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Child Health > 4th Year GI > Flashcards

4th Year GI Flashcards

1
Q

viral causes of gastroenteritis

A

norovirus
adenovirus
rotavirus

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2
Q

bacterial causes of gastroenteritis

A

e. coli 0157
c. diff
campylobacter
salmonella
cryptosporidium

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3
Q

parasitic cause of gastroenteritis

A

giardia

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4
Q

management of gastroenteritis

A

rehydration with dioralyte
water
ondansetron

loose stools can continue for a couple of weeks

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5
Q

define diarrhoea

A

more than 3 stools a day

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6
Q

what is toddler’s diarrhoea?

A

a benign condition due to colonic immaturity

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7
Q

what age does toddler’s diarrhoea improve?

A

5-6

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8
Q

presentation of toddler’s diarrhoea

A

up to 10 stools a day

thriving child

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9
Q

management of toddler’s diarrhoea

A

reduce excessive fruit juice
increase fat if on low fat diet
keep fibre normal
may need loperamide

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10
Q

causes of abdominal pain

A 
colic
intussusception
mesenteric adenitis
appendicitis
constipation
IBD
Coeliac's
testicular torsion
obstruction
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11
Q

constipation criteria

A

at least 2 and present for 1 month:

  • <3 defecations a week
  • one episode of faecal incontinence after toileting skills
  • history of excessive retention, painful/hard bowel movements
  • obstruction to toilet/ large mass
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12
Q

RF for constipation

A 
low fibre
low fluid
excessive dairy
lack of exercise
obesity
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13
Q

examples of softeners for constipation

A

magrocol (laxicod, movicol)

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14
Q

when might laxido be needed?

A

faecal impaction +/- soiling

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15
Q

how to wean off laxatives

A

aim for type 5 on Bristol stool chart for fortnight, then aim for type 4 for at least 6 months slowly weaning dose

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16
Q

examples of stimulants

A

docusate or senna

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17
Q

define infant dyschezia

A

problem in learning to defaecate with poor coordination of straining on stool and opening of external anal sphincter

18
Q

management of infant dyschezia

A

usually resolves after 2-4 weeks

19
Q

why do most babies get GORD?

A

milk all day + lying flat

20
Q

management of GORD

A 
thickening feed e.g. gaviscon or carobel
reduce stomach acid (PPI/H2A)
empty stomach faster e.g. domperidone
assess for overfeeding
consider CMPA and trial of hydrolysed formula
21
Q

management of eosinophilic oesophagitis

A

dietary with 6 food elimination = seafood, nuts, dairy, eggs, wheat, soya

2nd line is topical viscous budesonide

22
Q

complication of eosinophilic oesphagitis

A

oesophageal stricture

23
Q

management of pyloric stenosis

A

pyloromyotomy

24
Q

GOLD standard to diagnosis coeliac

A

endoscopy with duodenal biopsy

25
Q

associations with coeliac’s

A 
T1DM
AI thyroid
juvenile chronic arthritis
Down's
Turner's
William's
26
Q

complications of coeliac’s

A 
OP
anaemia
short stature
delayed puberty
female infertility
intestinal malignancy (T cell lymphoma)
27
Q

what is the wPCDAI score?

A

weighted paediatric Crohn’s activity index

28
Q

MILD UC

A 
distal colon only
<3 stools/day
little blood
no fever
no weight loss
29
Q

moderate UC

A 
3-5 stools/day
bloody
abdominal pain/cramp
low grade fever
mild anaemia
weight loss
30
Q

severe UC

A 
>5 stools a day
frank blood
fever
anaemia
leucocytosis
hypoalbuminaemia
pain
31
Q

complications of UC

A 
colon cancer
growth failure
arthropathy
episcleritis
erythema nodosum/ pyoderma gangrenosum
PSC
AI hepatitis
32
Q

diagnosis of UC

A

3 stool cultures
stool calprotectin
endoscopy/ colonoscopy

33
Q

typical histology of UC

A

polymorph nuclear leucocytes near base of crypts
crypt abscesses

no granulomas

34
Q

acute management of UC

A

steroids

35
Q

maintenance of UC

A 
MILD= mesalazine
MODERATE-SEVERE= mesalazine + azathioprine
NON-RESPONDERS= mesalazine + azathioprine + infliximab or adalimumab

cure= colectomy

36
Q

what is toxic megacolon?

A

transverse colon diameter >5cm in adults on AXR

37
Q

is toxic megacolon a surgical emergency?

A

yes as risks perforation

38
Q

management of toxic megacolon

A

drip and suck
IV antibiotics
early surgical review

39
Q

what is hypernatraemic dehydration?

A

sodium level is very high and is seen in the first few weeks when breast feeding is difficult

profuse watery diarrhoea and drowsy baby

40
Q

colic in neonates

A

paroxysmal crying with pulling of legs for more than 3 hours more than 3 days a week

can give lactase if lactose intolerance but REASSURE

41
Q

what is biliary atresia?

A

jaundice as bile is not secreted from gall bladder as ducts are small or absent
bilirubin not broken down
fat soluble vitamins not absorbed

Child Health (26 decks)

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