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GI_UW_pretest Flashcards

1
Q

Mesenteric adenitis presents how?

A

RLQ pain, abdominal guarding, and tenderness

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2
Q

Recurrent self limiting episodes of V/N without an apparent cause with family hx of migraines suggests?

A

Cyclic vomiting syndrome

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3
Q

Pyloric stenosis leads to what electrolyte derangement

A

Hypokalemia hyponatremia metabolic alkalosis

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4
Q

Tx for pyloric stenosis

A

IV rehydration, correction of electrolyte imbalances to reduce risk of post op apnea, and then pyloromyotomy

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5
Q

Pyloric stenosis found in what population and typically diagnosed when?

A

First born males. Diagnosed at ages 3-5 weeks.

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6
Q

What is the first line modality for ID-ing intususseption

A

U/S

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7
Q

What is the classic sign for intussusception on U/S?

A

Target sign

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8
Q

What are characteristic signs of biliary cysts?

A

Abdominal pain, jaundice, palpable mass. Majority of cysts present

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9
Q

Hirschsprung disease aka

A

Congenital aganglionic megacolon

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10
Q

Meconium ileus is pathognominic for

A

Cystic fibrosis

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11
Q

Hirschsprung is a/w which disorder?

A

Down syndrome

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12
Q

Primary diagnoses consideration in infant that fails ot pass meconium within 48 hours

A

Hirschsprung and meconium ileus

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13
Q

Why is there polyhydramnios with duodenal atresia

A

inability to swallow and remove amniotic fluid

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14
Q

What does x ray show for duodenal atresia

A

Air trapped in stomach, and duodenum => double bubble. No air in distal part of the GI tract.

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15
Q

Duodenal atresia is strongly a/w

A

Down Syndrome

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16
Q

What is a volvulus

A

Small bowel twists around the superior mesenteric artery resulting in vascular compromise to large portions of midgut

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17
Q

How does midgut volvulus usually present

A
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18
Q

What is the fastest and most accurate way to diagnose a volvulus?

A

Contrast in a corkscrew pattern => volvulus

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19
Q

What is the Ladd procedure

A

Fixing the bowel in a non-rotated position to minimize recurrent volvulus risk.

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20
Q

Pellagra classic ppt

A

Diarrhea, dermatitis dementia and if severe, death

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21
Q

Pellagra is due to deficiency in what?

A

Vitamin B3 (niacin)

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22
Q

Riboflavin deficiency presentation

A

Cheilosis, glossitis, seborrheic dermatitis (often affecting genital areas), pharyngitis and edema/erythema of the mouth

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23
Q

Pyridoxine deficiency is a known risk factor for?

A

Venous thromboembolic disease and atherosclerosis

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24
Q

What solution should be used for IV fluid resuscitation in children?

A

Isotonic crystalloid is the only crystalloid solution recommended - isotonic saline

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25
Presentation of Beckwith-Wiedemann Syndrome
Overgrowth disorder. PE = macrosomia, macroglossia, ompahlocele or umbilical hernia, hemihyperplasia.
26
What are the complications of Beckwith-Widemann
Wilms Tumor, hepatoblasoma
27
NEC presentation
Feeding intolerance, increased gastric residual volume, abdominal distension, bloody stools.
28
Risk factors for NEC
Prematurity,low birth weight, hypotension, congenital heart disease.
29
Hallmwark x-ray finding for NEC
Pneumostasis intestinalis and portal venis air
30
PE findings and X -ray findings for osteosarcoma
Large tender mass. X-ray finding: sun-burst periosteal pattern and "codman" triangle.
31
Lymphoblast histology/staining
Lack peroxidase positive material, often contain +PAS staining material, 95% immunostain for TdT. (TdT is only present in pre B and T lymphocytes)
32
Example of clotting disorders
Hemophilia A and B
33
Activated PTT time in hemophilias
Increased activated PTT
34
Examples of platelet defects
Von Willebrand and Bernard Soulier Syndrome
35
Ewing's sarcoma is often confused with
Osteomyelitis because of the intermittent fevers, leukocytosis, malaise, joint swelling
36
Characteristic x-ray findings for Ewing's sarcoma
Lytic, central bone lesion with periosteal reaction leading to onion skin appearance, followed by mottled appearance/moth eaten and extension into soft tissue
37
Cobalamin deficiency presents as
Macrocytic anemia
38
Most common inherited bleeding disorder
Impaired Von Willebrand factor
39
Primary dose limiting side effect of hydroxyurea
Myelosuppression
40
Brainstem is composed of
Midbrain, pons, medulla
41
Pineal gland secretes
Melatonin
42
What is parinaud syndrome
Downward gaze preference (sun setting gaze) with limited upward gaze, ptosis, upper eyelid retraction, pupillary abnormalities
43
What are the clinical sx of pineal gland mass
Parinaud syndrome, obstructive hydrocephalus, precocious puberty (if the pineal gland mass is a germ cell tumor that secretes b-HCG)
44
What are the clinical sx of obstructive hydrocephalus
papilledema, vomiting, headache, ataxias
45
What kind of masses can arise from pineal gland?
variety but most common is the germ cell tumor
46
Wht is the triad of hemolytic uremic sydnrome
renal failure, thrombocytopenia and microangiopathic hemolytic anemia
47
clinical ppt of HUS
abdominal pain and diarrhea followed by bloody diarrhea. Within 5-7 days => anemia, thrombocytopenia and renal insufficiency.
48
PE of HUS
Pallor, jaundice (hemolysis), edema, petechiae, HTN
49
What is the characteristic peripheral smear of HUS
Schistocytes and large platelet
50
Lead poisoning causes what kind of anemia
Microcytic anemia. Basophilic stippling on peripheral blood smear.
51
Triad of Wiskott Aldrich Syndrome
Eczema, thrombocytopenia (from decreased platelet production), hypogammaglobulinemia leading to recurrent bacterial infections.
52
How does polycythemia lead to cyanosis?
High red blood cell mass and hyperviscosity leads to cyanosis
53
What is the definition of neonatal polycythemia
Hematocrit greater than 65%
54
Wht are the risk factors for neonatal polycythemia
Increased erythropoiesis from Maternal diabetes, maternal hypertension, IUGR, smoking. Or erythrocyte transfusion from delayed cord clamping or twin twin transfusion
55
Clinical presentation of neonatal polycythemia
Neurologic manifestations (irritability, jitteriness), respiratory distress and hypoglycemia.
56
Doughy skin is indicative of
Hypernatremic dehydration
57
Dilated stool filled megacolon on x-ray, stool-filled anal canal with poor tone on PE of a well-grown child supports diagnosis of?
Functional constipation
58
Presence of nocturnal abdominal pain and GI bleeding in patient with positive family hx supports diagnosis of
PUD
59
Dx of PUD can be made by what procedure?
Endoscopy is preferred method althoug upper GI series can sometimes reveal an ulcer.
60
Tx of eosinophilic esophagitis
Avoidance of specific food allergens. Inhaled or systemic steroids have been helpful.
61
Sx of eosinophilic esophagitis
Similar to GERD but are not relieved with acid blockade.
62
Dilated stomach, proximal loops of bwel, curly Q twist of barium suspicious for?
Malrotation.
63
Patients with malrotation commonly present when with what?
First weeks of life with bilious vomiting, indicated of bowel obstruction and or intermitted abdominal pain
64
When does pyloric stenosis present?
Not until after around 3 wee os life. Presents with non bilious vomiting
65
Intusussception usually presents starting when?
Starting around 6 months or older
66
Jujenal and duodenal atresia usually present?
Very leafly in life. First day or so.
67
Meconium ileus is pathognomonic for?
Cystic fibrosis
68
Most serious complication of ulcerative colitis is
Toxic megacolon.
69
Intractable chronic constipation without fecal soiling- suspsect dx of?
Hirschsprung disease.
70
Cholecystitis and cholelithiasis are unusual in children and are almost always a/w
CF, pregnancy, hemolytic anemia, Crohns, obesity, or prior ileal resection. Dx confirmed on U/S of gallbladder
71
Usual presentation of intusussecption of infant? Age and sx
Usually 4-10 months of age, sudden onset of abdominal colicky abdoinal pain. Passage of stool containing blood nad mucus, described as currant jelly. Early exam can be unremarkable but passage of time shows sausage shaped mass in URQ.
72
What is Sandifer syndrome
Bending or arching of the neck caused by reflux.
73
Classic triad of Crohn's disease. Other ppt?
weight loss, diarrhea and abdominal pain. A/w with transmural, granulomatous intestinal lesions that are discontinus. Can appear in both small and large intestines. Risk of colonic carcinoma is increased but not to same degree as UC.
74
Giardia dx?
Identifying cysts or trophozoites makes the dx.
75
Tx option for Giardia
single dose of tinidazole or course of metronidazole.
76
What is mecekls diverticulum
Embryonic duct connecting the yolk sac to the intestine fails to regress completely and persists as a diverticulum attached to the ileum.
77
Diagnostic techniques for lactose intoelrance
Hydrogen breath test (basically bacterial metabolism of unabsorbed carb in colon into CO2 and h2.) and resolution of sx after removal of lactose from diet.
78
High concnetrations of sugars promotes dental disease in teeth but which teeth remain normal
Mandibular frontal teeth.
79
Congenital indirect hernia is a result of
incompelte closure of the processus vaginalis. In conrast to less commonly acquired direct inguinal hernia, caused by weakness in musculature of the inguinal canal.
80
activated charcoal can be effective for clearance of?
phneobarbital and TCAs (drugs with enterohepatic circulation or with prolonged absorption like sustained release theophylline). Not effect for alcohols, acids, ferrous sulfate, strong bases like drain cleaners and oven cleaners.
81
Lab must use what to assess for enterhemorragic E coli (shiga like toxin)
Sorbitol-macConkey agar.
82
Isoniazid competitively inhibits utlization of what vitamin
Pyridoxine. Vitamine B6
83
Vitamin A deficiency first manifests with what kind of clinical sx?
Visual changes, including night bldiness. Can also cause drying of conjunctiva and sclear. Skin is frequently dry.

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