Peds GI Flashcards
(49 cards)
1
Q
Pyloric stenosis- Eti
A
- Narrowing outlet of stomach- fails to relax after meal
- Unknown cause
- 3:1000
- M>F
- Fam hx
2
Q
Pyloric stenosis- Sx
A
- 2-4 wks of age
- Post-prandial distension, visible peristaltic wave
- Olive like mass
- Regurgitation, nonbilious vomiting, projectile
- Hungry
- severe dehydration, lytes imbalance, oliguria
3
Q
Pyloric stenosis- Dx
A
- Upper GI with barium: sting sign
- US
4
Q
Pyloric stenosis- Tx
A
- Most common cause for surg
5
Q
Intussusception- Eti
A
- Telescoping of bowel into distal segment
- Most common cause of intestinal obstruction in 1st 2 yrs
- Idiopathic
6
Q
Intussusception- Sx
A
- Current jelly stool - 12 hrs
- V/D
- Severe cycles of pain, appear well between
- Sausage shaped mass
- Tender to palpation, distension
7
Q
Intussusception- Dx
A
- Saline/ contrast/ air enema
- 3% risk of recurrence
8
Q
Intussusception- Tx
A
- Enema to reduce
- Surgery if perforation, peritonitis, necrosis
9
Q
Intussusception- Tx
A
- Enema to reduce
- Surgery if perforation, peritonitis, necrosis
10
Q
Meconium Ileus- Eti
A
- Bowel obstruction from thickened meconium
- CF until proven otherwise
11
Q
Meconium Ileus- Sx
A
- Normal wt
- Distended abd
- Failure to pass meconium
- Loops of thick, distended bowel on exam
12
Q
Meconium Ileus- Dx
A
- Abd film: Soap bubble in RLQ
- Gold standard: Water soluble contrast enema
- Sweat chloride for CF
13
Q
Meconium Ileus- Tx
A
- Enema
- NG suction
- IV fluids
14
Q
Meconium Ileus- Tx
A
- Enema
- NG suction
- IV fluids
15
Q
Malrotation- Eto
A
- Twisting of intestinal loop due to embryonic development
- Partial or complete obstruction
16
Q
Volvulus- Eti
A
Complication of malrotation- 50% children
- Sm bowel around mesenteric artery
- Ischemia & necrosis
17
Q
Malrotation/ Volvulus- Sx
A
- Look well then ill quickly
- Extreme pain
- Hemodynamic deterioration
- Bulging typanic mass
- Frank blood per rectum
18
Q
Malrotation/ Volvulus- Sx
A
- Look well then ill quickly
- Extreme pain
- Hemodynamic deterioration
- Bulging tympanic mass
- Frank blood per rectum
19
Q
Malrotation/ Volvulus- Dx
A
- ABd xray: coffee bean sigmoid
- Double bubble sign- dilated stomach & duodenum
- UGI: corkscrew
- Barium: birds beak
20
Q
Malrotation/ Volvulus- Dx
A
- ABd xray: coffee bean sigmoid
- Double bubble sign- dilated stomach & duodenum
- UGI: corkscrew
- Barium: birds beak
21
Q
Malrotation/ Volvulus- Tx
A
- Decompression
- Abx
- Surgery if ischemic
22
Q
Malrotation/ Volvulus- Tx
A
- Decompression
- Abx
- Surgery if ischemic
23
Q
Hirschprungs- Eti
A
- Failure of enteric NS to develop
- Absence of ganglion in colon- absence of peristalsis
- M>W
- ## Down syndrome assoc
24
Q
Hirschprungs- Sx
A
- Failure to pass meconium
- Vomiting, abd distension, no feeding
- Enterocolitis: fever, inflammation, diarrhea
- Ischemia, perforation & sepsis
- Fecal masses, peristalsis palpable
25
Hirschprungs- Dx
Abd film: loops of distended bowel, retained stool
| - Barium enema- narrowed, irregular
26
Hirschprungs- Tx
- Resection of aganglionic segment
27
Inperforate anus- Eti
- Infra or supralevator
- Infra in girls, supra in boys
- Abn anorectal termination
- M>W
- Tethered spinal cord, GI abn assoc with
28
Inperforate anus- Sx
- Bilous vomiting
- Lack of anal opening
-
29
Inperforate anus- Sx
- Bilous vomiting
| - Lack of anal opening
30
Inperforate anus- Tx
Surgery
31
Constipation- Eti
- Peak during pre-school
- 3-5% of visits
- BMs change with age
- Organic: dietary, structural, metabolic, skeletal or psych
32
Constipation- Sx
- Distended abd
- Stool in distended rectum
- Hemoccult testing
33
Constipation- Dx
2 for 1 to 2 months:
- 2 or fewer BM /week
- 1 episode of incontinance
- Hx of retention
- Hx of painful or hard bowels
- Presence of mass in recturm
- Large diameter of stools obstruction toilet
34
Constipation- Dx
2 for 1 to 2 months:
- 2 or fewer BM /week
- 1 episode of incontinance
- Hx of retention
- Hx of painful or hard bowels
- Presence of mass in recturm
- Large diameter of stools obstruction toilet
35
Constipation- Tx
- Remove impaction
- Increase fiber/ liquids
- Laxatives
36
Anal fissure- Eti
- Most common cause of rectal bleeding
37
Anal fissure- Sx
- Crying with defecation
- BRBPR
- See fissure
38
Anal fissure- Tx
- Tx underlying constipation
| - Sitz baths
39
Encopresis- Eti
- Repeated passage of feces in inappropriate places
- > 4 yrs, not related to med disorder
- 1% school aged
- Boy>girls
40
Encopresis- Sx
- Retentive most common- Constipation with overflow
- Continuous- never gained control over bowel function
- Discontinuous- hx of normal control, loss during stress
- Toile phobia- frightening structure, fear of being swept down
41
Encopresis- Sx
- Retentive most common- Constipation with overflow
- Continuous- never gained control over bowel function
- Discontinuous- hx of normal control, loss during stress
- Toile phobia- frightening structure, fear of being swept down
42
Encopresis- Tx
- Tx underlying cause
43
Colic- Eti
- 9-17%
- Idiopathic
- Benign/ self limited
- 2 wks - 3 months
44
Colic- Sx
- Paroxysmal crying- in afternoon and evening
- Minmal response to soothing
- Cries for > 3 hrs/ day, >3days / week, > 3 weeks
45
Colic- Tx
- Parental support, reassurance
| - Take breaks from baby
46
Colic- Tx
- Parental support, reassurance
| - Take breaks from baby
47
Normal Amt of crying
- 2 hrs at 2 wks
- 3 hrs at 6 wks
- 1 hd by 3 months
48
Normal Amt of crying
- 2 hrs at 2 wks
- 3 hrs at 6 wks
- 1 hd by 3 months
49
Recurrent abd pain- Eti
- 1/ mo x 3 mo
- Affects activities
- 4-6 yrs of age
- Organic v fxn, organic
