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primary care midterm > GI- Peds > Flashcards

GI- Peds Flashcards

1
Q

whole milk should not be given under 1 bc?

A

can cause microscopic bleeding and allergies

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2
Q

when should solid foods be introduced?

A

at 4 months

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3
Q

what foods are choking hazards for infants?

A

raisins, nuts, hot dogs, grapes

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4
Q

if a peds pt vomits their med within 20 mins of taking it, what do you do?

A

you can re-dose and not worry about overdosing

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5
Q

when to be concerned about vomiting

A
  • bile in vomit
  • blood in vomit
  • severe dehydration
  • significant changes in mental status/activity level “lethargic”
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6
Q

limit dairy to___ servings per day

A

2
*The more dairy they have, the more fluid they need to push it out

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7
Q

for constipation, what do you recommend?

A

a strict toileting schedule; at least have them attempt to sit and have a BM at least daily when constipation is a concern

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8
Q

if mucus in stool more concerning for a….

A

food intolerance/allergy

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9
Q

if blood in the stool, can be…

A

post-viral and if large amount and constant this is concerning!

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10
Q

when to be concerned about diarrhea

A
  • large amounts of blood in diarrhea
  • symptoms of diarrhea
  • significant weight loss
  • family hx of IBD
  • daily abd pain
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11
Q

tx of diarrhea

A
  • increase fluids
  • BRAT diet: bland, starching foods to bulk up stools–bananas, rice, applesauce, toast
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12
Q

constipation

A
  • dairy is VERY constipating
  • avoid Miralax
  • increase fluids
  • increase fiber: fruits with skin, most fibrous: peaches, pears, prunes, plumes, pineapples
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13
Q

giardiasis

A
  • can be passed to person to person contact (spread through feces)
  • poor sanitation and unsafe water increase the risk of catching intestinal parasites
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14
Q

giardiasis: s/s (typically appear 2 weeks after infection)

A
  • watery diarrhea
  • soft, greasy stools
  • fatigue
  • abd cramping
  • bloating
  • nausea
  • weight loss
  • does not have blood/mucus in stool
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15
Q

diagnosis giardiasis

A

stool culture

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16
Q

tx giardiasis

A
  • metronidazole
  • albendazole
  • mebendazole
  • nitazoxanide
  • tinidazole
  • albendazole
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17
Q

pinworm

A
  • Transmitted indirectly; eggs from an infected person can stick to toys/bedding/clothing/objects. (can live off of a host on material for up to 2 weeks)
  • Tiny, white, thread-like worms that live in the rectum
  • At night the worm crawls out of the anus and lays eggs in the nearby skin; this causes severe itching
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18
Q

pinworm s/s

A

o Itchy in anus: worst at night (when they are active)
o Parents report at times seeing something move in and out of the rectum (in the bath, when changing a diaper)

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19
Q

pinworm diagnosis

A

o Tape test: Cellophane tape is pressed against the skin around the anus. If doing the test at home, it is best to do it in the morning before your child bathes or goes to the bathroom. When you look at the piece of tape, you will see the worms.
o Another way to test for pinworm is if you see the adult worm around your child’s anus, in underwear or diapers, or in the toilet after going to the bathroom. Remember, they are white and only about a centimeter long.

20
Q

tx of pinworm

A
  • albendazole
  • mebendazole
  • pyrantel pamoate
21
Q

tapeworms

A
  • Caused by contaminated food or water
  • Flat, hermaphroditic worms that can live as parasites in the human gastrointestinal tract
  • Eggs move from intestines to form cysts in tissue/organs. Eaten tapeworm larvae can grow into adult tapeworms, which live in the intestines.
22
Q

tapeworms s/s

A

o Some can be asymptomatic
o Visible worms in stool
o Nausea
o Anorexia (not want to eat)
o Epigastric pain
o Urticaria

23
Q

diagnosis of tapeworm

A

stool culture

24
Q

tx of tapeworms

A
  • 1st line Praziquantel
25
Q

appendicitis

A

inflammation of appendix

26
Q

appendicitis testing

A

o Psoas sign: have the pt lie on his or her left side and then you flex their right thigh backward. If they have pain when flexing that right thigh backward that’s bc the muscle of the thigh and the movement is pushing up that inflamed appendix. If positive will elicit pain
o Obturator sign: have the pt lie on their back and do a slow internal movement of their hip joint while the right knee is flexed.
o Mc’ Burneys: Rebound tenderness; pain worse when you let go of RLQ, more than with pressing in
o Rovsing’s: Pain radiates to RLQ, when you palpate LLQ

