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מבחן גמר בילדים > גסטרו > Flashcards

גסטרו Flashcards

1
Q

מה כולל רפלקס ההקאות

A

ירידת הסרעפת, כיווץ שרירי הבטן והרפיה של הקרדיה של הקיבה

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2
Q

VACTERL syndrome clinical presentation?

A

V- vertebral anomalies 70%
A- anorectal malformaiton 50%
C- CV anomalis 30%
T- trachesophageal fistula 70%
E- esophageal atersia
R- Renal anomalies 50%
Limb defects- 70%

לרוב יהיה עורק אומביליקלי אחד

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3
Q

which other congenital lesions is most a/w esopahgeal atresia?

A

Tracheoesopahgeal fistula

90%

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4
Q

Dgx of esophageal atresia?

A

polyhydrmanoius, no air bubble in stomach

inability to pass zonda to the stomach

Tx- urgent surgery

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5
Q

first, second the third line for infant reflux?

A

fisrt line- no tx. 88% resolve within 1 yr of age
2nd line- PPI
3rd line- surgery

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6
Q

which disease is more common vomiting, dysphagia, atopic kids, paon in middle upper abdomen?

A

Allergic esoinophilic esophagitis

Dgx- biopsy
Tx- הפחתת צריכת מזונות אלרגניים, קו שני סטרואידים

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7
Q

Bird beak sign? and dgx?

A

Acaalesia

dgx- monometria

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8
Q

vomiting in infant age 1 wk- 5 month, with lab reasults of unconjugated hyperbili + metabolic alkelosis hypochloremic we should suspect?

A

pyloric stenosis

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9
Q

Olive sign in exmination of infant?

A

pyloric stenosis

Dgx- US

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10
Q

Tx for pyloric stenosis?

A

hydration + elctrolital repair. surgery

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11
Q

most common congenital GI malgormation in kids?>

A

Meckels diverticulum
50% of bleeding from lower GI in kids < 2 yrs

remenmant of vitelline duct in the ilium

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12
Q

position of meckel diverticulum?

A

50-70 cm from iliocecal valve

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13
Q

meckel diverticulum

clinical presentation?
complication?
Dgx?
Tx?

A

clinical presentation:
painless rectal bleeding and anemia < 2 yrs of age
complication- instetine obstruction, diverticulosis, perforation
Dgx- meckel scan = מיפוי טכניציום - will glow in the stomack and in the divrticulum due to ectopic gastric mucosa
Tx- surgical resection

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14
Q

מהי אנקופרזיס ובאיזה מצב נוכל לראות אותה בילדים?

A

בריחת צואה מעל גיל 4.
במצב של עצירות / עצירות פונקציונאלית - אי נוחות ללכת לשירותים בבית הספר / גמילה מוקדמת מדי

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15
Q

טיפול בעצירות

A

ריכוך צואה ותזונה עשירה בסיבים

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16
Q

what is the most common cause of obstruction in lower GI tract (colon)

A

functional obstraction = Hirshpaung

80% in recto-sigmoid part

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17
Q

definitive Dgx of Hirshpung?

A

biopsy with absence of gnaglions (2 cm above dentate line)

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18
Q

most common age of intussuscepttion
(התפשלות מעי)

A

6m-3 yrs

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19
Q

conditions that are a/w intussuseption in kids > 3 yrs

4

A
  • HSP
  • lymphoma
  • Meckels diverticulum
  • polyps- most common
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20
Q

10 month old present with abdominal pain.
on exmination a sausage like feeling. in RUQ with bloody jelly stool and latregy within colic episode

what is the most likley dgx?
what is the tx?

A

intussuseption

Tx- air / barium anema 80-95% success rate

21
Q

reccurence rate of intussuseption after anema and after laprotomia?

A

anema- 10%
surgery- 2-5%

22
Q

Which vaccine is C/I after intussuseption

A

Rota virus

23
Q

Volvulus
when is mostly common seen?

A

85% of cases- first year
50% first month

24
Q

X-ray finding of deodunal atresia?

A

double bubble sign

25
Q

what is the WHO recommendation for chronic diarrhea?

