Williams- PEDS GI of Upper Tract

Question 1

passage of esophageal contents into esophagus that happens in 2/3 healthy infants

Answer 1

gastric esophageal reflux (GER)

Question 2

painful passage of gastric contents into esophagus + complications such as projectile emesis and hematemesis

Answer 2

GERD

Question 3

children should double their weight by _____ months

Answer 3

3 months

Question 4

children should triple their weight by _____ months

Answer 4

12 months

Question 5

____ is normal

Answer 5

GER

Question 6

____ in infants is not a problem of excessive acid production

Answer 6

GER

Question 7

the ____ has the same pressure in infants as it does in adults (10-30 mmHg)

Answer 7

LES

Question 8

how to test for reflux

Answer 8

observation
pH testing

Question 9

what to not do when testing for reflux

Answer 9

do not do upper GI study

Question 10

what does this show

Answer 10

swallowing (pH doesnt drop)

Question 11

what does this show

Answer 11

acidic reflux event (pH drops)

Question 12

drop in pH

Answer 12

acid reflux episode

Question 13

no pH drop

Answer 13

nonacid reflux episode

Question 14

upper GI study is _______ justified to diagnose GER or GERD in infants

Answer 14

NOT

Question 15

______ imaging is useful in the evaluation of vomiting (due to obstruction)

Answer 15

upper GI

Question 16

how do H2 receptor antagonists work

Answer 16

inhibit acid secretion from H/K ATPase by blocking histamine

Question 17

histamine
gastrin
Ach

Answer 17

all cause acid production (H/K ATPase stimulation)

Question 18

these drugs physically attach to and block H/K ATPase

Answer 18

PPIs

Question 19

_____ blocks gastrin, histamine

Answer 19

somatostatin

Question 20

does not block vagal stimulation

Answer 20

somatostatin

Question 21

2 main H2 blockers used in peds

Answer 21

Famotidine
Nizatidine

Question 22

this suppresses acid production from 12-24 hours

Answer 22

PPIs

Question 23

PPI that can be given in first few weeks/months of life

Answer 23

Omeprazole

Question 24

this drug has no benefit in reducing crying or fussing and can be tied to increase risk for infection (due to decrease in acid production)

Answer 24

PPIs

Question 25

SE of this drug: necrotizing enterocolitis in preterm infants

Answer 25

PPIs

Question 26

this drug is a coating agent that is good if used short term

Answer 26

Sucralfate

Question 27

SE of this drug is bezoar formation

Answer 27

Sucralfate

Question 28

best position for babies to sleep in

Answer 28

supine

Question 29

FPIAP is aka

Answer 29

milk protein allergy/intolerance milk allergy

Question 30

explain FPIAP (milk protein allergy)

Answer 30

GI tract has allergic response (IgA mediated) to milk proteins and antibodies created against specific protein and attacks; inflames GI mucosa-----> mucosal injury

Question 31

sx's of this include: hematochezia fussiness mucus in loose stools

Answer 31

milk protein allergy (FPIAP)

Question 32

blood in stool

Answer 32

hematochezia

Question 33

how to manage milk protein allergy

Answer 33

change diet (exclude cow milk from mothers diet if breast feeding or use formula that is hydrolyzed)

Question 34

formula that does not have protein intact any longer

Answer 34

elemental formula (AA based)

Question 35

gastric emptying faster for ____ than for ______

Answer 35

human milk than formula

Question 36

if you are to use formula, what kind speeds up gastric emptying

Answer 36

hydrolyzed/elemental

Question 37

Answer 37

trachealization seen in eosinophilic esophagitis

Question 38

Answer 38

eosinophilic esophagitis

Question 39

pt has a food allergy and also dysphagia or odynophagia

Answer 39

eosinophilic esophagitis

Question 40

eosinophilic esophagitis is ______mediated

Answer 40

IgA-mediated

Question 41

to Rx eosinophilic esophagitis

Answer 41

food elimination diets PPIs Dupixent

Question 42

IL-4, IL-13 blocker used to treat eosinophilic esophagitis

Answer 42

Dupixent

Question 43

to dx eosinophilic esophagitis

Answer 43

EGD

Question 44

responsible for 90% of cases of peptic ulcer formation

Answer 44

H. pylori

Question 45

triple therapy Rx of H. pylori

Answer 45

PPIs Clarithromycin Amoxicillin

Question 46

quadruple therapy of H. pylori

Answer 46

PPIs tetracycline metronidazole bismuth

Question 47

congenital hypertrophy of pylorus muscle

Answer 47

pyloric stenosis

Question 48

palpable mass or "olive" noted on exam

Answer 48

pyloric stenosis

Question 49

infants will have PROJECTILE vomiting that will shoot across the room

Answer 49

pyloric stenosis

Question 50

to dx pyloric stenosis

Answer 50

ultrasound

Question 51

to Rx pyloric stenosis

Answer 51

surgery to cut hypertrophied muscle and open canal

Question 52

what makes up gluten

Answer 52

Gliadin + Glutanin (protein combo)

Question 53

gluten is found in

Answer 53

wheat, rye, barley

Question 54

explain celiac disease

Answer 54

body makes Ab's that attack gluten and injure the villi in small intestine

Question 55

patient experiences sx's to gluten but has negative lab findings

Answer 55

non-gluten celiac sensitivity

Question 56

pt has elevated specific Ab's for this and dermatitis herpetiformis

Answer 56

pathognomonic for celiac disease

Question 57

to dx this: upper endoscopy w/ atleast 6 biopsies in duodenum and atleast 2 from the bulb

Answer 57

celiac disease

Question 58

what must you always get when checking celiac specific antibodies

Answer 58

total IgA

Question 59

alleles that confer an increased risk for celiac disease

Answer 59

DQ2/DQ8

Question 60

to Rx celiac disease

Answer 60

gluten free diet

Question 61

intraepithelial lymphocytes in duodenum and damage to villi (think what)

Answer 61

celiac disease