27
Q

s/s appendicitis

A

o Sudden pain that begins on the right side of the lower abdomen
o Sudden pain that begins around your navel and often shifts to your lower right abdomen
o Pain that worsens if you cough, walk or make other jarring movements
o Nausea and vomiting
o Loss of appetite
o Low-grade fever that may worsen as the illness progresses
o Constipation or diarrhea
o Abdominal bloating
o Flatulence
o RLQ pain

28
Q

concerns with appendicitis

A
  • rupture/sepsis
  • abscess
29
Q

diagnostics for appendicitis

A

ultrasound/CT to confirm this

30
Q

Hirschsprung’s Disease

A
  • large intestine becomes swollen due to a blockage
  • affects the large intestine (colon)
  • causes problems passing stool
31
Q

Hirschsprung’s Disease: s/s in infants

A

o Failure to pass meconium
o Swollen belly
o Vomiting (bile stained)
o Flatulence

32
Q

Hirschsprung’s Disease: s/s in older children

A

o Swollen abdomen
o Chronic constipation
o Gas
o Failure to thrive
o Fatigue
o Ribbon-like (pencil) foul smelling stool

33
Q

Hirschsprung’s disease diagnosis

A

o Biopsy of colon
o Abdominal x-ray using contrast dye (avoid in pts with kidney issues, or family hx of allergies to contrast dye)

34
Q

Hirschsprung’s disease tx

A

Surgery: to bypass/remove portion of the colon lacking nerve cells
* Pull-through surgery: diseased portion of colon removed; normal section pulled through the inside of the colon and attached to the anus
* Ostomy: to allow time for colon to heal/rest; can be reverse

35
Q

pyloric stenosis

A

o Blocks foods from entering the small intestine
o Normally, a muscular valve (pylorus) between the stomach and small intestine holds food in the stomach until it is ready for the next stage in the digestive process. In pyloric stenosis, the pylorus muscles thicken and become abnormally large, blocking food from reaching the small intestine. This causes an “olive pit” palpable in the pylorus.

36
Q

pyloric stenosis: s/s

A

o Typically appear within 3-5 weeks after birth; rare in babies >3 months.
o Projectile vomiting after feeding
o Persistent hunger
o Abdominal contractions
o Dehydration
o Changes in bowel movements
o FTT

37
Q

risk factors for pyloric stenosis

A

o More often in males
o Caucasians
o Prematurity
o Family history
o Smoking during pregnancy
o Early antibiotic use

38
Q

how is pyloric stenosis diagnosed?

A

by ultrasound

39
Q

tx of pyloric stenosis

A

surgical correction is needed

40
Q

intussusception

A

Telescoping of a section of the intestines into the adjacent part of the intestines; this blocks food/fluid from passing through. It can also cut off the blood supply to the affected portion of the intestine, which can lead to a perforation in the bowel. This can result in infection/death of the bowel.

41
Q

intussusception: s/s

A

o “Currant jelly stool”; stool mixed with blood and mucus
o Vomiting
o Lump in the abdomen
o Weakness/lack of energy
o Diarrhea

42
Q

intussusception risk factors

A

o Age: more common in younger children; most common cause of bowel obstructions in children between the ages of 6months-3 years
o More common in males
o Increased risk when there is intestinal malrotation history
o Certain disorders predispose someone:
* CF
* Henoch-Schonlein Purpura (HSP) also known as IgA Vasculitis
* Crohn’s disease
* Celiac disease

43
Q

intussusception: complications

A

peritonitis
* Abdominal pain
* Abdominal swelling
* Fever
* Vomiting
* Cool, clammy, pale skin
* Weak, rapid, thready pulse
* Abnormal breathing
* anxiety/agitation
* Listlessness

44
Q

diagnostics of intussusception

A
  • abd ultrasound
  • x-ray
  • CT scan
  • any imaging will show a “bullseye”: intestine coiled within the intestine
45
Q

tx of intussusception

A
  • air enema (1st line)
  • surgery (if perforation/peritonitis)

primary care midterm (12 decks)

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