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PEDS 2- clinical disciplines > GI > Flashcards

Flashcards in GI Deck (95)
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1

What is esophageal atresia?

blind esophageal pouch w/ or w/o a fistulous connection between the proximal or distal esophagus & trachea

2

Clinical presentation of esophageal atresia?

Polyhydramnios (excess amniotic fluid)

only sxs within hrs of birth : infants in the 1st few hrs of life w/ copious secretions, choking, cyanosis & respiratory distress


3

Can esophageal FBs pass spontaneously?

yes, 80-90%

4

What is the MC FB ingested?

coin

5

management for coin ingestion?

Plain neck, chest, &/or abdominal radiographs

Esophageal coin on AP CXR

Tracheal coin - tends to be on its edge

Protect the airway

Give continuous oropharyngeal suction

6

Tx for coin ingestion?

Retrieval if:
Not passed into stomach
button battery
multiple magnets

7

What FB ingestion is a medical emergency?

button battery

may have perforation in 2 hrs

8

Tx for button battery?

Requires endoscopic retrieval if lodged in the esophagus:

If in stomach, watch for 24-48 hours to see if it passes, if not, must be removed endoscopically

9

Gastroesophageal reflux (GER) v GERD?

GER: uncomplicated recurrent spitting & vomiting
resolves spontaneously

GERD:
present when reflux causes secondary sx or complications

10

What is GER?

Reflux of gastric contents into the esophagus

occurs during relaxation of LE sphincter

common in young infants

11

sxs of GER?

infants: postprandial regurgitation from effortless to forceful


12

Tx of GER?

Usually benign

expected to resolve by 12-18mo of life

When infants develop sx like FTT, food refusal, pain, GI bleeding, upper or lower airway sx, etc. GER becomes GERD

13

sxs of GERD?

Older children = heartburn, dysphagia

14

Who is at risk for GERD?

asthmatics, Cystic Fibrosis, Developmental handicaps, Hiatal hernia, repaired TE fistula

15

complications of GERD?

esophagitits

recurrent pneumonia

recurrent cough
dental erosions

16

warning signs for GERD?

bile stained emesis (intestinal obstruction)

GI bleeding

Onset of vomiting after 6mo

Failure to thrive (FTT)

diarrhea, fever, hepatosplenomegaly

abdominal tenderness or distension or neuro changes

Need further work up!

17

Tx for GERD?

thickened feeds with oat cereal

milk free diet for 2 wks

H2 blocker v. PPI

Surg: Nissen Fundoplication

18

Epidemiology of eosinophillic esophagitis? EOE

all ages, M >F

19

What are the 2 MC comps of EOE?

1) esophageal food impactions

2) esophageal stricture

20

s/s of EOE?

feeding dysfunction, vague non specific sx of GERD

long meal times (washing down food w/ liquids)

avoidance of highly textured foods

No response to medical/ surg GERD tx

FH or PMH of atopy, asthma, dysphagia or food impaction

21

Dx of EOE?

Endoscopy:
esophageal mucosa w/ thickening, mucosal fissures, strictures & rings

esophagus sprinkled w/ pinpoint white exudates (resembles candida)

white spots composed of eosinophils

Need to r/o other causes

22

Tx of EOE?

elimination of food allergens

swallowed topical steroids (MDI)
-2 puffs of Fluticasone BID

23

What is Pica?

Persistent eating of nonnutritive substances

ex. Animal feces, Clay, Dirt, Hairballs, Ice, Paint, Sand

At least 1 month

Inappropriate to developmental level

24

Pica may be assoc. with...

iron and zinc deficiency

25

What is rumination?

Repeated regurgitation and re-chewing of food

At least 1 mo

More common 3 to 12 months

Less common in older children

26

Presentation of rumination?

Malnutrition

Failure to thrive

Weight loss

Bad breath

Tooth caries

27

Presentation of malabsorption?

Weight loss
Malnutrition
Diarrhea/steatorrhea (fat malabsorption)
N/V
Abd pain

28

Assessment of malabsorption?

Stool sample
Substance removal and challenge
Work up for celiac disease or cystic fibrosis

29

What is PhenylketonuriaPKU?

Most common inborn error of amino acid metabolism

Decreased activity of phenylalanine hydroxylase (enzyme that converts phenylalanine to tyrosine)

30

Presentation of PKU?

Intellectual disability *MC

Fair skin and hair (impairment of melanin synthesis)

Atopic dermatitis

hyperactivity

seizures

Musty or mousy odor to body & urine

Epilepsy (50%)