Chapter 42

Question 1

Absence of a normal body opening or passageway.

Answer 1

Atresia

Question 2

Twisting of loops of intestine on themselves, which obstructs the lumen

Answer 2

volvulous

Question 3

Neonates who have a congenital anomaly should be examined for the presence of (infection, other anomalies).

Answer 3

other anomalies

Question 4

Children who have cleft (lip, palate) tend to have repeated sinus & middle ear infections should be evaluated for loss of (hearing, smell).

Answer 4

palate, hearing

Question 5

In children, CHRONIC hepatitis most often occurs from which type of hepatitis?

Answer 5

B & C - because of the immature immune system

Question 6

Childhood chronic hepatitis usually has (no, numerous) symptoms.

Answer 6

No

Question 7

In intestinal malrotation (a congenital, an acquired) condition, the cecum & initial portion of the colon reside in the upper (right, left) quadrant of the abdomen.

Answer 7

congenital, right

Question 8

Stenosis of a segment of bowel causes (collapse, dilation) of the lumen proximal to the obstruction and (collapse, dilation) distal to it.

Answer 8

dilation proximal, collapse distal

Question 9

A child who falls below the (third, tenth) percentile on the growth curve is likely to have failure to thrive.

Answer 9

Third

Question 10

Rotavirus is a leading cause of (acute gastroenteritis, necrotizing enterocolitis) in infants & young children.

Answer 10

Acute GE

Question 11

Congenital or acquired?
imperforate anus
esophageal atresia
hep A
Cleft lip
trachoesophageal fistula
intussusception
eosinophilic esophagitis
Hirschsprung disease
cirrhosis
necrotizing enterocolitis

Answer 11

CONGENITAL:
imperforate anus, esophageal atresia, cleft lip, TE fistula, & Hirschsprung disease

ACQUIRED:
Hep A, intussusception, eosinophilic esophagitis, cirrhosis, & necrotizing enterocolitis

Question 12

Why is maternal polyhydramnios associated with esophageal atresia?

Answer 12

Because normally the fetus swallows amniotic fluid that then absorbs into placental circulation. Because the esophagus is a blind pouch in esophageal atresia, this process cannot occur and therefore, there is an increased amount of amniotic fluid. Esophageal atresia & tracheoesophageal fistula can occur alone or together. As the infant swallows oral secretions or ingests milk, the pouch fills causing either drooling or aspiration into the lungs.

Question 13

Why is an infant with tracheoesophageal fistula at higher risk of pneumonia?

Answer 13

Air will enter the stomach distending it, gastric secretions will regurgitate into trachea & enter lungs causing inflammation & damaging lung tissue.

Question 14

What is the difference between marasmus & kwashiorkor?

Answer 14

Marasmus is severe acute malnutrition caused by deficiency of all nutrients.

Kwashiorkor is severe acute malnutrition caused by deficiency of protein. (Like those children in Africa on commercials with the big belly)

Question 15

What is the difference between organic and nonorganic failure to thrive?

Answer 15

Organic FTT has a known pathophysiologic cause that results in insufficient nutrients becoming available for the body’s needs.

Nonorganic FTT occurs in the absence of known physiologic causes & is associated with ineffective nurturing or neglect.

Question 16

What is the difference between the times at which physiologic jaundice & pathologic jaundice arise in infants?

Answer 16

Physiologic jaundice arises during the 2nd or 3rd day after birth for full term infants & 2-4 weeks after birth in premature infants.

Pathologic jaundice arises after that time period or else within 24 hours after birth with high bilirubin levels.

Question 17

Conditions & risk factors:
Cleft lip
Distal intestinal obstruction syndrome
Pyloric stenosis
Hep B infection
Hep A infection

Answer 17

Cleft lip - MATERNAL VIT B DEFICIENCY

Distal intestinal obstruction syndrome - CYSTIC FIBROSIS

Pyloric stenosis - MATERNAL HYPERSECRETION OF GASTRIN

Hep B infection - FREQUENT BLOOD TRANSFUSIONS FOR HEMOPHILIA

Hep A infection - DAYCARE PERSONNEL WHO DO NOT PRACTICE GOOD HAND HYGIENE, yuck!

