what to the following AXR/US signs mean... 1. double bubble 2. triple bubble 3. soap bubble 4. football sign, loops of bowel & bowel oedema 5. pneumatosis intestinalis (intramural gas) 6. target sign

1. duodenal artresia 2. jejuno-ileo artresia 3. mecnoium ileus 4. NEC (perforated) 5. NEC

What are these... 1. vomiting & regurgitation after feegding, nothing else wrong 2. billous vomit, intramural gas (pneumotosis intestinalis), loops of bowel + oedema on AXR 3. very sore, knees up to chest, sausage shapped mass 4. congenita diaphragmatoc hernia, ompalocele

1. GORD 2. NEC 3. intusseception 4. malrotation

Peads GI Flashcards by Sandy 27

Does GORD usually reslove spontaneoulsy?

Yes it does

How well did you know this?

Not at all

Perfectly

What 3 conditions result in GORD not being self-limitng

Cystic fibrosis

Neurological disorders

Motility disorders

How well did you know this?

Not at all

Perfectly

how do you get bullous vomiting

what does it mean

It means bowel obstruction

but only at a level below the jejunum

this is cause bile is released from the gallbladder and into the jejunum

so, the obstuction must occur below cause else would it be travelling upwards for you to spew it up

How well did you know this?

Not at all

Perfectly

How well did you know this?

Not at all

Perfectly

what to the following AXR/US signs mean…

double bubble
triple bubble
soap bubble
football sign, loops of bowel & bowel oedema
pneumatosis intestinalis (intramural gas)
target sign

duodenal artresia
jejuno-ileo artresia
mecnoium ileus
NEC (perforated)
NEC

How well did you know this?

Not at all

Perfectly

If an AXR shows a soap bubble, what is it

what other condition is the kid deffo gonan have

how do you get it

Meconium ileus

Deffo gonna have CF

The meconium is way too sticky, so it doesn’t budge

How well did you know this?

Not at all

Perfectly

If they have billous vomit & the baby has not yet passed meconium, what are the 3 differentials & why

Meconium ileus -> poo too sticky due to CF

Hirschprungs -> ganglion cells haven’t buggered off (not migrated)

Ano-rectal malformation -> rectum is buggered, so poo can’t physically leave lol

How well did you know this?

Not at all

Perfectly

What are these…

vomiting & regurgitation after feegding, nothing else wrong
billous vomit, intramural gas (pneumotosis intestinalis), loops of bowel + oedema on AXR
very sore, knees up to chest, sausage shapped mass
congenita diaphragmatoc hernia, ompalocele

GORD
NEC
intusseception
malrotation

How well did you know this?

Not at all

Perfectly

what’s the best imaging for intusseception & pyloric stenosis

USS

How well did you know this?

Not at all

Perfectly

3 day old kid

Green vomit

Not passed meconium yet

Genetics show MEN 2B

what’s this

what is the diagnostic test

how do you treat

Hirschprungs disease

Rectal biopsy

1st line -> rectal washout/bowel irrigation

2nd line -> surgery

How well did you know this?

Not at all

Perfectly

what genetic condition is hirschprugs associated with

MEN-2b

also associated with…

medullay thyroid ca

Phaenochromocytoma

How well did you know this?

Not at all

Perfectly

when is mssconium usually passed

within 24hrs

start to worry if after 48

How well did you know this?

Not at all

Perfectly

what is the big bad risk factor for meconium aspiration

post-term

How well did you know this?

Not at all

Perfectly

Child

Painless GI bleeding

Can cause appendicitis like abdo pain

Needs blood transfusion

What is it

whats it a remnant of

whats it the main cause of

Meckel’s diverticulum

Yolk sac

Painless GI bleeding

How well did you know this?

Not at all

Perfectly

what is a serious GI cause of death in premature babies

NEC

Nectorising EnteroColitis

How well did you know this?

