GI Book

Question 1

is the GI system is immature at birth

Answer 1

yes

Question 2

what is sucking before 6 weeks

Answer 2

primitive reflex

Question 3

when do you develop the voluntary control of swallowing

Answer 3

6 wks

Question 4

who has increases peristalsis

Answer 4

newborn

Question 5

is the stomach size small in the newborn

Answer 5

yes

Question 6

increase peristalsis and small stomach size in the newborn contribute to

Answer 6

small frequent feedings
increase frequency of BM and liquid consistency

Question 7

why do you get regurgitation

Answer 7

relaxed cardiac sphincter

Question 8

digestion occurs in

Answer 8

duodenum

Question 9

why do kids get abdominal distention

Answer 9

due to decrease enzymes

Question 10

when is the GI system normal

Answer 10

2 years

Question 11

when are they able to control sphincter and then potty train

Answer 11

18 mo

Question 12

for cleft lip and/or palate what is the majority of cases

Answer 12

majority are combination
~45%

Question 13

repair of CP/L

Answer 13

lip is done at 3-5 mo to help with feeding to create a seal
palate is done at 12 mo to protect formation of tooth buds and speech pattern

Question 14

post op CP/L

Answer 14

minimize crying as it can affect the suture line

Question 15

pyloric stenosis

Answer 15

hypterropic obstruction of the circular muscle of the pyloric canal so the lumen becomes inflamed and edematous

Question 16

pyloric stenosis s/s

Answer 16

projective vomiting
- 3 feet
nonbilous or blood tinged throw up
hungry after emesis
fails to gain weight
fewer and smaller stools
dehydration
M. Alk
observed peristalsis
olive sided mass in RUQ

Question 17

pyloric stenosis tx

Answer 17

pylormytomy
pyloric muscle is split

Question 18

GER/GERD

Answer 18

return of gastric contents into the esophagus
result of relaxation of the esophageal sphincter

Question 19

most common esophageal disorder in kids

Answer 19

GER

Question 20

GER s/s

Answer 20

regurgitation
spitting up
decrease wt
frequently hungry

Question 21

GERD s/s

Answer 21

refusal of eating
sleep distrubances
coughing
choking
wheezing
arching of back during feedings

older: dysphagia, heartburn

Question 22

GER/GERD diagnosis

Answer 22

esophageal pH monitoring

Question 23

GER/GERD tx

Answer 23

mild
- feeding modification with thicker foods and positioning
smaller feedings and increase frequency
H2 blocker and PPI

Question 24

GER/GERD surgery

Answer 24

wrapping the greater curvature of the stomach around distal esophagus

Question 25

GER/GERD how long should we hold the infant upright for after feeding

Answer 25

20-30 min

Question 26

omphalocele

Answer 26

congenital malformation in which intraabominal contents herniate through the umbilical cord

Question 27

gastroschisis

Answer 27

congenital defect of abdominal wall protrusion through a defect in the abdominal wall to the right of the umbilicus no membrane

Question 28

omphalocele/gastroschisis treatment

Answer 28

surgery place infant feet first into bowel bag

Question 29

intussusception

Answer 29

one portion of the intestines prolapses and invaginates or telescopes into another intensities rub togethers causing inflammation and edema which leads to decreased blood flow and edema, necrosis, and perforation

Question 30

intussusception most common location

Answer 30

ileocecal valve

Question 31

intussusception s/s

Answer 31

abrupt onset bilious emesis palpable abdominal mass red currant jelly stool

Question 32

intussusception tx

Answer 32

air enema - use air over barium because of decreased risk of perforation

Question 33

Hirschsprung disease

Answer 33

congenital anomaly in which inadequate motility causes mechanical obstruction of intestine which causes absence of ganglion cells which doesn't allow for peristalsis

Question 34

Hirschsprung disease s/s - newborn

Answer 34

abdominal distention feeding intolerance bilious vomit failure to pass med in first 24-48 hours

Question 35

Hirschsprung disease s/s - older infant/child

Answer 35

decrease wt gain and constipation

Question 36

Hirschsprung disease - results of rectal biopsy

Answer 36

absence of ganglion cells

Question 37

Hirschsprung disease - result of radiology

Answer 37

dissented bowel with dilated bowel loops

Question 38

Hirschsprung disease tx

Answer 38

remove aganglionic portion: pull through procedure

Question 39

appendicitis

Answer 39

inflammation of appendix - obstruction and then there is continued secretion of mucus following obstruction leading to increased pressure causing ischemia, cellular death, and ulceration

Question 40

appendicitis s/s

Answer 40

periumblicus cramps abdominal tenderness anorexia pain in RLQ - mcburney point guarding rigidity rebound tenderness

Question 41

appendicitis tx

Answer 41

surgical removal

Question 42

appendicitis abscess tx

Answer 42

drain, antibiotics and remove at later time - interval appendectomy

Question 43

education for parasite disorder

Answer 43

sandbox covered good hand hygiene proper med administration