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PEDS UWORLD > ABD problems > Flashcards

ABD problems Flashcards

1
Q

Bilious emesis is sign of

A

neonate sign of interstinal obstruction require immediate workup

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2
Q

Newborn with obstruction, on xray you see pneumoperitoneum; next step?

A

emergent surgery

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3
Q

Newborn w/ obstruction, x-ray shows dilated loops and no feces in rectum, next step?

A

water soluble contrast enema

can be therapeutic (breaks up feces)

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4
Q

meconium ileus is assoc with

A

Cystic fibrosis

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5
Q

Recurrent UTI in infants and children should ring a bell for?

A

Congenital UT anomaly

Vesicoureteral reflux

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6
Q

Vesicoureteral reflux causes

A 
dilation of ureters (hydroureter)
and kidneys (hydonephrosis)
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7
Q

DX VUR

screen w/

A

voiding cystourethrogram

screen: USG

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8
Q

Chronic pyelonephritis appears

A

blunting of calices (calyceal clubbing)

focal parenchymal scarring

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9
Q

How to evaluate renal scarring?

A

Scinigraphy w/ Dimercaptosuccinic acid

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10
Q

MCC of chronic renal insufficiency/failure in kids

A

Posterior urethral valves

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11
Q

Increased AFP and bowel free in amniotic fluid

A

Gastroschisis

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12
Q

Complications due to amniotic fluid inflammation/edema in gastroschisis

A

necrotizing enterocolitis
short bowel syndrome
Dysmotility: prolonged reliance of TPN

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13
Q

Gastroschisis is an isolated defect _% of the time

A

90

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14
Q

Rx of Gastroschisis

A

After delivery cover in sterile saline and plastic wrap (minimizes insensible heat and fluid loss)
place NG tube
Start Antiobiotics
Prompt surgical repair

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15
Q

Omphalocele infants typically have 50% chance of

A

other major malformations:
cardiac disease
NT defects
Trisomy

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16
Q

Constipation in kids is exacerbated by

A

excessive milk consumption
toilet training
adjustment to day care or transitional events

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17
Q

Complications of constipation in kids

A 
anal fissures
hemorrhoids
encopresis
enuresis/UTI
Vomiting
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18
Q

Rx constipation in kids

A

Increase dietary fiber

limit cows milk intake to

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19
Q

MCC of UT Obstruction in newborn?

A

Posterior urethral valves

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20
Q

Potters Syndrome

A

Pulmonary hypoplasia
Oligohydramnios
Twisted skin
Twisted face (facial abnormalities: flat facies)
Extremities (limb defects)
Renal agenesis
Sonogram: PUV= hydroureters, hydronephrosis

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21
Q

MC renal malignancy in kids

A

Nephroblastoma: Wilms tumor

mc age 2-5

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22
Q

Indications for renal and bladder USG during UTI?

A

kid

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23
Q

USG sees some hydronephrosis and scarring; next step?

A

VCUG

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24
Q

IDIOT: kid eats his moms iron tablets, antidote?

A

IV fluids

Deferoxamine

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25
Q

Iron poisoning causes

A 
free radical production and lipid peroxidation which imparis various cell processes= systemic manifestation
ABD pain
hematemesis
Hypovolemic shock
M. Acidosis
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26
Q

Lead poisoning C/f in kids?

A 
Irritability
poor appetitie
Headaches
ABD pain/anemia
Rx: Calcium EDTA, Succimer
27
Q

Kid with blious emesis, given NG tube decompression and IV fluids, ABD xray shows no air in interstine, next step?

A 
Upper GI series
possible malrotation (ligament of treitz on R side of abd)
28
Q

Procedure called for fixing a volvulus?

A

Ladd procedure:

fixing the bowel in a non-rotated position to minimize recurrent volvulus risk

29
Q

Classic triad of Biliary cyst

A

Pain, jaundice and palpable mass

Usually present

30
Q

Dx and Rx biliary cyst

A

DX: USG and ERCP
Rx: Surgical resection to relieve obstruction and prevent malignant transformation

31
Q

recurrent cystitis c/f

A 
suprapubic pain
dysuria
pyuria
bacteriuria
toddlers: constripation
32
Q

henoch schonlein purpura c/f

A 
Typically follows infection
Palpable purpura
arthitis/arthralgia
abd pain, inussusceptions
renal disease similar to IgA nephropathy
33
Q

rx HSP

A

Supportive: hydration and NSAIDS
Severe: hospitilization and steroids

34
Q

Nephrotic syndrome assoc w/ HBV

A

membranous nephropathy

also: sle, drugs, infections

35
Q

Nephrotic syndrome assoc w/ HIV

A

FSGS

also: heroin, CKD, Sickle cell

36
Q

infantile hypertrophic pyloric stenosis r/f

A

first born boy
formula feeding: gradual hypertrophy of pylorus
onset around 3-5 wks

