CV + GI Flashcards
L-to-R shunts:
R-to-L shunts:
late-onset cyanosis due to Eisenmenger syndrome; includes VSD, ASD, PDA
early-onset cyanosis; includes ToF, TGV, TAPVR, Tricuspid atresia
Eisenmenger syndrome =
pulmonary hypertension reverses L-to-R shunts into R-to-L shunts
TOF =
PROVe – Pulmonic stenosis (determines Prognosis), RVH, Overriding aorta, VSD
Life-threatening cyanosis in a newborn + single loud S2 without murmur
Transposition of the great vessels
**emergent PGE1 then cath lab for atrial septostomy
Aortic coarctation tx?
balloon angioplasty
Ebstein anomaly:
RA hypertrophy + atrialized RV + tricuspid valve dilatation
mid-systolic click and late-systolic rumble
MVP (AD)
Rheumatic fever = type __ hypersensitivity
2
Bronchiolitis ppx for high risk infants?
pavilizumab
Eosinophilic esophagitis:
dx?
tx?
allergic response to food in esophagus → GERD-like sx unresponsive to PPIs
Dx EGD + bx shows eosinophils in esophagus
Tx PO steroids
Milk protein intolerance:
neonate w/ bloody diarrhea + eosinophils in stool
Volvulus (malrotation):
incomplete rotation of GI tract during development → bilious vomiting, abdominal pain/distention
Dx barium enema shows malposition of the cecum
Tx emergent surgical correction (↑risk of short gut)
Meconium ileus:
presentation?
dx?
tx?
(pathognomonic for CF) presents in newborn w/ bilious vomiting, abdominal pain/distention
Dx KUB shows dilated megacolon but barium enema shows microcolon from disuse
Tx gastrograffin enema
Hirschsprung disease:
dx?
tx?
neural crest cells fail to migrate → lack of nerves in distal colon → chronic constipation since birth
Dx screen w/ barium enema, confirm w/ rectal bx
Tx surgical pull-through
Necrotizing enterocolitis:
dx?
tx?
presents as abdominal distention, vomiting, GI bleed, decreased bowel sounds
Dx KUB shows pneumatosis intestinalis
Tx NPO/IVF/abx if unperforated, surgery if perforated
Meckel diverticulum:
dx?
tx?
MCC painless LGIB in a child
Dx technetium uptake for ectopic gastric mucosa
Tx surgery if symptomatic
Toddler diarrhea:
chronic explosive diarrhea in an infant w/ normal physical exam; Tx reassurance
Abetalipoproteinemia:
tx?
celiac disease-like presentation but normal GI bx
Tx ADEK supplements + low-fat diet
Crohn: location? morphology? complications? dx?
“mouth to anus” w/ skip lesions, rectal sparing
transmural inflammation, cobblestoning, noncaseating granulomas

strictures, fistulas, SBO

+calprotectin, +ASCA, KUB shows terminal ileal “string sign”
UC location? morphology? complications? dx?
colorectal, continuous
mucosal inflammation, crypt abscesses and pseudopolyps

toxic megacolon, colorectal cancer
+calprotectin, +p-ANCA, KUB shows “lead pipe sign”
Rotor syndrome:
neonatal direct hyperbilirubinemia + ↑LFTs + no black liver
Dubin-Johnson syndrome:
neonatal direct hyperbilirubinemia + ↑LFTs + “black liver”
Breast-milk jaundice:
due to glucuronidase and indirect bilirubin in breast milk
Breast-feeding jaundice:
tx?
↓feeding → dehydration → retained meconium → ↑enterohepatic circulation of bilirubin
Tx ↑feeding frequency
