1.4 MTB Step 3 - The Newborn (GI & Hepatobiliary) Flashcards
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
MECONIUM PLUGS (Lower Colon) & MECONIUM ILEUS (Lower Ileum)
What is the Initial Presentation for both Meconium Plugs and Meconium Ileus?
Intestinal Obstruction
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
MECONIUM PLUGS (Lower Colon) & MECONIUM ILEUS (Lower Ileum)
What are (4) Conditions associated with Meconium Plugs (Lower Colon)?
- Small Left Colon in IODM
- Hirschsprung Disease
- Cystic Fibrosis
- Maternal Drug Abuse
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
MECONIUM PLUGS (Lower Colon) & MECONIUM ILEUS (Lower Ileum)
What is (1) Condition associated with Meconium Ileus (Lower Ileum)?
- Cystic Fibrosis
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
MECONIUM PLUGS (Lower Colon) & MECONIUM ILEUS (Lower Ileum)
What is the Best INITIAL Diagnostic Test for both Meconium Plugs (Lower Colon) and Meconium Ileus (Lower Ileum)?
Abdominal X-Ray
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
MECONIUM PLUGS (Lower Colon) & MECONIUM ILEUS (Lower Ileum)
What is the Best Treatment for both Meconium Plugs (Lower Colon) and Meconium Ileus (Lower Ileum)?
Gastrografin Enema
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
UPPER GASTROINTESTINAL MALFORMATION
“A newborn is born by normal vaginal delivery without complication. There is no respiratory distress. Upon his first feed, he is noted to have prominent drooling; he gags and develops respiratory distress. CXR reveals an infiltrate in the lung.” Which Test will Confirm the Diagnosis?
Nasogastric Tube (NGT) Placement:
- This patient has a Tracheoesophageal Fistula (TEF).
- Classically, there is choking and gagging with the First Feeding and then respiratory distress develops due to Aspiration Pneumonia.
- The feeding tube will be coiled in the chest
- Don’t forget to look for other abnormalities associated with VACTERL Syndrome.
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
UPPER GASTROINTESTINAL MALFORMATION
What are the V.A.C.T.E.R.R.L. Abnormalities?
- V ertebral Defects
- A nal Atresia
- C ardiac Abnormalities
- T racheoesophageal Fistula w/ E sophageal Atresia
- R adial Anomalies
- R enal Anomalies
- L imb Syndrome
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
UPPER GASTROINTESTINAL MALFORMATION
What is the Cause of Tracheoesophageal Fistula (TEF)?
Embryological Malformation:
- Division of the Cranial part of the Foregut into the Respiratory and Esophageal parts is Incomplete.
- Occurs at Week 4 of Development.
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
UPPER GASTROINTESTINAL MALFORMATION
What are (3) Common Disorders Associated with Duodenal Atresia?
- Premature infant
- Down Syndrome
- Polyhydramnios
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
UPPER GASTROINTESTINAL MALFORMATION
What are the (2) Steps in the Treatment of an infant with Duodenal Atresia?
Nasogastric Decompression
and
Surgical Correction
**You MUST search for other VACTERRL Abnormalities with X-Ray of the Spine, Abdominal US, and Echocardiogram**
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
UPPER GASTROINTESTINAL MALFORMATION
What are the (4) Differential Diagnoses of “Double-Bubble” seen on X-Ray?
- Duodenal Atresia
- Annular Pancreas
- Malrotation
- Volvulus
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
UPPER GASTROINTESTINAL MALFORMATION
What is the Mechanism of Duodenal Atresia?
- During Duodenal development, the Lumen is COMPLETELY Occluded by Epithelium, then is Re-Formed.
- Duodenal Atresia = Failure to Re-Form a Lumen
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
ANNULAR PANCREAS
What is an Annular Pancreas?
- In this condition, the Pancreas surrounds the Second Part of the Duodenum in a ringlike formation and can cause obstruction.
- Annular Pancreas forms when the Ventral Bud does NOT rotate with the Duodenum during the 7th week of gestation. This causes encasing of the Duodenum
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
ANNULAR PANCREAS
What are (3) other Clinical Disorders / Findings Associated with Annular Pancreas?
- Polyhydramnios
- Low Birth Weight (LBW)
- Feeding Intolerance
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS
ANNULAR PANCREAS
How do you Diagnose Annular Pancreas?
Abdominal X-Ray