Gi Bleeding

Question 1

Q: What are the symptoms of upper GI bleeding?

Answer 1

A: Hematemesis (vomiting blood) and melena (black, tar-like stool).

Question 2

Q: What are the symptoms of lower GI bleeding?

Answer 2

A: Hematochezia (passing bright red blood or blood clots in stool).

Question 3

What is the most common cause of GI bleeding in neonates for lower GI bleeding?

Question 4

What condition in neonates is marked by abdominal distension, poor feeding, and bloody stool?

Answer 4

A: Necrotizing enterocolitis (NEC), typically seen in premature infants.

Question 5

Describe the presentation of malrotation with midgut volvulus in neonates.
A:

Answer 5

Sudden onset of melena, bilious emesis, and abdominal distension.

Question 6

How can maternal blood ingestion cause GI bleeding in neonates?

Answer 6

A: Swallowed blood during birth or can appear in the stool or vomit.

Question 7

What is stress gastritis in neonates, and how is it diagnosed?

Answer 7

A: Found in NICU patients, often diagnosed with upper endoscopy.

Question 8

What deficiency causes hemorrhagic disease in newborns, leading to GI bleeding?

Answer 8

A: Vitamin K deficiency affecting clotting factors II, VII, IX, and X.

Question 9

What is the common cause of esophagitis in children aged 1 month to 1 year?

Answer 9

A: Gastroesophageal reflux or eosinophilic esophagitis.

Question 10

What are the primary causes of gastritis in children?

Answer 10

A: Helicobacter pylori infection, NSAID use, and Zollinger-Ellison syndrome.

Question 11

What is intussusception, and how does it present in infants?

Answer 11

Bowel segment pulled into another; presents with cramping, sausage-shaped abdominal mass, and “currant jelly” stools.

Question 12

Q: What is the preferred diagnostic tool for detecting intussusception?

Answer 12

A: Ultrasonography, showing target sign or pseudokidney sign.

Question 13

How is milk protein allergy related to GI bleeding in infants?

Answer 13

A: Causes colitis with symptoms like diarrhea, weight loss, and bleeding.

Question 14

What causes peptic ulcers in children and their main clinical presentation?

Answer 14

A: Caused by H. pylori infection or stress; presents with hematemesis, melena, and abdominal pain.

Question 15

What is Zollinger-Ellison syndrome?

Answer 15

A: Rare disorder with excessive gastric acid secretion due to a gastrinoma, leading to refractory peptic ulcers.

Question 16

What are juvenile polyps and how do they present?

Answer 16

A: Benign growths in the colon causing painless rectal bleeding; diagnosed with colonoscopy.

Question 17

What is Meckel’s diverticulum?

Answer 17

A: A congenital pouch in the ileum causing painless lower GI bleeding due to ectopic gastric tissue.

Question 18

Q: What diagnostic test is used for Meckel’s diverticulum?

Answer 18

A: Technetium-99m pertechnetate scan (Meckel’s scan).

Question 19

What are esophageal varices, and what causes them?

Answer 19

A: Enlarged veins in the esophagus, often due to liver disease or portal vein thrombosis.

Question 20

What is the initial management approach for GI bleeding in children?

Answer 20

A: Stabilization with oxygen, IV access, fluid resuscitation, and addressing coagulopathies.

Question 21

Q: What is the clinical significance of the “corkscrew sign”?

Answer 21

A: It’s an imaging finding associated with midgut volvulus, visible on an upper GI contrast study

Question 22

How does maternal blood ingestion in neonates differ from fetal blood?

Answer 22

A: The Apt test distinguishes between maternal and fetal hemoglobin.

Question 23

What are the risks of mechanical ventilation in neonates regarding GI bleeding?

Answer 23

A: It increases the risk of stress gastritis, particularly in premature and distressed infants.

Question 24

How is vitamin K deficiency treated to stop hemorrhagic disease in newborns?

Answer 24

A: Administration of 1 mg vitamin K intravenously, stopping bleeding within 2 hours.

Question 25

What is eosinophilic esophagitis, and how is it treated?

Answer 25

A: An allergic condition causing esophagitis; treated with allergen elimination and specific medications.

Question 26

What are common symptoms of gastritis in children?

Answer 26

A: Abdominal pain, nausea, loss of appetite, and weight loss.

Question 27

How does Helicobacter pylori infection in children often spread?

Answer 27

A: Through horizontal transmission, sometimes through breastfeeding if the mother is infected.

Question 28

What is the role of proton pump inhibitors (PPIs) in gastritis treatment?

Answer 28

A: They reduce stomach acid, aiding in the treatment and healing of gastritis.

Question 29

Describe the “currant jelly” stool seen in intussusception.

Answer 29

A: It’s a mixture of blood and mucus in the stool, commonly seen in intussusception.

Question 30

What is the target sign in intussusception diagnosis?

Answer 30

A: An ultrasound finding indicative of intussusception, showing concentric rings in the bowel.

Question 31

How are severe cases of intussusception treated if an enema is unsuccessful?

Answer 31

A: Surgical intervention may be necessary to correct the bowel obstruction.

Question 32

What distinguishes gangrenous bowel from other causes of GI bleeding in children?

Answer 32

A: It results from decreased blood flow, causing symptoms like sudden abdominal pain and urgent bowel movements.

Question 33

What is the treatment for milk protein allergy in infants with GI symptoms?

Answer 33

A: Removal of cow’s milk protein from the diet or use of hypoallergenic formulas.

Question 34

What is the role of the C-urea breath test in diagnosing peptic ulcers?

Answer 34

A: It detects H. pylori infection, which is a common cause of peptic ulcers in children.

Question 35

What are the two main goals of ulcer therapy in children?

Answer 35

A: Ulcer healing and elimination of the primary cause, such as H. pylori.

Question 36

What type of polyp is most common in children with GI bleeding?

Answer 36

A: Juvenile (hamartomatous) polyps, which are benign but can bleed.

Question 37

How is Meckel’s diverticulum bleeding typically managed?

Answer 37

A: Surgical resection to prevent further bleeding or complications.

Question 38

Why are esophageal varices particularly dangerous in children?

Answer 38

A: They can cause significant blood loss and are associated with serious liver disease.

Question 39

How is infectious diarrhea associated with GI bleeding managed?

Answer 39

A: Initial focus on rehydration, with antibiotics if caused by bacteria like E. coli or Shigella.

Question 40

What diagnostic method is preferred for visualizing esophageal varices?

Answer 40

A: Upper endoscopy to definitively identify varices and assess for bleeding.

Question 41

How is active variceal bleeding managed?

Answer 41

A: Through hemodynamic stabilization, vasopressors, antibiotics, and possible endoscopic treatment.

Question 42

What are vascular lesions, and how do they present in GI bleeding?

Answer 42

A: Malformations like hemangiomas or AV malformations that can cause GI bleeding, especially in the colon.

Question 43

What are the primary interventions for acute GI bleeding in children?

Answer 43

A: Stabilization, oxygen delivery, IV fluids, and blood resuscitation if needed.

Question 44

How is gangrenous bowel identified in children?

Answer 44

A: Symptoms include sudden abdominal pain, tenderness, and blood in the stool.