Pedi GI Flashcards
(52 cards)
When is pyloric stenosis typically noticed in infants
withing the first 3-5 weeks of life, rare after 12
Clinical presentation of pyloric stenosis
- 3 to 6 week old with post prandial non bilious projectile vomiting
- weight loss
- hungry after vomiting
PE for a baby with pyloric stenosis
- appears think
- palpable olive at lateral edge of rectus
- peristaltic waves may be visualized pre emesis
- may be jaundice
Diagnostics of pyloric stenosis
-ultrasound
-
Treatment of pyloric stenosis
- correct hydration status first
- pyloromyotomy
When is intussesception most commonly seen
3 months to 5 years old
Where is the typical site of intussusception
near the iliocecal junction
Etiology of intussusception
proximal bowel telescopes into distal segment–> associated mesentary dragged along–> venous and lymphatic congestion–> intestinal edema–> possible ischemia
What causes intusscusception
most cases idiopathic
- virus
- post infectious bacterial enteritis
- lead point from underlying pathology
Clinical manifestations of intusscusception
- sudden, severe, crampy, progressive pain
- child will be incosolable with legs drawn up
- non bilious vomiting post pain
Presentation of intusscusception between episodes
- normal and pain free
- stool main contain gross or occult blood
- currant jelly stool
- may feel sausage shaped mass of right side of abdomen
Test to look for intusscusception
ultrasound!
“bull’s eye” or “coiled spring”
Intusscusception on xray
shows crescent sign
Non operative treatment for intusseception
- enema with hydrostatic or pneumatic pressure
* treatment of choice in stable pt w/o signs of perforation
When is surgical treatment indicated
if non operative approach failed
What always gets referred to surgery whether acute or intermittent and presently asymptomatic
intusseception
What is phenylketonuria
deficiency of pkenylalanine hydroxylase
What does a deficiency of PAH cause
increase in serum and urine phennylalanine—> intellectual disability
Increased phenylalanine interfers with what
- brain growth
- mylenination
- neurotransmitter sunthesis
Clinical findings in untreated PKU patients
- mental disability and impaired IQ-epilepsy
- abnormal gait
- pigmentation issues
- eczema
- blood and urine may smell mousy
When should treatment of PKU be started
by one weeks of life
When do levels of phenylalanine need to be monitored
- weekly for the first year
- twice a month years 1 to 12
- monthly after 12 for life
How does a child less than 5 present with appendicitis
listless, feverish kid with diffuse pain, womitting, rebound, gaurding–> perforated
Treatment of non perforated appendicitis in kids
- fluids
- pain control, anti pyretics, anti emetics
- NPO
- pre op abx (cefoxitin)
