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COMAT - Peds > Congenital GI Conditions > Flashcards

Congenital GI Conditions Flashcards

1
Q

What maternal medication use may cause pyloric stenosis?

A

Erythromycin

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2
Q

What type of emesis will be present with pyloric stenosis?

A

NON-bilious, although projectile

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3
Q

List the main findings with pyloric stenosis

A
  • Non-bilious vomiting after each feed
  • Olive shaped mass in epigastric region
  • Visible peristaltic waves
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4
Q

Olive shaped mass and visible peristaltic waves are seen with what condition?

A

Pyloric Stenosis

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5
Q

What imaging modality should be done with pyloric stenosis?

A

US

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6
Q

What metabolic derangement will be present with pyloric stenosis?

A

Metabolic Alkalosis
LOW K+ and Cl-

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7
Q

What is the treatment for pyloric stenosis?

A

NPO
Hydration/electrolyte correction
Pyloromyotomy

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8
Q

What is intussusception and where does it usually occur?

A

Portion of bowel telescopes into an adjacent portion
- often at ileocecal valve

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9
Q

What is the triad of symptoms with Intussusception?

A
  1. Episodic abdominal pain
  2. Vomiting
  3. Bloody “currant jelly” stool
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10
Q

What is the triad of symptoms with Intussusception?

A
  1. Episodic abdominal pain
  2. Vomiting
  3. Bloody “currant jelly” stool
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11
Q

What type of mass may be felt with Intussusception?

A

Sausage shaped in the RUQ with an empty RLQ

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12
Q

What will an US show with Intussusception?

A

Bullseye

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13
Q

What is the best diagnostic/treatment for Intussusception?

A

Air enema

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14
Q

Malrotation with volvulus involves what?

A

Bowel twists on itself causing an obstruction

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15
Q

What symptoms will be present with Malrotation/Volvulus?

A

Bilious emesis
Abdominal distention
Bloody stool

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16
Q

What symptoms will be present with Malrotation/Volvulus?

A

Bilious emesis
Abdominal distention
Bloody stool

17
Q

What causes a Meckel Diverticulum?

A

Failure of the vitelline duct to obliterate which causes a true diverticulum

18
Q

What type of ectopic tissue is the in the Meckel Diveritculum?

A

Gastric and Pancreatic tissues

19
Q

What is the main sign of Meckel Diverticulum?

A

PainLESS blood in the stool

20
Q

Painless blood in the stool is concerning for?

A

Meckel Diverticulum

21
Q

Rule of 2’s with Meckel Diverticulum

A

2 types of tissue
2x more common in boys
2 years of life is common presentation
2 inches long
Within 2 feet of ileocecal valve

22
Q

What test is diagnostic for Meckel Diverticulum? What does it detect?

A

Meckel Scintigraphy scan (tech 99m) detects gastric tissue

23
Q

What causes Hirschsprung disease?

A

Lack of ganglion cells to migrate to the distal colon

24
Q

When ganglion cells do not migrate to the distal colon, what occurs there?

A

Unopposed contraction, with no relaxation and no peristalsis

25
Q

What is often the first sign of Hirschsprung Diisease?

A

Failure to pass meconium

26
Q

With a rectal exam, what 2 findings are often seen with Hirschsprung Disease?

A
  • NO stool in the rectal vault
  • Expulsion of stool after rectal exam
27
Q

If Hirschsprung disease is mild, how may it present in older kids?

A

Chronic constipation

28
Q

What will be seen on XR with Hirschsprung Disease?

A

Distended proximal bowel with paucity (absent) of air in rectum

29
Q

What will a Barium Enema show with Hirschsprung Disease?

A

Dilated proximal colon
Narrow distal colon

30
Q

What is the most definitive test for Hirschsprung disease?

A

Rectal biopsy

31
Q

What will a rectal biopsy show with Hirschsprung Disease?

A

Absent myenteric and submucosal plexuses

32
Q

A portion of the bowel undergoes necrosis with Necrotizing Enterocolitis. What are 2 risk factors?

A

Premature birth
Formula feeders

33
Q

In the first few days/weeks of life, what will present with Necrotizing Enterocolitis?

A

Feeding intolerance
Abdominal distention
Bloody stool

34
Q

In the first few days/weeks of life, what will present with Necrotizing Enterocolitis?

A

Feeding intolerance
Abdominal distention
Bloody stool

35
Q

What is diagnostic on XR for Necrotizing Enterocolitis?

A

Pneumatosis Intestinalis
= Air bubbles in the bowel wall

36
Q

If you see air in the bowel wall, what should you suspect?

A

Necrotizing Enterocolitis

37
Q

If Necrotizing Enterocolitis is more severe, what else can you see on XR?

A

Air under the diaphragm (perf.)
Air in portal venous system

38
Q

What is the treatment for necrotizing enterocolitis?

A

NPO, IV antibiotics and surgery

COMAT - Peds (12 decks)

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