37
Q

acid base disturbance in pyloric stenosis

A

hypochloremic m. alkalosis

from vomiting

38
Q

milk protein allergy c/f

A

vomiting
poor weight gain
bloody stools

39
Q

asian newborn with jaundice have decreased

A

hepatic UGT activity

40
Q

physio jaundice pathophys (3 reasons)

A

At bith high HCT w/ short life span= high Hb turnover
Decreased UGT activity until 2 wks of age
Sterile newborn gut= inc enterohepatic recycling (cant breakdown bilirubin to urobilinogen)

41
Q

Reye syndrome labs

A 
Hyperammonemia
n/inc: bilirubin, ALP
Increased PTT
hypoglycemia
elevated AST,ALT, LDH
42
Q

Biopsy of Liver in Reye syndrome

A

Microvesicular steatosis

43
Q

Breastfeeding failure jaundice is

A

exaggerated unconjugated hyperbilirubinemia inf FIRST week of life that is caused by lactation failure

44
Q

normal infant stool

A

Normally pass dark sticky meconium during first 2 days of life
then should transition to yellowish or green stool in ingesting adequate milk

45
Q

breast milk jaundice time frame

A

starts age 3-5 days peaks at 2 weeks

46
Q

breast milk jaundice is what

A

High levels of B-glucuronidase in breast milke deconjugate intestinal bilirubin and increase enterohepatic circulation
Normal exam and adequate breastfeeding
Indirect (unconjugated) hyperbilirubinemia up to 10-30 mg/dl

47
Q

Rx breastfeeding failure jaundice

A

increase frequency and duration of feeds to stimulate milk production, adequate hydration and promote bilirubin excretion

48
Q

Neonates and breast feeding times?

A

8-12 times a day (every 2-3 hrs)

for 10-20 mins per breast for 1st month of life

49
Q

ingestion of chemical management

A

Secure ABCs
Remove contaminated clothing and visible chemical: irrigate exposed skin
Chest xray if resp symptoms
Endoscopy w/in 24 hrs

50
Q

Gut immaturity, exposure to bacteria from enteral feeds,, leads to cascade of inflammation and damage to bowel wall; Dx?

A

Necrotizing enterocolitis (NEC)

51
Q

Decreased rates of NEC in premature infants when fed?

A

breast milk instead of formula

52
Q

Xray of NEC?

A

Air visible in bowel wall= pneumatosis intestinalis
portal venous air
severe intestinal necrosis can cause perforation and pneumoperitoneum

53
Q

Meckels diverticulum c/f

A 
Asymptomatic incidental finding
painless hematochezia (melena stools)
intussception
intestinal obstruction 
volvulus
54
Q

Dx meckels?

A

Technetium 99m pertechnetate scan

55
Q

meckels is what

A

incomplete obliteration of fetal vitelline (omphalomesenteric) duct

56
Q

In 1-8 wks a kid develops, Jaundice, acholic stools or dark urine, Hepatomegaly, Conjugated hyperbilirubinemia, Mildly elevated transaminases; Dx?

A

Biliary atresia

57
Q

Dx biliary atresia

A 
USG: absent or abnor Gallbladder
Hepatobiliary scintigraphy: failure of tracer to excretion
Intraoperative cholangiogram(gold standard): biliary obstruction
58
Q

Rx biliary atresia

A

Hepatoportenterostomy (Kasai procedure)

LIver transplant

59
Q

Intussusception r/f (6)

A 
Viral illness or rotavirus vaccine
Meckels
HSP
Celiac disease
Intestinal tumor
Polyps
60
Q

Wilms tumor arises from what embryologic precursor

A

Metanephros: renal parenchyma

61
Q

Embryologic structures of mesonephros

A

Seminal vesicles
epididymis
ejaculatory ducts
ductus deferens

62
Q

Paramesonephron gives rise to

A

fallopian tubes
uterus
part of vagina

63
Q

Risk factors for jejunal atresia

A

vasoconstrictive meds
cocaine
tobacco
not assoc w/ chromosomal abnormalities

64
Q

Jejunal atresia presents how

A

bilious vomiting
abd distention
Abd xray: triple bubble sign

PEDS UWORLD (9 decks)

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