Not at all

Perfectly

Billous vomiting

Nappy is a bit red (blood)

Not feeding right

Abdo pain

Whats this

what investigation

management

NEC

AXR

Management

NBM

Lapratomty + abxs (broad spectrum)

How well did you know this?

Not at all

Perfectly

what happens to the bowel in intusseception

One bit invaginates into another

How well did you know this?

Not at all

Perfectly

colicky abdo pain

Knees to the chest

Billous vomit

“red currant jelly” in stool

whats this

what would the mass feel like on palpation

investigation to do

Management

Intussception

Sausage-shapped

USS

1st line -> air enema (reduction by air insufflation)

2nd line -> surgery & abxs

How well did you know this?

Not at all

Perfectly

How well did you know this?

Not at all

Perfectly

intussception

What does the mass feel like

When does billous vomiting occur

Most common location

Sauage-shapped

POST-natal period

Ielo-cecal valve

How well did you know this?

Not at all

Perfectly

Fairy liquid vomit

Scaphoid abdomen

How well did you know this?

Not at all

Perfectly

Red currant jelly in stool is sign of what

Intussception

How well did you know this?

Not at all

Perfectly

what are the key signs of malrotation

Fairy liquid vomit

Sacphoid abdo

How well did you know this?

Not at all

Perfectly

what sorta pain does intussecption present with

Colicky abdo pain

Knees drawn to chest as a result

How well did you know this?

Not at all

Perfectly

Fairy liquid vomit Scaphoid abdomen May have omphaocele & congenital diaphragmatic hernia **whats this** **investigation** **management** **whats going on if baby is unwell**

Malrotation USS + UGI contrast study surgery -\> Lapraotomy & LAD's procedure Volvulus

whats the main cause of billous vomit until proven otherwise

Malrotation Small intesine is all tangeled up

What are the causes of billous vomiting

**Anything that causes bowel obstruction below the jejunum** Malrotation INtussecption Duodenal & jejuno-ileal artresia Meckels diverticulum NEC Hirchbrungs Ano-rectal malformation Mecnoium ieleus Strangulated hernia

does pyloric stenosis cause billous vomiting

Absolutley not cause the obstruction is clearly above the jejunum

Effotless vomiting is a sign of...

GORD

Effortless vomiting **whats this gonna be** **when is it not self-limiitng** **Investigations** **Management**

GORD Not self-limiting -\> cerbral palsy **investigations** Feeding trial (main) Barrium swallow & video fluroscopy Endoscopy **management** Change feeding position v Food thickeners v gaviscon v PPI v Surgery - nissan fundoplication

what surgery can be done for GORD what are the indications

**Nissan fundoplication** FTT Recurrent aspiration

What are the different types of diarrhoea

Motility Secretory Osmotic Inflammatory

Give causes for the following typrs of diarrhoea ## Footnote Motility Secretory Osmotic Inflammatory

Motility -\> toddlers diarrhoea, IBS Osmotic -\> allergies, celiacs, CF (malabsorption) Secretory -\> infections Inflamatory - \>IBD

What are the differneces between osmeotic and secretory diarrhoea

**osomtoic** Smaller stool volume Goes away after you stop eating Caused by malabsoprtion (allergies, coeliacs, CF) **secretory** Larger stool volume Doesn't stop after eating caused by infections

Casues of malabsoroption

Coeliacs Crohns CF

Diarrhoea Dehydrated Can't eat Fever **whats this** **management** **are abxs usually used**

Gastrotenteriris stable -\> Encourage fluids unstable -\> Oral rehydration therapy very unstable -\> IV fluids Abxs are not usually used, only if like septic

bloody diarrhoea just visited a zoo **whats the cause**

E.coli 0157

a child presents with a puffy face kinda looks like an allergy but unsure what investigation needs to be done & wh7

