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424 > 424--Quiz 3 (GI & GU) > Flashcards

424--Quiz 3 (GI & GU) Flashcards

1
Q

Outline for GI disorders

A 
•Variations in peds
•GI tract abnormalities
o	Cleft Lip/Palate
o	Omphalocele/Gastroschisis
o	Analrectal Malformation
•Hernias
•Acute GI disorders
o	Vomit/diarrhea—dehydration
o	Constriction of GI tract
	Meckel’s Diverticulum
	Pyloric stenosis
o	Intussusception
o	Malrotation/Volvulus
o	Necrotizing Enterocolitis
o	Appendicitis
o	GI reflux
o	Constipation/Encoporesis
o	Hirschsprung’s Disease
o	Celiac Disease
o	Recurrent Abdominal Pain
•Hepatobiliary disorders
o	Pancreatitis
o	Gallbladder Disease
o	Jaundice
o	Biliary Atresia
o	Portal Hypertension
o	Liver Transplant
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2
Q

GI variations in peds

A

LES–not fully developed until 1 mo.
Stomach–NB 10-20 ml, age 16 1500ml
Liver–large at birth
Fluid balance–>body water than adults, increased risk dehydration

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3
Q

Cleft Lip and Palate

A

Most common craniofacial anomaly.

Complications: feeding, dentition, otitis media.

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4
Q

Omphalocele/Gastroschisis

A 
Omphalocele = intestine herniate into the umbilical cord.
Gastroschisis = intestine and stomach herniate through the abd wall.
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5
Q

Analrectal Malformation

A

“Imperforate Anus.”

Nx: assess NB for meconium.

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6
Q

Hernias (2 types)

A

Inguinal = bulging of intestine into the inguinal area
Tx: surgery
Umbilical: incomplete closure of the umbilical ring-stomach contents herniate through
Tx: observation/should close by 5 years old

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7
Q

Vomiting/Diarrhea–Dehydration

A

Vomiting: usually d/t some other condition.
Diarrhea: usually d/t viruse (ex: Rotavirus),
Nx: give probiotics to reduce risk of C-Diff.
Dehydration ==> hypovolemic shock.
Tx: restore fluid balance, start oral fluids SLOWLY.

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8
Q

Meckel’s Diverticulum

A

A constriction of the GI Tract: incomplete fusion causing a fibrous band to connect small intestine to the umbilicus.

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9
Q

Pyloric stenosis

A

A constriction of the GI Tract: circular muscle of the pylorus becomes hypertrophied and thickens.
S/S: forceful vomiting; hunger soon after;

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10
Q

Intussusception

A

Segment of the bowel “telescopes “ upward.

S/S: Pain (draw knees up), “current-jelly” stool.

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11
Q

Malrotation and Volvulus

A

Intestine abnormally attaches causing the mesentery to narrow and twist on itself.
Volvulus = is the twisting on itself.

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12
Q

Necrotizing Enterocolitis (NEC)

A

Ulceration and necrosis of the distal ileum and proximal colon.
3 factors for developing: Intestinal ischemia, enteral feedings, bacterial infections.
Tx: ABX, bowel rest, surgery?

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13
Q

Appendicitis

A

Most common reason for 911 abd surgery in peds.
S/S: unable to climb exam table without help.
Tx: surgery, if perf: IV ABX 7-14 days.

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14
Q

GI Reflux

A

Outgrow 6 mo.

Tx: upright after feeding, small frequent/thickened feedings, drugs (histamine blockers, PPI, prokinectics).

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15
Q

Constipation/Encoporesis

A

Constipation: passing hard or small marble stools.
Encoporesis: soiling of fecal contents beyond the age of toilet training.
Tx: behavior modification, increasing fiber and fluids, laxative therapy.

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16
Q

Hirschsprung’s Disease

A

Lack of ganglion cells in the small intestine to colon with inadequate motility (constipation in newborns).
S/S: no meconium in 24 hrs.
Tx: resection + colostomy.
Complication: short bowl syndrome.

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17
Q

Celiac Disease

A

Gluten in grains causes damage to the villi of the small intestines.
S/S: distended abdomen and wasted extremities.
Tx: gluten-free diet for life.

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18
Q

Recurrent Abdominal Pain

A

Common complaint.
Integrated neurotrasmitter pathways.
“Does not wake up at night with pain”
Tx: coping with the pain/diet modification.

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19
Q

Pancreatitis

A

S/S: persistent midepigastric pain & periumbilical pain with radiation to the back or chest.
Tx: NPO, NG tube.

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20
Q

Gallbladder Disease

A

Cholelithiasis/cholecystitis.
S/S: RUQ pain radiating to shoulder.
Tx: NPO, IV fluids & ABX, surgical removal.

21
Q

Jaundice

A

Most common reason for readmission in the 1st week.
Physiological = 24 hours post birth/ go by 1 week.
Pathologic = Comes and goes/ lasts > 1 week.
Tx: eat, phototherapy.

22
Q

Biliary Atresia

A

Absence of some or all biliary ducts causing obstruction of bile flow.
S/S: persistent/recurring jaundice.
Tx: vit/caloric support, Kasai procedure (surgical bypass).

23
Q

Portal Hypertension

A

Resistance of blood flow to/through/from liver.

S/S: jaundice, spider angiomas, palmer erythema.

24
Q

Liver Transplant

A

Monitor for infect.
Monitor for rejection: fever, increasing liver function test results, increasing pain, redness, swelling.
Fam risks: possible job loss, finances, transportation, lodging.

