GI part 1 Flashcards

Question

Labs for appendicitis

Answer 1

``` WBC count >10K UA KUB, abdominal X-rays Amylase, lipase, and liver enzymes CT scan when studies are inconclusive ```

Answer 2

Crying for more than 3 hrs/day, at least days per week, for more than 3 wks Colicky crying is often described as paroxysmal and may be characterized by facial grimacing, leg flexion, and passing flatus

Answer 3

Description of the crying, including duration, frequency, intensity, and modifiability Onset, diurnal pattern, any changes in quality, and triggers or activities that relieve crying

Answer 4

Check vital signs, weight, length, and head circumference | ID possible skin lesions, corneal abrasions, hair tourniquets, skeletal infections, or signs of child abuse

Answer 5

Education and demystification -The mean crying duration begins to decrease at 6 wks of age and decreases by half by 12 wks of age -Techniques for calming infants -Avoidance of dangerous soothing techniques -Coaching to learn to read infant's cues Avoidance of medications and dietary changes

Answer 6

In infants younger than 8-12 mos old

Answer 7

``` Heartburn Cough Epigastric abdominal pain Dysphagia Wheezing Aspiration pneumonia Hoarse voice Failure to thrive Recurrent otitis media or sinusitis ```

Answer 8

Poor growth Pain Breathing difficulty

Answer 9

Indicated if there are persistent sx or complications or if other sx suggest possibility of GER in absence of regurgitation Barium upper GI series 24 hr esophageal pH probe monitoring Endoscopy

Answer 10

For infants with complications: an h2 blocker or PPI Feeding jejunostomy In older children, discuss lifestyle changes: -Cessation of smoking -Weight loss -Not eating before bed or exercise -Limiting intake of caffeine, carbonation, and high-fat foods Proton pump inhibitor therapy

Answer 11

Two or fewer stools per week or passage of hard, pellet-like stools for at least 2 wks

Answer 12

``` Straining with defecation Hard stool consistency Large stool size Decreased stool frequency Fear of passing stools Any combination of these ```

Answer 13

Standing or sitting with legs extended and stiff or crossed legs- part of constipation

Answer 14

Prolonged course of stool softener therapy to alleviate fear of defecation Sitting on the toilet in the morning and immediately after meals Use of positive reinforcement

Answer 15

Vomiting that is frequent and projectile in nature Vomit never contains bile Ravenous hunger early in the course, but becomes more lethargic with increasing malnutrition and dehydration Peristaltic waves in the LUQ Hypertrophied pylorus may be palpated

Answer 16

``` Hypochloremic hypokalemic metabolic alkalosis Elevated BUN Plain abdominal X-rays U/s Barium upper GI series: string sign ```

Answer 17

IV fluid and electrolyte resuscitation followed by surgical pyloromyotomy

Answer 18

1-2 yrs old

Answer 19

Ileocolonic

Answer 20

``` Infant's knees draw up Pallor with a colicky pattern occurring every 15-20 minutes Feedings are refused Bilious vomiting Third space fluid losses "Currant jelly" stools Lethargy Sausage-shaped mass in the RUQ or epigastrum ```

Answer 21

Abdominal u/s | Pneumatic or contrast enema- can ID and treat the dz

Answer 22

Fluid resuscitation | Surgical consultation

Answer 23

Results from the absence of enteric neurons within the myenteric and submucosal plexus of the rectum and/or colon

Answer 24

Infants can present with abdominal distention, failure of passage of meconium within the 1st 48 hrs of life, and repeated vomiting Malnutrition resulting from early satiety, abdominal discomfort, and distention Chronic constipation Empty rectal vault

Answer 25

Single contrast barium enema Plain abdominal radiography Rectal manometry Suction rectal bx or transanal wedge resection

Answer 26

S/sx of high-grade intestinal obstruction: IV hydration, withholding of enteral intake, and intestinal and gastric decompression Surgery