Paediatric Alimentary - Liam

Question 1

Abdominal migraine:

• treatment

Answer 1

Pizotifen (preventative medication)

Question 2

Constipation:

• treatment

Answer 2

Laxatives (movicol)

Question 3

Projectile vomiting cause

Answer 3

Pyloric stenosis

Question 4

Haematemesis cause

Answer 4

Peptic ulcer, oesophagitis or varices

Question 5

Bile stained vomit cause

Answer 5

Small intestine obstruction

Question 6

Blood in stool cause

Answer 6

Gastroenteritis or cows milk protein allergy

Question 7

Gastroenteritis:

• organism

Answer 7

• Viral
  
  • Rotavirus or norovirus
• Bacterial
  
  • E-coli
  • Compylobacter jejuni
  • Bacillus cereus

Question 8

Coeliac disease:

• genetic associations

Answer 8

HLA-DQ2

HLA-DQ8

Question 9

Coeliac disease:

• antibodies

Answer 9

Anti-TTG

EMAs

anti-DPGs

Question 10

Coeliac disease

• investigations

Answer 10

• Coeliac antibodies
  
  • Raised anti-TTG and raised anti-EMAs
• Endoscopy
  
  • Crypt hypertrphy
  • Villous atrophy

Question 11

Describe Crohns using NESTS mneumonic

Answer 11

No blood or mucous

Entire GI tract

Skip lesions on endoscopy

Terminal ilium most affected and transmural (full thickeness) inflammation

Smoking is risk factor

Question 12

Describe ulcerative colitis using CLOSEUP mneumonic

Answer 12

Continuous inflammation

Limited to colon and rectum

Only superficial mucosa

Smoking is protective

Excrete blood and mucus

Use aminosalicylates

Primary sclerosing cholangitis

Question 13

Inflammatory bowel disease

• investigations

Answer 13

• Bloods tests for anaemia, infection, thyroid, kidney and liver function
  
  • Raised CRP indicates active inflammation
• Faecal calprotectin
  
  • Released when intestine inflammed
• Endoscopy and colonoscopy
• Imagin
  
  • USS, CT and MRI

Question 14

Crohns

• inducing remission

Answer 14

Steroids (oral prednisolone)

Question 15

Crohns

• maintaining remission

Answer 15

1. Azathioprine or mercaptourine

Question 16

Ulcerative colitis

• inducing remission

Answer 16

Aminosalicylate

Question 17

Ulcerative colitis:

• severe disease drug

Answer 17

IV corticosteroids (hydrocortisone)

Question 18

Hirshsprungs disease:

• pathology

Answer 18

Congenital - nerves from myenteric plexus absent in distal bowel and rectum

Question 19

Intussusception

• pathology

Answer 19

Bowel invaginates on itself causing obstruction

Question 20

Intussusception:

• presentation

Answer 20

Redcurrent jelly stool

Severe abdominal pain

Vomiting

Question 21

Intussusception

• diagnosis

Answer 21

USS or contrast enema