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Exam - M - Paediatrics (Megan) > Vomiting + malabsorption > Flashcards

Vomiting + malabsorption Flashcards

GOR GORD Pyloric stenosis Cows Milk protein allergy Overfeeding Coeliac Intussusception (53 cards)

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1
Q

what are signs of chronic constipation?

A 
poor appetite
irritable 
lack of energy
abdominal pain
distention
witholding/straining
diarrhoea 
loss of the sensation to move the bowels

Usually gets better after passing bowel movement then gradually gets worse again.

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2
Q

where is the vomiting centre located?

A

in the medulla oblongata

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3
Q

where do chemoreceptors stimulate vomiting?

A

in the chemoreceptor trigger zone just below the base of the 4th ventricle

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4
Q

what signs precede vomiting?

A

pallor
nausea
tachycardia

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5
Q

what signs follow on from vomiting?

A

lethargy
pale
sweaty

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6
Q

what are the main types of vomiting?

A 
with retching
projectile vomiting
bilious vomiting
effortless vomiting (regurgitation)
haematemesis
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7
Q

what usually causes blood in the vomit?

A

peptic ulcers

portal hypertension

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8
Q

what does vomiting in the morning signify?

A

intracranial pathology

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9
Q

what are the most common causes of vomiting in neonates?

A

COR
cows milk allergy
infection
intestinal obstruction

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10
Q

what is the most common cause of vomiting in children?

A 
gastroenteritis
infection
appendicitis 
coeliac disease
raised ICP
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11
Q

what is the most common cause of vomiting in young adults?

A 
gastroenteritis
infection
H. Pylori
Raised ICP
DKA
cyclical vomiting syndrome
bulimia.
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12
Q

how much should neonates be fed?

A

150ml per kg per day.

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13
Q

how much should babies aged 1-12 months be fed?

A

100mls per kg per day.

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14
Q

what does bilious vomiting ALWAYS signify?

A

Intestinal obstruction - ALWAYS an emergency.

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15
Q

what causes bilious vomiting?

A

Volvulus
intussisception
Ileus
crohns with strictures

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16
Q

what typical mineral abnormality does pyloric stenosis present with?

A

Metabolic alkalosis
Hypochloraemia
Hypokalaemia

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17
Q

Who are most at risk of pyloric stenosis?

A

Babies aged 4-12 weeks
Boys
First born males

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18
Q

What signs suggest pyloric stenosis?

A 
Hungry baby 
thin and pale
failure to thrive
dehydrated
sunken fontanelles 
PROJECTILE NON BILIOUS VOMITING 
Firm round olive mass felt in the upper abdomen
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19
Q

how is pyloric stenosis treated?

A

Fluid resuscitation

Ramsted’s pyloromyotomy.

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20
Q

what investigation is done for lyric stenosis?

A

abdominal ultrasound

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21
Q

What is gastrooesophageal reflux?

A

when the contents from the stomach reflux through the lower oesophageal sphincter, into the oesophagus, the throat then the mouth.

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22
Q

what usually causes gastro oesophageal reflux?

Study These Flashcards
A

Immaturity of the lower oesophageal sphincter.

23
Q

when is GOR normal?

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A

If they are still having normal growth

24
Q

When does GOR usually stop?

Study These Flashcards
A

90% stops after 1yr.

25
What are problematic signs of GOR?
``` cough cry reluctant to feed pneumonia poor weight gain ```
26
what signs of GOR are often seen in older children?
Children >1yr often have the same symptoms as adults with GORD: heartburn epigastric pain bloating
27
when does GOR begin, get worse then resolve?
begins at 2 weeks gets worse at months 4-6 begins to get better after 1 year, as the child begins to eat solid food, and sits up instead of lying down.
28
when is GOR investigated?
If it doesn't improve after 1yr. IF there is growth faltering (child is moving down centiles). if theres no response to reflux medication
29
what is the investigation done in GOR?
video fluroscopy barium swallow Upper GI endoscopy
30
which conditions might cause GOR that doesn't improve?
Cerebral palsy + other neurological conditions.
31
What is the treatment for GOR?
Gaviscon (to thicken fluids) Surgery - nissen fundoplication
32
what are red flags considering vomiting?
``` Not keeping down any feeds projectile vomiting Bilious vomiting Haematamesis Abdominal distention Apnoea ```
33
what is the common management for vomiting?
small frequent meals burping not over feeding keep baby bright
34
what are medications used for vomiting?
gaviscon ranitidine omeprazole
35
what is sanders syndrome?
a rare condition caused by brief episodes of abnormal movements associated with GOR. presents with contraction of the neck muscles or dystonia.
36
when is diarrhoea acute?
< 1 week
37
hen is diarrhoea persistent?
2-4 weeks
38
when is diarrhoea chronic?
> 4 weeks
39
what are the signs of IBS?
stomach pains get BETTER after passing stools
40
what type of defecation is always pathological?
Nocturnal
41
what are the main differences between osmotic and secretory diarrhoea?
Osmotic: small, stops when fasting, low pH, low sodium, potassium and chloride. Secretory: large, continues when fasting, higher pH, high sodium, potassium and chloride.
42
what does coeliac do to the intestines?
causes blunting of the villi +. crypt hypertrophy
43
what are the main signs of coeliac disease?
``` diarrhoea belatedness failure to thrive short stature tiredness ```
44
what is the gold standard investigation for coeliac disease?
endoscopy + duodenal biopsy
45
what antibodies are seen in coeliac disease?
Anti TTG | Anti EMA
46
what condition often occurs alongside coeliac disease?
Type 1 diabetes
47
which genetics are involved in coeliac disease?
HLA DQ2 | HLA DQ8
48
what is the treatment for coeliac disease?
gluten free diet for life
49
what is intussusception?
when the bowel invaginate into itself. Leads to a thickening of the overall size of the bowel but narrowing of the lumen of the part that's narrowed.
50
what age does intussusception occur at?
6 months - 2 yrs. | Most common in boys
51
what are the signs of intussusception?
``` severe colicky abdominal pain pale lethargic abdominal distention RED CURRANT JELLY STOOLS Right UQ mass Vomiting Intestinal obstruction SAUSAGE SHAPED MASS IN THE ABDOMEN. ```
52
What is the treatment for intussusception?
Enema - contrast, water and air are pumped into the colon to force the bowel out. Surgery - if the above doesn't work. surgical resection - if theres necrosis.
53
what are the complications of intussusception?
Obstruction Gangrenous bowel Perforation Death

Exam - M - Paediatrics (Megan) (57 decks)

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