Common Ped Medical Problems

Question 1

Pyloric Stenosis

Answer 1

“Projectile” nonbilious vomiting
Infant immediately hungry “Hungry vomiter”
May be dehydrated
May be jaundiced
US
Palpate abdomen for “olive”—present 50-90%
Treatment: pyloramyotamy

Question 2

GERD

Answer 2

VERY common in healthy infants “Happy spitters”
Bilious vomiting, GI bleeding, forceful vomiting
Prolonged constipation, diarrhea or abdominal distension
HSM, bulging fontanelle, seizures
Poor weight gain, blood in stool

Question 3

Colic Rule of threes

Answer 3

Greater then 3/= hours a day of crying
Greater then 3/= days a week
Lasts at least 3/= weeks
And infant < 3 months old

Question 4

Oral Rehydration Therapy

Answer 4

Small amounts of liquid taken orally to replace fluids and electrolytes
Pedialyte first choice
Idea is to coat the esophagus WITHOUT causing a large enough bolus in the stomach (which will irritate the stomach and induce emesis)
Increase as tolerated.
A great technique is to use a syringe (5ml) every 2 – 3 minutes

Question 5

Enuresis

Answer 5

Involuntary discharge of urine after the age at which bladder control should have been established
Control usually established by 5yo
Significant genetic component