Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 4 Repro and paeds > Billious vomiting > Flashcards

Billious vomiting Flashcards

1
Q

what colour is bile stained vomit?

A

green

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what colour is bile?

A

yellow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is billious vomit suggestive of?

A

intestinal obstruction - distal to ampulla of vater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

cause of duodenal atresia

A

failure of recanalisation of fetal duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

duodenal atresia incidence

A

1 in 5000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

duodenal atresia diagnosis

A

antenatal USS
polyhydramnios
double bubble sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

presentation of duodenal atresia

A

billious vomiting in first hours of life
scaphoid abdomen
double bubble sign xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

duodenal atresia initial management

A

NG tube insertion

IV resus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

duodenal atresia definitive management

A

laparotomy

diamond shaped duodeno-duodenostomy = kimura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

duodenal atresia associations

A

50% congenital abnormalities
trisomy 21 - 30%
CHD, VACTERL, renal anomalies, malrotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

VACTERL

A 
vertebral 
anal atresia
cardiac defects
Tracheooesophageal fistula
renal anomalies 
limb abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

normal rotation during development of the gut

A

midgut herniate into extra-embryonic coelom
270 counter clockwise turn around sup.mesen.artery
DJ flexure in LUQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

where does the DJ junction lie in malrotation?

A

right of the midline

caecum abnormally located

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

malrotation - caecum

A

fixed to right lateral abdominal wall by ladds bands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

volvulus

A

bowel mesentery prone to twisting around itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what can volvulus lead to?

A

high intestinal obstruction
midgut ischaemia
infarction
death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

malrotation incidence

A

1 in 6000
75% <1months
90% <1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

malrotation presentation

A

billious vomiting

rapid deterioration with abdominal pain and distention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

late signs of malrotation/volvulus

A 
metabolic acidosis
hypovolaemia
abdominal wall erythema
haematemesis
malaena
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

infant with billious vomiting has what until proven otherwise?

A

malrotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

diagnosis of malrotation

A

upper GI contrast study
abnormal DJ flexure
corkscrewing of duodenum - volvulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

malrotation treatment

A

fluid resus
broad spectrum abx
exploration with ladds procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

ladds procedure

A 
counter clockwise detorsion of bowel 
divide ladds bands
broaden mesentery
incidental appendicectomy
reposition small bowel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

cause of jejuno-illeal atresia

A

ischaemic insult late in utero

reabsorption of affected segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
jejuno-illeal atresia presentation
abdominal distention | billious vomiting
26
jejuno-illeal atresia AXR
triple bubble sign dilated SB loops no distal gas
27
jejuno-illeal atresia contrast enema
disused micro-colon
28
jejuno-illeal atresia treatment
resection of affected atretic gut | primary anastamosis
29
meconium ileus association
CF
30
meconium in CF
low water content high protein waste thick, hard - intestinal obstruction
31
CF gene mutation
delta F508 - CFTR
32
meconium ileus antenatal
hyperechogenic bowel | non-visualisation gallbladder
33
presentation of simple ileus
abdominal distention and billious vomiting 1-2 days PN
34
meconium ileus examination
empty rectum | meconium filled loops palpable in abdomen
35
what can complicated ileus result in?
``` intrauterine volvulus atresia perforation meconium peritonitis pseudocyst ```
36
meconium ileus AXR
soap bubble sign | swallowe airm mixed with meconium
37
meconium ileus treatment
contrast enema
38
other meconium ileus treatments
N-acetylcysteine PR and via NG tube | laparotomy
39
Hirschprung's disease
absent intestinal ganglionic cells
40
Hirschprung's disease incidence
1 in 5000 | 90% neonatal period
41
Hirschprung's disease presentation
fail to pass meconium at 48hrs, billious vomiting and abdo distention
42
Hirschprung's disease types
75% short segment - male | 25% long segment - equal
43
Hirschprung's disease AXR
grossly dilated bowel proximal to affected segment
44
Hirschprung's disease rectal exam
rapid propulsion of stool
45
Hirschprung's disease gold standard diagnosis
suction rectal biopsy
46
Hirschprung's disease suction rectal biopsy
absent ganglion cells | increased uptake of Acetylcholinesterase in hypertrophied nerve trunks
47
Hirschprung's disease treatment
regular rectal washouts | surgery - resect affected bowel and pull through of normal ganglionated bowel with anastamosis
48
Hirschprung's disease contrast enema
collapsed distal rectum with dilated proximal bowel
49
low vs high anorectal malformation
``` low = opening on perineum high = fistula between bowel/urinary tract ```
50
anorectal malformation - what do all require?
abdo/spinal XR, ECHO, renal/spinal USS, pass NGT
51
treating low ARM
anal cutback
52
treating high ARM
defunctioning stoma | staged PSARP - posterior saggital anorectoplasty
53
low ARM association post op
constipation
54
high ARM association
long term incontinence
55
NEC
ischaemia and infection of bowel wall
56
NEC untreated
perforation, sepsis and death
57
NEC incidence
1-3 in 1000 | 8% NICU
58
NEC predisposing factors
``` prematurity resp distress birth asphyxia prolonged ROM caesarean section CHD formula feeds foetal distress labour ```
59
NEC presentation
increasing abdo distention feed intolerance billious vomiting
60
NEC aspirates
billious ng aspirate
61
NEC later signs
abdominal wall discoluration haematochezia apnoea, bradycardia, generalised oedema
62
NEC radiography
``` dilated loops of bowel pneumatosis intestinalis pneumoperitoneum fixed loop of bowel football sign = perforation ```
63
pneumotosis intestinalis
NEC
64
NEC management
IV abx triple therapy cessation oral feeds gastric decompression
65
NEC - signs conservative management failing
thrombocytopenia resp instability worsenign acidosis abdominal erythema
66
NEC surgery
laparotomy - intestinal resection | anastamosis/stoma
67
NEC complications post-op
strictures short bowel syndrome adhesive obstruction
68
NEC mortality
25-40%
69
meckels diverticulum is a remnant of?
omphalomesenteric duct
70
what does meckels diverticulum contain?
heterotopic mucosa
71
meckels diverticulum presentation
bleeding - ulceration obstruction - intussusception or volvulus inflammation
72
what reduces risk of adhesional obstruction?
laparoscopy
73
adhesional obstruction presentation
colicky abdominal pain billious vomiting abdo distention absence flatus/stool
74
adhesional obstruction diagnosis
AXR | contrast flow through
75
adhesional obstruction treatment
resus fluids NG tueb to decompress gut laparotomy and adhesiolysis

Year 4 Repro and paeds (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions