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FINALS - CHILD HEALTH > neonatal GI > Flashcards

neonatal GI Flashcards

(60 cards)

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1
Q

what is meconium aspiration

A

resp distress in newborn from meconium in trachea

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2
Q

RF meconium aspiration

A

post term // resp distress // maternal hypertension, pre-eclampsia, chorioamnionitis, smoking, substance abuse

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3
Q

what is bilious vomiting

A

bile eg green or yellow

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4
Q

causes bilious vomiting neonates

A

duodenal, jejunal atresia // malrotation with volvulus // meconium ileus // nec enterocolitis

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5
Q

features deodenal atresia

A

downs // present just after birth with vomiting

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6
Q

inxv + mx deodenal atresia

A

AXR = double bubble // Duodenoduodenostomy

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7
Q

presentation intestinal Malrotation with volvulus

A

3-7 days post birth // peritonism + haemodynamically unstable // vomiting // high caecum

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8
Q

classic presentation intestinal malrotation

A

bilious vomiting + obstruction

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9
Q

inxv intestinal Malrotation +/- volvulus

A

upper GI contrast + USS

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10
Q

mx intestinal Malrotation +/- volvulus

A

no volvulus = lap // with volvulus = ladd procedure

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11
Q

presentation meconeum ileus

A

CF // 24-48 hours of life // abdo distension, vomitting

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12
Q

what causes pyloric stenosis

A

hypertrophy of muscles of pylorus

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13
Q

RF pyloric stenosis

A

males // FH // first borns

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14
Q

features pyloric stenosis

A

2-4 weeks old // projectile vomiting after feed // dehydration + consipated // palpable mass

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15
Q

metabolic changes pyloric stenosis

A

hypoCl, hypoK, alkalosis

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16
Q

invx + mx pyloric stenosis

A

USS –> Ramstedt pyloromyotomy.

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17
Q

age and demographic intussusception

A

boys 16-18 months

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18
Q

features intussusception

A

severe, crampy abdo pain // mass // crying ++ // draw knees up and go pale // red current jelly in stool // vomiting

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19
Q

invx intussusception

A

USS –> target

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20
Q

mx intussusception

A

air into rectum –> surgery

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21
Q

what is hisrchprungs disease

A

no parasympathetic development to bowel –> functional obstruction

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22
Q

presentation hisrchprungs

A

boys // downs // neonatal failure to pass meconium // constipation

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23
Q

invx hisrchprungs

A

abdo xray // rectal biopsy = gold standard

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24
Q

mx hisrchprungs

A

rectal washout or irrigation –> definitive surgery

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25
types of biliary atresia
1 = only common bile duct affected // 2= atresia of cystic duct + hepatic duct // 3 = atresia of the left and right ducts to the level of the porta hepatis (90%)
26
presentation biliary atresia
fist few weeks // jaundice >2 weeks long // dark urine + pale stools // reduced appetite and growth // haepatosplenomegaly
27
invx biliary atresia
normal total bilirubin, raised conjugated bilirubin (dark urine) // raised AST // serum a1 deficiency // sweat test (CF) // USS
28
mx biliary atresia
surgery
29
complications biliary atresia
anastomosis, liver disease --> cirrhosis --> hepatocellular carcinoma
30
who is at risk of Necrotising enterocolitis
preterms -- death !!
31
symptoms Necrotising enterocolitis
reduced feeding // abdo distension + bloody stool // perforation, peritonitis
32
invx Necrotising enterocolitis
abdo Xray: dilated loops, pneumatosis intestinalis (intramural gas)!!!, oedema
33
presentation colic
<3 months // crying, pulling legs, worse in evening
34
mx colic
NO simeticone or lactase
35
features cows milk allergy
<3 months // formula fed baby // regurg + vomiting // diarrhoea // urticaria or eczema // colic // wheeze
36
diagnosis cows allergy
skin prick or patch // RAST IgE
37
mx cows allergy
extensive hydrolysed formula if formula fed // continue breastfeeding if breastfed, reduce cow milk from maternal diet, ca supplement
38
which type of cows milk allergy grow out of it
non IgE by age 3
39
common hernias in children
umbilical, inguinal diapgramatic
40
where do umbilical hernias appear
symmetrical bulge under umbilicus
41
assoc umbilical hernias
black!! // downs,
42
mx umbilical hernias
resolve before age 4-5
43
assoc congenital inguinal hernia
premature males
44
where do inguinal hernias appear
60% right sided
45
what can cause inguinal hernia kids
patent processus vaginalis may persist
46
mx inguinal hernia kids
surgically repair to reduce risk of incarceration
47
what is a Congenital diaphragmatic hernia
incomplete closure of pleurperitoneal canal (diaphragm) --> herniation of abdominal viscera --> chest
48
symptoms Congenital diaphragmatic hernia
pulmonary hypoplasia and hypertension --> resp distress
49
most common Congenital diaphragmatic hernia
left-sided posterolateral Bochdalek
50
survival congenital diaphragm hernia
50%
51
what is meckels diverticulum
congenital diverticulum of small intestine // remnant of omphalomesenteric duct
52
rule of 2 meckels diverticulum
2% population // 2 feet from ileocaecal valve // 2 inches long
53
symptoms meckels diverticulum
usually asymptomatic abdo pain // massive GI bleed age 1-2!!!! // obstruction
54
invx meckels diverticulum
stable = meckles technetium scan // severe = mesenteric arteriography
55
meckels diverticulum mx
removal if narrow neck
56
what are Gastroschisis and exomphalos
congenital visceral malformations.
57
what is Gastroschisis
defect in anterior ando wall just lateral to umbilicus
58
mx Gastroschisis
vaginal delivery ok --> theatre straight away
59
what is Exomphalos
abdo contents protrude out of anterior abdo wall but covered by protective membrane
60
mx Exomphalos
C section + staged repair

FINALS - CHILD HEALTH (16 decks)

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