Urine dip -\> check for protein Could be minimal change disease

how would you describe the vomiting in pyloric stenosis

Persistent & projectile Low Cl & K ALKALOTIC

if the diarrhoea is full of undigested food, what is the cuase

toddler's diarrhoea

**gastroeneteritis** Main cause cause if you get loose stools after recovering from it

Rotavirus Lactose intolerance

**Diarrhoea** Causes of acute & chronic pls

**acute** -\> gastroenteritis **Chronic** CMPA Toddler's diarrhea Coeliacs

Kid is very jittery Hypertonia Hyperreflexia Been having diarrhoea **What is going on**

Hypernatraremic deyhradation **too much salt**

causes of bloody diarrheoa in kids

E.coli campylobacter Salmonella Shigella Protozoa

Projectile vomiting Visible gastric peristalsis Mass in abdomen weight loss Low Cl & K **whats this** **what shape is the mass** **Inestigations** **management**

Pyloric stenosis Olive shapped USS IV fluids & surgery (pyloromyotomy)

what surgical procedure is done for pyloric stenosis

Pyloromyotomy

causes of constipation in a kid

TOILET ANXIETY Dehydration Anal fissures Hirschprungs Opiates Psychological -\> sexual abuse

how is constipation treated

1st line -\> movicol 2nd line -\> add senna

what type of laxatives are movicol and senna

movicol -\> osmotic senna -\> stimulant

how can impaction lead to overflow

Since stool is always sitting against the anal sphincter, the muscle weakens so some shit is squirted out

diarrhoea/constipation just started formula feeds **whats this**

CMPA cows milk protein allergy

whats like the normal range of stool frquency

4 per day -\> 1 per week

whats the cycle of toliet anxiety that can lead to

Stool sits in rectum v stool absorbs water & gets bigger v Next poo is painful due to size v kid doesn't want to go to toliet again v from the top now y'all

what is a complication of constipation & what are some signs

**Imapaction** Pain Pooing themselves (overflow)

what type of exams should you do if a kid presents with chronic constipation

Neuro of lower limbs PR

**CMPA** Is it IgE mediated? Investigation Management

No Milk-free feeding trial Hydrolysed feeds, PPIs

Few weeks old baby Dark urine Pale poo Poor appetite Hepatosplenomegaly **Most likely diagnosis** **Type of raised bilirubin** **investigations** **management**

Biliary artresia CONJUGATED **Investigations** Bloods -\> bilirubin & LFTs USS of biliary tree **Management** Surgery -\> kasai procedure

What do these surgical procedures treat... 1. Nissan fundoplication 2. Pyloromyotomy 3. Kasai procedure

1. GORD 2. pyloric stenosis 3. biliary artresia

what complication of jaundice can serious fuck up your brian it's the basal ganglia thats fucked

Kernickerus

Is jaundiced baby just after birth normal

Absolutley not it's ALAYS PATHOLOGICAL

**Jaundiced baby at birth** Commonish/unexciting cause where must you see it Management

Bruising Must be seen in the sclera **Management** Measure bilirubin within 2hrs Blood film Referral to PAU Phototherapy (incubator) Maybe IV fluids

Causes of conjugated & unconjugted jaundice

**Conjugated** Biliary artesia Neonatal hepatitis **Unconjugated** Hypothyroid Gliberts

3 histologicla signs of coeliacs

Total villous atrophy Crypt hyperplasia WC infiltreation

**causes of abdo pain in peads** 1. 5yo, RIF pain, no guarding/tenderness, recent viral infection 2. 5yo, RIF pain, guarding & tenderness, raised CRP/ESR 3. RIF pain, +ve urine dip 4. 2yo, severe RIF pain, lots of rectal bleeding, needs transfusion 5. \<9m old, severe colicky abdo pain, knees to chest, red jelly stool

1. mesenteric adenitis 2. acute appendicitis 3. pyleonephritis 4. meckles diverticulum 5. intussecpetion

Peads GI Flashcards

(66 cards)