babies

Question 0

tx biliary atresia

Answer 0

kasai procedure- connect bowel lumen to porta hepatis- most successful if done in first two months of age

Question 1

congential anomalies

Answer 1

duodenal atresia- bilious emesis
tracheoesophageal fistula
biliary atresia- failure of fetus to develppe atequate bile drain from liver to intestine–main cause lethal liver disease in children

Question 2

meckle’s diverticulum

Answer 2

MC congenital anomaly where vitelline duct fails to involute at week 8 of gestation
rule of 2- 2% of population, 2% manifest clinical problems, 2 years old, 2 feet proximal of ileocecal valve, 2’ long

Question 3

site of obstruction with malrotation and volvulus

Answer 3

2nd portion of duodenum and has bird’s beak or corckscrew appearance

Question 4

midgut volvulus

Answer 4

small intestine is not fixed in teh abdomen–>suspected by a stalk containing the SMA –>twist–>ischemia and infarct

4 year olds–emergency!

Question 5

intussuception

Answer 5

invagination of terminal ileum into cecum usually at the ileocecal junction
current red stool

intermittent pain and red stools

Question 6

when is nursing contraindicated

Answer 6

contagious TB, HIV+

Question 7

solids at what age

Answer 7

4-6 months

Question 8

cow milk

Answer 8

none till 1 year

no Fe and will block Fe absorption–>anemia and cholitis

Question 9

three mechanisms for Failure to thrive

Answer 9

decreased input
increased output
absorption issue

Question 10

pyloric stenosis red flags

Answer 10

nonbillous vommiting at 2-4 weeks of life-emesis becomes projectile with dehydration-hypoka, metabolic alk, visible peristalisis

tx-pylormyotomy, electrolyte correction

Question 11

encopresis

Answer 11

overflow incontinence, bowel incontinence, fecal soiling

txs-clean out with oral rectal meds and ng, educate

Question 12

external vs internal anal spincter

Answer 12

extrenal- vol *most continence

internal- invol

Question 13

pelvic floor dysfunction

Answer 13

forget how to have do it; pudednal nerve issue; PT for pooping

Question 14

sharp knife-like pain after defectation

Answer 14

anal fissure; disease of younger patients

Question 15

etio fissure

Answer 15

constipation (high pressure)
frequent diarrhea (low pressure)
prior surgery-relative stenosis

Question 16

fissure off-midline

Answer 16

HIV

IBD

Question 17

tx fissure

Answer 17

lifestyle
medication
laternal internal sphincteromy

Question 18

hemorrohids

Answer 18

constipation

pauinful straining–>lump that swells up; acute discomfort 3-5 days

Question 19

perianal skin tags

Answer 19

you can ignore them

Question 20

sx hemorrhoids

Answer 20

painless bleeding

Question 21

rectal prolapse

Answer 21

rings

Question 22

perianal abscess

Answer 22

cysts get blogged up
drain, seton, endorectal flap repair
anal fistula plug, LIFT procedure

Question 23

pilonodal cyst

Answer 23

intergluteal cleft–>cysts there–>gets infected, abscess–>hair gets stuck in there