A

lactose free diet

26
Q

שלשול אוסמוטי לעומת סקרטורי

באיזה מהם נמצא חומרים מחזרים בצואה?

A

שלשול אוסמוטי

27
Q

most common reason for hypoalbuminemia?

A

loss trough urine due to kidney disease

28
Q

Which marker can suggest loss of protein trough the GI Tract?

A

eleveted levels od alpha-1- AT in stool

29
Q

Low levels of elastase in stool with loss weight is suggest of?

A

insufficency of exocrine pancreas

think CF- most common

30
Q

Which allele is a/w celiac disease?

A

HLA-DQ2 /8

95% of pt

31
Q

Extra intestianal menefistation of Celiac in
neurologic
dermatologic
endocrine

A

neuro- megaloblastic anemia- ataxia, neuropathy and epilepsy
endocrine- late puberty
derma- dermatitis herpetiformis, apthous somatitis

32
Q

Which Autoimmune diseases are in a/w celiac?

A

DM type 1
williams
turner
addison
IgA deffic.
Sjoren
RA
down

33
Q

Dgx of celiac for symptomatic pt?
for IgA deff.
and non IgA deff.

A

Dgx
TTG IgA < 10X of normal value&raquo_space; dueodenal biopsy
or
TTG IgA > 10X of normal value&raquo_space; HLA + anti- Endomysial - not need also biopsy

for IgA def
TTG IgG+ and as mention above (biopsy or HLA + anti-EM

pass for biopsy if TTG = at least X10 for normal value

34
Q

a-symptomatic pt but high risk
dgx of celiac?

DM-1, Down, Sick 1st relative

A

HLA&raquo_space; anti-TTG
Titer Ab > X3&raquo_space; biopsy
Titer Ab < X3&raquo_space; anti-EM&raquo_space; biopsy

35
Q

Which conditions are a/w IgA deficiency?

A

Celiac or like celiac syndrome
+
Anaphylaxis for blood transfusion

Dgx- serum IgA < 10 mg/dL with normal other Ig.

36
Q

which electrolyte disbalance is a/w acute pancreatitis?

A

Hypocalcemia

37
Q

Tx for acute pancreatitis?

A

nasogastric tube
PPI
* imipenem- if necrosis or infection
* ERCP- if stones
* Trauma / abcesses- surgery

prognosis- healing in 4-5 days

38
Q

which Abs are a/w autoimmune pancreatitis?

A

IgG4

in kids mainly heart involve with normal levels of IgG4

Tx- steroids

39
Q

Which gene is involve in Wilson disease?

A

ATP7B
should connect copper to ceuroplasmin in order to excrete trough the bile

if ceuroplasim is not connected to copper its going degradation

40
Q

Dgx of wilson disease?

A

low levels of ceuroplasmin in blood
+ high serum copper leves and 24h of high copper in urine

41
Q

Tx for wilson?

A

D-phenycylamine - copper cathelathor

42
Q

liver damgage + neurologic signs as tremor, worsening hand writing, decrease school performance
with hemolytic anemia and low ceuroplasmin levels

which disease?

A

wilson disease

43
Q

Which autoimmune disease can be in a/w Autoimmune hepatitis?

A

SLE

44
Q

autoimmune hepatitis (AIH)
type 1 and type 2 Abs?

A

high IgG
Type 1- ANA, ASMA
type 2- anti- LKM1

45
Q

Which type of cells and necrosis in seen in hepatocytes in AIH

A

Plasma cells and lympocytes

Piecemeal necrosis

46
Q

Tx for AIH?

A

Steroids and Imuran/ MP6

47
Q

Approch to swollowing foreign object:

  1. in stomch
  2. in esophagus
  3. when we need to sugcally intervention
A
  1. in stomch- supportive.
  2. in esophagus-endoscopy
  3. surgery intervention- > 1 magnet, lead objects, lithum battery, large battey > 48 hrs in stomach, large and sharp objects.
48
Q

C/I for Gastroscopia?

A

peritonitis signs

מבחן גמר בילדים (23 decks)

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