peds gi Flashcards

Question

tef/esophageal atresia: suction considerations

Answer 1

prn with EXTREME CAUTION | - possible interference with fresh postop repair!

Answer 2

with no connection between sucking and satiety, oral aversion is possible; no drive to eat - start g tube feeds slowly - start oral feeds slowly after healed - feeding difficulties not uncommon! MONITOR!

Answer 3

protrusion of organ through an abnormal opening; become dangerous when constriction leads to impaired circulation or impaired respiration

Answer 4

3rd week of gestation

Answer 5

herniation of abdominal contents through umbilical ring; intact peritoneal sac 75%ish survival (associated anomalies)

Answer 6

herniation of abdominal contents lateral to umbilical ring, no peritoneal sac 85-100% survival

Answer 7

high risk of infection!! cover with sterile wrap, give abx IVFs to prevent fluid loss

Answer 8

incomplete fusion of umbilical ring where umbilical vessels leave abdominal wall. most common type of hernia. complications rare. surgery if still present at 2-3 years.

Answer 9

umbilical hernia

Answer 10

if still present at 2-3 years

Answer 11

SIGNIFICANT! diaphragm not completely formed allowing intestines and/or organs to enter thoracic cavity; restricted lung growth due to competition for space

Answer 12

acute respiratory distress during newborn period; can have significant decreased cardiac output + possible shock

Answer 13

media stinal shift, see loops of bowel in chest wall | - ideally picked up in week 20 ultrasound

Answer 14

chest x-ray = loops of bowel in chest

Answer 15

- respiratory support via hood or intubation (no bagging because that can introduce air into stomach which will then go into bowel!) - gi decompression via ngt - hob elevated

Answer 16

chronic lung disease, gastroesophageal reflux, growth failure

Answer 17

protrusion of small intestines/fluid into groin through a weakness or tear in the abdominal wall m>f ; premie > term

Answer 18

mass in groin, can present as painless inguinal swelling; CAN be painful sac is present at birth but inguinal hernia may not manifest until 2-3 months

Answer 19

2-3 months, though sac IS present at birth

Answer 20

put surgery off until 10 pounds because bigger, stronger babies do better in surgery surgery is outpatient and not very scary!

Answer 21

congenital aganglionic megacolon

Answer 22

congenital anomaly that results in mechanical obstruction from inadequate motility in part of the intestine; no innervation = no peristalsis AND decreased relaxation of internal rectal sphincter; collapsed rectum can also result megacolon occurs due to obstruction in portion directly above part of tract with no ennervation

Answer 23

absence of autonomic parasympathetic ganglion cells (of the submucosal plexus of Meissner and the myenteric Auerbauch plexus) in one or more segments of the colon

Answer 24

41-64%; abdominal distension, vomiting, no meconium in 48 hours big, shiny basketball tummy

Answer 25

21-35%/15-26% | chronic constipation, ftt, foul smelling and ribbonlike stools, abdominal distension

Answer 26

foul smelling and ribbonlike*

Answer 27

surgical removal of aganglionic bowel, temporary 6 mo ostomy over stretched out area - it needs to rest

Answer 28

8mo - 1yo -OR- 20 lbs | "pull" the end of intact bowel down to rectum for reanastomosis

Answer 29

closure of colostomy, usually 3 mo after stage II

Answer 30

occasional enemas, develop regular poo pattern, at continued risk for development of enterocolitis (population with mild sx very small)

Answer 31

inflammation of bowel, esp small intestine signs: explossive, watery diarrhea, fever, appears significantly ill

Answer 32

SEPSIS! (prior to surgery)

Answer 33

- abdominal pain - distension - nausea, vomiting - change in stool

Answer 34

early, nonbilious vomiting beginning around 3 weeks of age, progressing to projectile olive shaped mass in epigastrum palpable*; can see waves of peristalsis too

Answer 35

olive shaped mass in epigastrum palpable*

Answer 36

narrowing of the pyloric sphincter at the outlet of the stomach, obstructing the flow of food into the small intestines

Answer 37

muscle of pyloric sphincter becomes thick, elongated, narrowing the pyloric channel

Answer 38

early, nonbilious vomiting beginning around 3 weeks of age, progressing to projectile olive shaped mass in epigastrum palpable*; can see waves of peristalsis too

Answer 39

upper, central region of abdomen

Answer 40

- often made by hx, pe - ultrasound - possible metabolic alkalosis, severe volume depletion

Answer 41

metabolic alkalosis possible, correct before surgery!

Answer 42

- feed 4-6 hours after - vomiting is not uncommon - manage pain

Answer 43

telescoping of the bowel upon itself after fixing, only 10% reoccur

Answer 44

triad! - pain: sudden onset of crampy abdominal pain - sausage shaped abdominal mass - currant jelly stool

Answer 45

pain, sausage, currant jelly stool | if ACUTE intussusception

Answer 46

diarrhea, anorexia, weight loss, vomiting, periodic pain

Answer 47

barium/hydrostatic reduction (ie, enema) - 75% success surgical manipulation surgical resection

Answer 48

failure to thrive, anorexia, irritability, recurrent pneumonia (aspirating feedings)

Answer 49

permanent intestinal intolerance to dietary wheat and related proteins that produce mucosal lesions in genetically susceptible individuals malabsorption syndrome second to cf in cause of malabsorption in children

Answer 50

- impaired fat absorption (steatorrhea, foul-smelling poo) - impaired nutrient absorption (malnutrition, muscle wasting esp in legs/butt, anemia, anorexia, abdominal distension) - behavioral changes (irritable, uncooperative, apathy)

Answer 51

withdraw gluten from diet = full remission of sx tx 100% dietary management

Answer 52

excessively largel pale, oily, frothy stools | - see in children with celiac disease

Answer 53

upper gi swallow study

Answer 54

feed at higher angle, sit up 30 min after feeds, feed small amount more often, burp a lot, med management possible

Answer 55

feed at higher angle, sit up 30 min after feeds, feed small amount more often, burp a lot, med management possible, nissen fundoplication

Answer 56

after eating, environment, medication management all tried stomach is its own cardiac sphincter! (wrap around bottom of esophagus)

Answer 57

transfer of gastric contents into esophagus; physiologic phenomenon occurring throughout the day (most frequently after meals and at night) usually resolves spontaneously by 1 year of age

Answer 58

gerd is sx/tissue damage that result FROM ger. ger -> gerd when complications seen: - failure to thrive, bleeding, dysphagia, anorexia, irritability, recurrent pneumonia (aspirating feedings)

Answer 59

mesh used to house omphalocele that is extremely large or that can't be pushed back into abdominal cavity because cavity is small. can be suspended using mild tension. antibacterial ointment applied to prevent infection. compressed on a daily basis. ideally accomplished within 7 to 10 days.

peds gi Flashcards

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