Vomiting Flashcards

Question

When do you conisder fundolipication

Answer 1

Persistent FTT Oesophagitis Aspiration

Answer 2

``` Distress FTT Aspiration Otitis media Dental erosion ```

Answer 3

Reflux Dystonia Torticollis Refer as Dx could be West syndrome

Answer 4

CMPI | Think if poor response or atopy

Answer 5

150ml/kg/day Position Routine

Answer 6

Bloating Dumping Retching

Answer 7

Delayed non-Ige reaction to milk (intolerance) Usually present first 3 months in formula fed (can occur in breast) If IgE would be immediate (known as allergy) Can get anaphylaxis / angiooedema but rare

Answer 8

``` Reflux symptoms don't improve - Regurgitation + vomit - Wheeze - Chronic cough Skin involvement Gut involvement ```

Answer 9

Rash Ectopic eczema Urticaria FH atopy

Answer 10

``` D+V - osmotic Blood / mucous Frequent runny stools Abdo pain Distension Poor feed FTT ```

Answer 11

Formula fed babies | FH atopy

Answer 12

Clinical Eliminate diet Skin prick can be done

Answer 13

Bile | FTT despite change in milk

Answer 14

Milk challenge as anaphylaxis can rarely occur

Answer 15

4 week milk avoidance Continue breast but eliminate cow from diet Calcium supplement

Answer 16

Highly hydrolysed cow milk protein - protein broken down | AA if severe colitis

Answer 17

Rechallenge | Milk ladder approach - cooked milk in biscuit then yoghurt then milk

Answer 18

Obstruction as CMPI doesn't cause

Answer 19

``` Reflux Coeliac - not if baby Cows milk allergy - no allergic / skin symptoms (will still grow if have milk will just feel sick) Pyloric stenosis NEC Surgical Infection - culture? ```

Answer 20

``` Inflammatory bowel necrosis common in pre-term Necrosis can lead to bowel perforation, peritonitis and death - Pre-term - LBW - Enteral feeding - Formula feed - Resp distress - Sepsis ```

Answer 21

``` Poor feed Abdo distension Bloody / mucous stool Lethargy Vomiting bile Sepsis Vital signs instability Absent bowel sounds Rapid progression ot shock requiring mechanical ventilation ```

Answer 22

``` FBC, CRP Blood gas Stool and blood culture X-match blood AXR ```

Answer 23

``` Asymmetrical dilated bowel Bowel oedema Pneumatosis intestinalis - gas in gut wall Free air Pneumoperitoneum ```

Answer 24

``` Stop feed + NBM NG IV fluids TPN if long term Ax as risk of perforation Surgical laparotomy if perforate / to remove necrotic bowel May need resection + stoma ```

Answer 25

Amoxicillin Metronidazole Gentamicin

Answer 26

Careful introduction of food | Breast milk protective

Answer 27

``` Shock DIC Perforation Peritonitis Stricutres Abscess Long term stoma Short bowel syndrome ```

Answer 28

CMPI Hirschprung Volvulus

Answer 29

Pylorus muscle hypertrophies at 6 weeks

Answer 30

``` Projectile non bile vomit 30 mins after feed No bowel Sx Palpable mass Visible peristalsis Constipation Dehydration Weight loss FTT ```

Answer 31

6 weeks Male FH

Answer 32

USS - olive shape mass U+E = hypochlorameia / hypokalaemia alkalosis Test feed

Answer 33

IV fluid to correct electroylte NBM and NG to remove acid Pyloromytomy when biochemistry improves

Answer 34

Lose HCL in vomit Lose K to keep H Increased bicarb

Answer 35

Dehydration

Answer 36

Invagination of one portion of bowel into adjacent | Commonly ileo-caecal

Answer 37

``` Hx viral illness Intermittent colic or crying Drying spell due to vagal - floppy / apnoea Abdo distension Loose frequent stool Billious vomit Toxic / irritable Blood / mucous PR Mass RIF Long cap refil Not always bilious / blood ```

Answer 38

Toddler 6-18 months Older tha DIC

Answer 39

USS = target mass 1st line AXR rule out obstruction CT / bowel enema

Answer 40

Pneumostatic reduction urgent under radiological guidance = 1st line Barium enema

Answer 41

Laparotomy if fails or peritonitis

Answer 42

Dehydration Obstruction Necrosis of bowel

Answer 43

Gastroenteritis | Sepsis

Answer 44

Lack of fever | Immense frequent stools

Answer 45

High caecum Bile vomit Volvulus = scaphoid

Answer 46

Newborn but any age Diaphragmatic hernia Duodenal atresia Exomphalos

Answer 47

Upper GI contrast study and USS

Answer 48

Laparotomy | Ladds if volvulus

Answer 49

Obstruction Peritoneal signs Instability

Answer 50

Cyclical N+V lasting hours to days Well in between May be associated with weight loss, poor appetite, diarrhoea, abdominal pain, headache, dizzy, photophobia

Answer 51

``` Clinical Blood tests to rule out Pregnancy in young women Avoid triggers Fluid Medication ```

Answer 52

Few hours after birth Billious vomitnig Down = increased risk AXR = double bubble sign

Answer 53

ABCDE Don't forget glucose Vitals Signs of dehydration

Answer 54

``` Intracranial Surgical Serious bacterial - Dip urine for UTI DKA / hypo ```

Answer 55

``` Coeliac disease Iron deficiency anaemia CMPI / lactose intolerance Cow's milk anaemia IBD but quite young Metabolic ```

Answer 56

FBC to look for anaemia | Coeliac screen + IgA

Answer 57

Coeliac disease

Answer 58

``` Tend to not have GI Sx Low energy levels Iron anaemia Rash / joint pain / chronic cough Also neuro Sx adults ```