Question 18

Cleft palate arises during the third ______ of gestation, and cleft lip arises during the fourth ______ of gestation.

Answer 18

third month - cleft palate,

fourth week - cleft lip

Question 19

Wilson disease, also called __________ degeneration, is an autosomal __________ defect of _______ metabolism that damages the _______, brain, eyes, & kidneys.

Answer 19

hepatolenticular; recessive, copper, liver

Question 20

In biliary atresia, some of the _____ ducts are absent or obstructed, which leads to development of portal _____ & cirrhosis.

Answer 20

bile; hypertension

Question 21

Gluten-sensitive enteropathy, AKA _____ disease or _______ _______, is an autoimmune disease in which reactive ___ lymphocytes mediate damage to the intestinal _______.

Answer 21

celiac, celiac sprue, T-lymphocytes, epithelium

Question 22

In kwashiorkor, generalized edema occurs because of decreased plasma _______; the liver accumulates ______ because of lack of amino acids to make lipoproteins.

Answer 22

proteins (albumin); fat

Question 23

Children who have marasmus do not have the subcutaneous ____ seen with kwashiorkor, & their livers are not _________.

Answer 23

fat, enlarged

Question 24

Brain damage caused by high bilirubin levels is known as

Answer 24

kernicterus

Question 25

The immature mucosal barrier of a premature infant’s GI tract is an important factor in the development of ________ ________, which can lead to abdl distention, ______ perforation, sepsis &________.

Answer 25

necrotizing enterocolitis; bowel perforation, & death

Question 26

Many infants who have GE reflux develop _______ pneumonia; although children usually outgrow the reflux, if it persists in childhood, the child may develop chronic ______, hoarseness, & recurrent __________.

Answer 26

aspiration pneumonia, chronic cough, recurrent pneunomia

Question 27

Cystic fibrosis is characterized by a deficiency of _______ enzymes, hypersecretion of respiratory _______, & ______ sodium & chloride in _______.

Answer 27

pancreatic enzymes, respiratory mucous, increased Na & Cl in sweat.

Question 28

Typical signs and symptoms of the following:

portal hypertension
biliary atresia
Hirschsprung disease (congenital aganglionic megacolon)
Pyloric stenosis
Lactose intolerance

Answer 28

portal hypertension - enlarged spleen, bloody emesis or melena, & ascites

biliary atresia - jaundice, enlarged liver, clay-colored feces, failure to gain weight

Hirschsprung disease - chronic constipation, poor weight gain, & progressive abdominal dissension; may develop small volume diarrhea

Pyloric stenosis - infant who previously fed well & gained weight develops repeated projectile vomiting & wants to eat again soon after each vomiting episode

Lactose intolerance - abdominal pain, bloating, flatulence, & diarrhea after drinking milk

Question 29

What is Meckel diverticulum?

Answer 29

Outpouching of all layers of the small intestine caused by failure of the fibrous band that connects the small intestine to the umbilicus.

Question 30

What is the most common cause of acquired intestinal obstruction in infants?

Answer 30

Intussusception - a condition in which one portion of the bowel telescopes or invaginates into another, most commonly at the ileocecal junction, sometimes a result of rotavirus vaccine.

Question 31

What is the etiology of acute diarrhea in infants & children? What are some of the consequences?

Answer 31

Most commonly caused by infection, can rapidly lead to dehydration & electrolyte imbalances because fluid reserves are relatively small.

Question 32

What is the most common cause of acute diarrhea in children?

Answer 32

Bacterial or viral enterocolitis.

Question 33

What is the length of time for diarrhea to be considered chronic?

Answer 33

Diarrhea lasting 4 weeks or longer.

Question 34

What is the most common cause the need of a liver transplant in children?

Answer 34

biliary atresia

Question 35

What is the most common form of childhood hepatitis?

Answer 35

Hep A

Question 36

What is the most common cause of portal hypertension in children? What is the most common sign of portal hypertension in children?

Answer 36

caused by thrombus of portal vein….most common sign is splenomegaly.

Question 37

What are the three most common metabolic disorders that cause liver damage in children?

Answer 37

galactosemia, fructosemia, & Wilson disease (defective copper metabolism).