GI/GU Flashcards by Bethany Ahrens

what is the most common cause of malnutrition

enviormental

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what are enviormental factors that can lead to malnutriton

poor feeding techniques, maternal depression, emotional deprivation, poverity

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what are some organic causes of malnutrition

celaic, GERD, infection, congential heart disease

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with malnutrition what initally declines

weight

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what is the retrograde movement of gastric contents upward into the esophagus

Gastreoesophgeal reflux

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A patient presents with poor feeding, weight loss, and is contantly spitting up his meals

GERD

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what can be used to diagnose GERD

barium upper GI
24 hour Ph monitoring
Endoscopy

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what is the treatment of GERD

infants with complicatins get PPI

If healthy no treatment needed

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what is a tracheoesophageal fistula (TEF)

communication between trachea and esophagus due to defect during development

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what are sx of esophgeal atresia

polyhydramnios, infant drools, mucous, and saliva bubbling from mouth.

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what is the most common tracheoesophageal fistula

esophgeal atresia

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how can you diagnose tracheoesophageal fistula

CXR can show tube coiled in stomach,

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what is a pt with tracheoesophageal fistula at risk for

aspiration pna

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what do you want to avoid if a pt has a tracheoesophageal fistula

barium due to the high risk of aspiration

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what is the treatment of tracheoesophageal fistula

surgery

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what is pyloric stenosis

hypertrophy and spasm of pyloric muscle

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what is an gastric outlet obstruction

pyloric stenosis

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Is pyloric stenosis congential or aquired

aquired..you are not born with it

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Who is pyloric stenosis more common in

males

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what are the sx that will make you think pyloric stenosis

Projectile vomiting in the 1st few weeks of life

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when does the vomiting occur in pyloric stenosis

immidiate postprandial, nonbilious, projectile

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what is found on exam of pyloric stenosis

palpable “olive” mass

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how do you assess for dehydration in pyloric stenosis

BUN and creatine

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How do you diagnose pyloric stenosis

US - pyloris will be thickened and elongated

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what is the treatment of pyloric stenosis

surgical pyloromyotomy

what is a miggut malrotation

abnormal rotation of the small intestines in utero

what are those with miggut malrotation suscceptible to

volvulus

what is a volvulus

twisting around mesenteric base, comprimises vascular supply

A patient is brought to you with abd pain, N/V and peritoneal signs. What are you thinking and what is the treatment

midgut malrotation treat with surgery

what is a congential intestinal motility disorder

Hirchsprung disease

what can failure of ganglion cells to migrate to the distal bowel early in development lead to

Hirchsprung disease

where do most cases of Hirchsprung disease occur at

rectosigmoid colon

what is the most common presentation of Hirchsprung disease

a pt who has not passed a BM within the 1st 24 hours of life. They may present with chronic constipation or failure to thrive

If you have a pt that is brought to you with bilious vomiting and find out with questions the pt is alos chronically constipated what should you be thinking

Hirchsprung disease

How do you definitivly diagnose Hirchsprung disease

biopsy reveals absence of ganglion cells

what is the treatment of Hirchsprung disease

surgery

what is Meckel diverticulum

remnant of the fetal omphalomesenteric duct

A patient is brought to you for painless GI bleeding what should you be thinking

Meckel diverticulum

what can Meckel diverticulum lead to

Intussusception

How do you diagnose Meckel diverticulum

Meckel scan

what is the treatment of Meckel diverticulum

surgical excision

What is telescoping of a segment of proximal bowel into distal bowel

Intussusception

What is the most common abd emergency in children

Intussusception

Where do most Intussusception occur at

ileocolic

A patient is brought in with abd pain. The pain started suddenly and the pt is laying down with his knees drawn into his chest. He is refusing to eat. what is the most likly diagnosis

Intussusception

What will you find on physical exam of a pt with Intussusception

current jelly stools and palpable sausage in abd

What can you use to dx Intussusception

US, but definitive diagnosis is air or barium enema

what is the treatment of Intussusception

air or barium enema

What is the most common bacteria to cause a UTI

E. coli

What are some sx in a neonate that may lead you to think UTI

Failure to thrive, feeding problems, fever

On UA what must the pyuria be to dx a UTI

>10 wbc

What must the urine catch specimen be to diagnose a UTI in an infant or child

>50,000 in infants | >100,000 in a child

What is the treatment for a UTI

Oral abx for 7 Days | Cefixime cefdner augmentin Bactrim

What is the most common cause of vesicoureteral reflex

Incompetent of UV Junction

When do you check a voiding cystourethrogram

2 or more febrile UTI | 1st febrile UTI and abnormal US

When do you get a renal bladder US

Children who do not respond to therapy Children <2 with their first febrile UTI Recurring febrile UTI Children with a UTI and a family hx of renal disease

What are the two types of cryptorchidism

Absent testies | Retractable testies

When do most undesended testies descend by

6 months on their own

When do you refer someone for an undesended testies

If not descended on its own by 6-12 months

What hormone can you try to help desend the testies

HCG

When do you want to do surgery by with cryptorchidism

By 2 is best outcome

What complications could occur if you don’t fix cryptorchidism

Infertility and testicular cancer

What is the most common renal malignancy in children

Wilms tumor

Around what age do you often diagnose wilms tumor

3-3 and a 1/2

What type of cells does a wilms tumor arise from

Primitive cells

How is wilms tumor often diagnosed

By an abdominal mass

What is the initial test for wilms tumor

Ultrasound

Where do you want to look for Mets in wilms tumor

Lungs

How do you definitely diagnose wilms tumor

Histology

The presence of what would make a wilms tumor unfavorable

Presence of anaplasia

If wilms tumor recurs where is it most likely to recur at

In the lungs within 2 years

What type of genetic disorder is PKU

Autosomal recessive

What chromosome is affected by PKU

Chromosome 12

What is pku

Deficiency of phenylalanine hydroxylase

What does phenylalanine hydroxylase do

Converts phenylalanine to tyrosine

At what level are you concerned for PKU on newborn screening

>360

What is the treatment of PKU

Dietary restriction of phenylalanine

At what levels do you want to maintain PKU at

120-360

GI/GU Flashcards

(78 cards)