25
Q

Outline for GU Disorders

A 
•Ped A&P
•Structural
o	Bladder exstrophy
o	Hypospadias/epispadias
o	Obstructive uropathy
o	Hydronephrosis
o	Vesicoureteral reflux
•Urinary
o	UTI
o	Enuresis
•Renal disorders
o	Nephrotic Syndrome
o	Acute Glomerulonephritis
o	Hemolytic-Uremic Syndrome
o	Renal Failure:
	Acute Renal Failure
	End-stage Renal Disease
	Renal Transplant
•Reproductive organ disorders
o	Female:
	Labial adhesions
	Vulvovaginitis
	Pelvic Inflammatory Disease
	Menstrual Disorders
o	Male:
	Phimosis/paraphimosis
	Circumcision
	Cryptorchidism
	Hydrocele/varicocele
	Epididymitis
26
Q

GU variations in peds

A

Urine concentration–slower blood flow ==> increased risk dehydration.
Output–0.5-2ml/kg/hr.
Kidneys–large.
Reproductive organs–immature until puberty.

27
Q

Bladder exstrophy

A

Bladder located on outside.
Tx: surgery, urinary reservoir made in small intest (stoma created to drain the bladder 4X’s a day)
Nx: Keep bladder moist with sterile covering, mucus-like urine from stoma.

28
Q

Hypospadias/Epispadias

A

Hypospadias = urethral opening on lower (ventral) portion of the penis
Epispadias = urethral opening on top (dorsal) of the penis
Chordee = fibrous band causing penis to curve downward.
Nx: ed. about double-diapering & care of stent at home.

29
Q

Obstructive Uropathy

A

Obstruction of upper/lower urinary tract, unilateral/bilateral ==> partial/complete obstruction.
S/S: Recurrent UTI’s, incontinence, fever, foul smelling urine, flank/abdominal pain, urinary frequency/urgency.

30
Q

Hydronephrosis

A

Dilation of pelvis and calyces of the kidneys; d/t obstruction or VUR.
S/S: failure to thrive, intermittent hematuria, s/s of UTI, sepsis.

31
Q

Vesicoureteral Reflux (VUR)

A

Reflux of urine into ureters during bladder contraction.
Graded I-V depending on severity (I & II generally resolve, III-V usually assoc. with recurrent UTI, hydronephrosis & progressive renal damage).
Nx: prophylactic ABX, ed. empty bladder completely & hygiene.

32
Q

UTI

A

85-90% E-Coli.
Infants: irritability, fever, vomiting, failure to thrive.
Children: vomiting, fever, dysuria, frequency, pain, enuresis, constipation/incontinence.

33
Q

Enuresis

A

Incontinence beyond the age of toilet training.
4 types:
Primary—Never achieved bladder control
Secondary—previous bladder control 3-6 mos; may be d/t Diabetes Insipidous, obstruction, etc.
Diurnal—during day; loss of bladder control
Nocturnal—nighttime wetting. Usually subsides by age 6.

34
Q

Nephrotic Syndrome

A

Golumerular membranes become permeable to proteins.
Lifelong illness.
S/S: protienuria, hypoalbuminemia, altered immunity, (periorbital) edema, n/v.
Labs LOW protein and albumin, urine HIGH protein.
Nx: fluid & Na+ restrict, daily weights, corticosteroids, diuretics.

35
Q

Acute Glomerulonephritis (APSGN)

A

Strep infection gets stuck in the golmerulus causing decreased blood flow (immune process injured glomeruli)
One-time illness.
S/S: fever, edema, crackles, protienuria, hematuria, tea-colored urine.
Nx: fluid & Na+ restrict, daily weights, antihypertensives.

36
Q

Hemolytic-Uremic-Syndrome (HUS)

A

3 features: hemolytic anemia + thrombocytopenia + acute renal failure.
S/S: Usually preceded by watery diarrheal illness (E. Coli).
Nx: bact shed up to 17 days after resolution.

37
Q

Renal Failure

A

Kidneys cannot concentrate urine, excrete wastes or maintain electrolytes.

38
Q

Acute Renal Failure

A

D/t hypovolemia, septic shock, hemolytic anemia, nephrotoxic meds.
Tx: underlying cause, F&E, BP control, diuretics

39
Q

Chronic Renal Failure (ESRD)

A

D/t congenital structure defects, obstructive uropathy, infect.
S/S: low birth weight, failure to thrive, dry/itchy skin, bone/joint pain.
Nx: renal diet, EPO, GH, dialysis–assess fistula for bruit/thrill.

40
Q

Labial adhesions/labial fusion

A

Partial or complete adherence of labia minora, usually 3 mo-4 yrs.
Tx: topical estrogen cream.

41
Q

Vulvovaginitis

A

Inflammation of vulva and vagina as a result of bacteria or yeast overgrowth.

42
Q

Pelvic Inflammatory Disease

A

Inflammation of upper female genital tract and nearby structures.

43
Q

Mittleschmerz

A

Pain associated with release of the egg from the ovary

44
Q

Phimosis

A

Cannot retract the foreskin

45
Q

Paraphimosis

A

retraction of the foreskin causes constricting band behind the glans of the penis ==> incarceration if not surgically corrected.

46
Q

Circumcision

A

Abnormal attachment to scrotum that is twisted. Usually adolescents.

47
Q

Cryptorchidism

A

Undescended testicle

48
Q

Hydrocele/Varicocele

A

Hydrocele = fluid in the scrotum.

Varicocele =venous varicosity along the spermatic chord causing swelling.

49
Q

Epididymitis

A

Inflammation of epididymis (lies on top of testicle inside) d/t bacteria.

424 (3 decks)

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