GI

Question 1

hirschprung disease also known as

Answer 1

congenital (born with) aganglionic megacolon

Question 2

why are ganglionic cells important

Answer 2

parasympathetic nervous system uses ganglionic cells to propel stool through colon

Question 3

what is hirschprung disease

Answer 3

a portion of colon is aganglionic (without ganglionic cells)

Question 4

what happens in hirschprung disease

Answer 4

a portion of the bowel lacks cells needed for motility; stool just stops; continues to build up; leads to mechanical blockage/obstruction

Question 5

can you see liquid stool with hirschprung disease

Answer 5

sometimes

Question 6

s/s of hirschprung disease

Answer 6

chronic constipation
pencil thin/ribbon-like stools
fecal odor on breath
lg/firm abdomen
rectal sphincter fails to relax
ftt
vomit/diarrhea (leakage)
delayed passage of meconium

Question 7

high incidence of hirschprung disease in this population

Answer 7

down syndrome

Question 8

the diseased portion of the colon looks healthy and the non diseased portion looks unhealthy, why

Answer 8

mechanical obstruction occurs proximal (upstream) to diseased portion making healthy part appear enlarged

Question 9

what procedure may be done to help kids with enlarged colon

Answer 9

temporary colostomy

Question 10

hirschprung disease can lead to

Answer 10

enterocolitis - can lead to death

Question 11

where do we see hirschprung disease most

Answer 11

recto-sigmoid area

Question 12

dx for hirschprung disease

Answer 12

*rectal biopsy
manmatery (how tight is internal sphincter) - balloon for rectal pressures
barium enema

Question 13

most common congenital malformation of GI tract

Answer 13

meckel diverticulum

Question 14

onset (rules of 2) of meckel diverticulum

Answer 14

age 2 y.o.
length is usually 2 inches in length
occurs 2 feet from ileo-fecal valve
2 times more common in males
2% of population suffers
2 types of tissue (stomach and pancreatic)

Question 15

what condition can happen from meckel diverticulum

Answer 15

perforation of diverticula
can lead to enterocolitis - can die
strangulation of the bowel - can lead to blockage
vulvus/twisting of the bowel

Question 16

what is meckel diverticulum

Answer 16

congenital disorder of developing digestive system (yolk sac)
small pouches in the wall of intestine

Question 17

meckel diverticulum s/s

Answer 17

painless frank (bright red) bleeding

Question 18

dx procedure for meckel diverticulum

Answer 18

nuclear medicine - meckel scan

Question 19

treatment for meckel diverticulum

Answer 19

surgery to repair

Question 20

pyloric stenosis s/s

Answer 20

projectile vomiting
regurgitating
irritable
palpable olive shaped mass in rt upper quadrant
visible peristaltic waves from left to right

Question 21

what is pyloric stenosis

Answer 21

constriction of pyloric sphincter with obstruction of gastric outlet
hypertrophy of pyloric sphincter - limits transition of food from stomach to duodenum

Question 22

who is more affected with pyloric stenosis

Answer 22

males

down syndrome

Question 23

cause of pyloric stenosis

Answer 23

idiopathic; may be inherited

Question 24

when do symptoms present in pyloric stenosis

Answer 24

2-3 weeks old

Question 25

***children with pyloric stenosis are at risk for

Answer 25

hypochalemic metabolic alcholosis | make them NPO

Question 26

surgery for pyloric stenosis

Answer 26

pylomylootomy

Question 27

intussusception manifestations

Answer 27

telescoping of a portion of an intestine into another

Question 28

rotoshield vaccine was taken off of market due to

Answer 28

intussusception

Question 29

intussusception most commonly occurs prior to this age

Answer 29

1 year of age most common between 4-7 months can occur at any point in life

Question 30

children w/cystic fibrosis commonly have intussusception t or f

Answer 30

true

Question 31

what part of the intestine is commonly involved in intussusception

Answer 31

ileocycl valve

Question 32

cause of intussusception

Answer 32

unknown

Question 33

dx for intussusception

Answer 33

barium enema - treats it as well

Question 34

*characteristics of stools r/t intussusception

Answer 34

currant-jelly like stool (mucous and blood)

Question 35

s/s of intussusception

Answer 35

``` acute pain colicky draw legs up vomiting feel sausage shaped mass in abdomen ```

Question 36

celiac disease also referred to as

Answer 36

gluten induced enteropathy

Question 37

what happens in celiac disease

Answer 37

individual cannot tolerate the intake of wheat inability to detoxify/ingest glidden (protein) in wheat products (wheat, oats, hops) can use rice, soy, corn bases

Question 38

what type of disorder is celiac disease

Answer 38

auto-immune disorder

Question 39

celiac disease can lead to

Answer 39

malabsorption disorder - malnutrition

Question 40

patho of celiac disease

Answer 40

intestinal inflammation - damage to villi-malabsorption-malnutrition

Question 41

trt for celiac disease

Answer 41

gluten free diet - life long | usually resolves the issue

Question 42

s/s of celiac disease

Answer 42

malnutrition steattorrhea - fat in stool abdominal distention

Question 43

who is more prone to celiac disease

Answer 43

kids with diabetes

Question 44

what type of disorder is esophageal atresia and tracheosophageal fistula

Answer 44

congenital disorder | malformation of trachea and esophagus

Question 45

patho of esophageal atresia and tracheosophageal fistula

Answer 45

esophagus ends in blind pouch (atresia) - no connection between stomach and mouth part of the trachea can attach itself to esophagus

Question 46

positive indicator for esophageal atresia and tracheosophageal fistula

Answer 46

maternal polyhydraminos (too much amniotic fluid)

Question 47

when suspecting esophageal atresia and tracheosophageal fistula look for big 3 C's

Answer 47

coughing choking cyanosis

Question 48

esophageal atresia and tracheosophageal fistula occurs

Answer 48

4-5th week gestation | premature/low birth weight infants

Question 49

with esophageal atresia and tracheosophageal fistula what should we do

Answer 49

make child npo until dx/surgery to avoid aspiration | aspiration can lead to pneumonia

Question 50

with esophageal atresia and tracheosophageal fistula look for other deficits, what are they

Answer 50

``` VACTERL VERTEBRAL ANAL CARDIOVASCULAR TRACHEAL ESOPHAGEAL RENAL LIMB DEFOMITIES ```