal atresia
- X ray
- Double bubble
- dilated stomach and dilated duodenum
- no gas beyond this point
54
Mx of duodenal atresia
- surgery definitive
55
Meckles diverticulum
- Congenital diverticulum in the small intestine
- Contains ectopic, ilealgastric or pancreatic mucosa
- 2 inches long, 2 feet from ileocaecal valve
56
Sx of Meckles diverticula
- Abdominal pain, rectal bleeding and obstruction
**Most common cause of rectal bleeding**
57
Ix and Mx for Meckles diverticula
Ix - Meckles scan
Mx - Surgical resection - lap
58
What is intestinal malrotation
- Midgut rotates around SMA causing volvulus and bowel obstruction sx
59
When should hypospadis surgery be carried out
- 12 months
60
Ix for reflux nephropathy
- micturating cystography
61
What are Infantile spasms
* WEST SYNDROME*
- Epileptic encephalopathy
62
What age do infantile spams occur
- 3-12 months
63
Sx of infantile spasm
- No crying, keying movements, arms fall floppy, dazed after
- After waking up
- Clusters
- developmental regression
64
Ix for infantile spasms
EEG - hypsarrhythmia
MRI
65
Mx of infantile spasms
- Same day seen by paeds
- High dose pred
66
Haemophilia mode of inheritance
- X linked recessive
67
Mitochondrial inheritance
- From mother
68
Shaken baby triad
- Retinal haemorrhage, subdural, encephalopathy
69
Cows milk protein allergy mx
1st line - extensive hydrolysed formula
2nd line - amino acid based formula
