GI Disorders Flashcards
1
Q
What are the different types of vomiting?
A
- vomiting with retching
- projectile vomiting
- bilious vomiting
- effortless vomiting
2
Q
What can stimulate the vomiting centre?
A
- enteric pathogens
- intestinal inflammation
- metabolic derangement
- infection
- head injury
- visual stimuli
- middle ear stimuli
3
Q
What are features of vomiting with retching?
A
- pre-ejection phase
- pallor
- nausea
- tachycardia
- ejection phase
- retch
- vomit
- post-ejection phase
4
Q
What are indications for a test feed?
A
- palpation of ‘olive’ tumour
- visible gastric peristalsis
- projectile non-bilious vomiting
5
Q
What is the management?
A
- fluid resuscitations
- Ramstedts pyloromyotomy
6
Q
What are features of pyloric stenosis?
A
- 4-12 weeks age
- boys > girls
- projectile non-bilious vomiting
- weight loss
- dehydration +/- shock
- electrolyte disturbance
- metabolic alkalosis
- hypochloraemia
- hypokalaemia
7
Q
What are features of bilious vomiting?
A
- always draw serious attention
- usually due to intestinal obstruction
- intestinal atresia
- malrotation +/- volvulus
- intussusception
- ileus
- Crohn’s disease
- XR
- contrast meal
- laparotomy
8
Q
What are features of effortless vomiting?
A
- usually due to GORD
- very common
- self limiting + usually resolves
- except; cerebral palsy, progressive neurological problems, oesophageal atrasia, generalised GI motility problem
9
Q
What are the symptoms of reflux?
A
- GI
- vomiting
- haematemesis
- nutritional problems
- failure to thrive
- feeding problems
- respiratory
- apnoea
- cough
- wheeze
- chest infections
- neurological
- Sandifer’s syndrome
10
Q
What are the investigations for reflux?
A
- exam
- video fluoroscopy
- barium swallow
- pH study
- oesophageal impedance monitioring
- endoscopy
11
Q
What is the treatment for reflux?
A
- feeding advice
- thickeners for liquid
- appropriate amount, thickness of food
- behavioural programme
- feeding position
- nutritional support
- calorie supplements
- exclusion diet (milk free
- NG tube
- gastrostomy
- medical treatment
- feed thickener- Gaviscon, Thick + Easy
- prokinetic drugs
- acid suppressing drugs
- surgery
- failure of medical treatment
- Nissen fundoplication
12
Q
What is the definition of chronic diarrhoea?
A
- ≥ 4 stools per day
- > 4 weeks
- > 1 week: acute diarrhoea
- 2-4 weeks: persistant diarrhoea
- > 4 weeks: chronic diarrhoea
13
Q
What are causes of diarrhoea?
A
- motiltity disturbance
- toddler diarrhoea
- IBS
- active secretions (secretory)
- acute infective diarrhoea
- IBD
- malabsorbtion of nutrients
- food allergy
- coeliac disease
- cystic fibrosis
14
Q
What is osmotic diarrhoea?
A
- movement of water into bowel to equal osmotic gradient
- usually a feature of malabsorbtion
- enzymatic defect
- transport defect
- mechanism of action of lactulose/movicol
- usually with macro/microscopic intestinal injury
- clinical remission with removal of causative agents
15
Q
What is secretory diarrhoea?
A
- usually toxin production
- vibrio cholerae
- e. coli
- intestinal fluid secretion
- active Cl- secretion via CFTR
