Peds GI

Question 1

What is the definition of pyloric stenosis

Answer 1

acquired condition d/t hypertrophy and speasm of the pyloric muscle, nonbilious “projectile vomiting”

Question 2

PE of pyloric stenosis

Answer 2

firm “olive” in RUQ, wave-like contractions visible across upper abd

Question 3

What age is pyloric stenosis common

Answer 3

3-12 weeks of age, 1st born white males

Question 4

When is a string sign seen

Answer 4

barium swallow in pyloric stenosis

Question 5

Treatment of pyloric stenosis

Answer 5

pyloromyotomy

Question 6

what will esophageal atresia most offten occur with

Answer 6

tracheoesophageal fistula d/t defect in co-development

Question 7

diagnosis of esophageal atresia

Answer 7

attempt of passage of NG tube with confirmatory CXR revealing blind pouch

Question 8

What are the risks of GERD in infants

Answer 8

body position, large feedings, small stomach, immature lower esophageal sphicter

Question 9

when is GERD pathologic

Answer 9

presence of sx after 18 mos

Question 10

what medications are utilized in GERD in infants

Answer 10

H2 receptor antagonists, PPI

Question 11

What is the presentation of GERD

Answer 11

rapid weight gain, Sadifer’s sign, frequent burping

Question 12

Etiology of upper GI bleeding in neonate

Answer 12

swallowed maternal blood during delivery, AV malformation, peptic disease, coagulopathy, volvulus

Question 13

Eitology of lower GI bleeding in neonate

Answer 13

allergic colitis, necrotizing enterocolitis, volvulus, anal fissure

Question 14

Etiology of upper GI bleeding in infant/toddler

Answer 14

esophageal varices from liver disease, peptic disease, NSAIDs or steroids

Question 15

Etiology of lower GI bleeding in infant/toddler

Answer 15

Intussusception, Meckel diverticulum, bacterial enteritis

Question 16

Etiology of upper GI bleeding in older children

Answer 16

peptic disease, esophageal varices, NSAIDs or steroid use, Mallory-Weiss syndrome

Question 17

Etiology of lower GI bleeding in younger children

Answer 17

IBD, bacterial enteritis, pseudomembranous colitis, juvenile polyp, meckel diverticulum, nodular lymphoid hyperplasia, hemolytic uremic syndrome

Question 18

what is Hirschsprung disease

Answer 18

Motility defect due to failure of ganglion cells to migrate into distal bowel during fetal life; Presentation in newborn with failure to pass meconium in first 24 hours

Question 19

when will a “double bubble” present

Answer 19

in duodenal atresia or dilated loops of bowel in distal intestinal obstruction

Question 20

What is the presentation of Meckel Diverticulum

Answer 20

Fetal remnant of omphalomesenteric duct, results in outpouching of the distal ileum; May also be a lead point for intussusception or allow twisting of bowel around vascular supply

Question 21

What is intussusception

Answer 21

Telescoping of segment of proximal bowel into distal bowel, often lead points; Sudden onset of crampy abdomenal pain, currant jelly stools; Age range 1-2 years old

Question 22

What is meconium ileus

Answer 22

mc GI obstruction with cystic fibrosis, occurs d/t inspissated meconium

Question 23

what is necrotizing enterocolitis

Answer 23

MC GI medical/surgical emergency in a neonate; poor feeding, feeding intolerance. delayed gastric emptying, abdominal distention, abdominal tenderness, or both, decreased bowel sounds, abdominal wall erythema (advanced stages), hematochezia

Question 24

Treatment of necrotizing enterocolitis

Answer 24

IVF, NPO, ceompression of GI tract, antibiotics

Question 25

What is the defect in CF

Answer 25

due to the effect of the gene on the regulation of epithelial chloride and sodium transport causing viscous mucus, malabsorption and respiratory infections

Question 26

How to diagnose CF

Answer 26

sweat testing is Gold Standard

Question 27

Treatment of CF

Answer 27

surgical correction of anomalies, replacement of pancreatic enzymes, increased caloric intake, vitamin replacement

Question 28

when is abd pain chronic

Answer 28

> 3 mos; multiple episodes

Question 29

what is functional abd pain

Answer 29

daily or near daily pain not associated with eating or bowel movements or loss of normal activity.

Question 30

what is irritable bowel syndrome

Answer 30

pain begins with change in stool frequency or consistency, alternating diarrhea and constipation, relief of pain with bowel movement.

Question 31

what is the definition of diarrhea

Answer 31

Excessive daily stool liquid volume (>10ml stool/kg body weight per day)

Question 32

When is diarrhea considered chronic

Answer 32

>2 weeks

Question 33

What is secretory diarrhea defined as

Answer 33

secretion of fluid and electrolytes into the stool directly from the mucosa due to inflammation (inflammatory bowel disease or chemical stimulus), infection (cholera triggers secretory diarrhea due to endotoxin) or more rarely, hormones secreted by tumors (neuroblastoma)

Question 34

What is osmotic diarrhea defined as

Answer 34

due to water pulled into the bowel lumen after malabsorption such as undigested lactose triggering osmotic effect after intestinal brush border disruption from AGE

Question 35

what is the definition of constipation

Answer 35

2 or fewer stools per week or passage of hard, pellet-like stools for at least 2 weeks

Question 36

What is the treatment of constipation

Answer 36

Positive reinforcement; scheduled toilet times, or stool-softeners