Diseases Flashcards
What disease is meconium ileum associated with
Cystic fibrosis
Why does CF cause meconium ileus
Meconium blocks the lumen of the bowl due to increase stickiness of the intestinal tract
XR sign for meconium ileus
Soap bubble sign
Symptoms of meconium ileus
Bowels not opened in first 48 hours of life
What is duodenal atresia
Congenital malformation of the bowel where the intestine is completely closed off causing complete obstruction preventing the passage of food and fluids
Diseases associated with duodenal atresia
Polyhydramnios, Down’s syndrome, cardiac abnormalities, prematurity
Symptoms of duodenal atresia
Bilious/non-bile stained vomiting in 24-38 hours of life (depending on whether its before/after the ampulla of Vater)
XR sign for duodenal atresia
Double bubble on XR
Treatment of duodenal atresia
NG tube + IV fluids, surgery= duodena-duodenostomy
What is biliary atresia
Failure of biliary tract to develop causing scarring and blockage of bile ducts, preventing the passage of bile out of the liver, causes and accumulation of conjugated bilirubin in the blood which cannot enter the intestinal tract
Symptoms of biliary atresia
Prolonged jaundice > 14 days + pale, chalky white stools
Cause of inguinal hernia
Failure of processes vaginalis to close allowing a loop of bowel to become stuck in inguinal canal
What is volvulus
Twisting of the bowel causing intestinal blockage, twisting of the mesentery surrounding the bowel can cut off blood supply to the midgut
Symptoms of volvulus
Bilious vomiting (mossy green colour)
What is necrotising enterocolitis
Inflammation of the bowel leading to necrosis, dead bowel perforates and leaks contents into the abdomen, bacteria enters bloodstream causing sepsis
Symptoms of necrotising enterocolitis
Passage of blood + mucous, distended abdomen, sepsis
Investigations of necrotising enterocolitis
Stool cultures, abdo XR
Treatment of necrotising enterocolitis
Stop feeding orally, broad spectrum antibiotics, parental nutrition, surgery
What is Hirschsprung disease
A congenital abnormality resulting in lack of parasympathetic ganglion in the intestine causing an absence of peristalsis causing functional obstructin
Symptoms of Hirschsprung disease
Failure to pass stool in the first 48 hours of life, abdominal distension, bile-stained vomiting, narrowed segment on rectal examination with gush of liquid tools on withdrawal of finger
Epidemiology of pyloric stenosis
Boys, first born, familial occurrence, 2-7 weeks old
Pathogenesis of pyloric stenosis
Thickening of pylorus muscle preventing passage of materials through the pylorus
Symptoms of pyloric stenosis
Projectile non bile stained vomiting, frequency + severity increases as the child grows
Diagnosis of pyloric stenosis
US, pyloric mass present in RUQ, test feed
Treatment of pyloric stenosis
IV fluid for resuscitation and correct electrolytes, surgery-= Rundstedt’s pyloromyotomy
Diseases associated with coeliac disease
Positive family history, T1DM, Down’s syndrome, IgA deficiency, dermatitis herpetiformis
Symptoms of coeliac disease
Irritability, loose stools, abdomen distension, buttock wasting
Diagnosis of coeliac disease
Jejunal biopsy to confirm villus atrophy, screen for IgA gliadin antibodies
What is Gilbert’s Syndrome
Mild liver disorder where the liver doesn’t properly process bilirubin, jaundice is usually worse when the patient is under physiological stress such as infection
What is intussusception
Part of the bowel has invaded telescopically into the next part of the bowel
Presentation of intussusception
Cough, cold, off their food, high pitch cry, severe colicky abdomen pain, palpable sausage shaped mass, vomiting, red jelly-like stools
Diagnosis of intussusception
US= target lesion, blood on rectal exam, AXR
Treatment of intussusception
Air reduction
Symptoms of appendicitis
Pain starts centrally and migrates towards RIF, pain on road bumps + jumping
Diagnosis of appendicitis
US
Treatment of appendicitis
Appendicectomy
What increases risk of RDS
C-section delivery
What causes RDS
Surfactant deficiency causing alveolar collapse
Symptoms of RDS
Increased work of breathing + hypoxia, cyanosis, subcostal + intercostal recession, expiratory grunting
Diagnosis of RDS
Ground glass appearance on XR
Treatment of RDS
Avoid hypoxia, acidosis + hypothermia, CPAP machine, ventilate + give surfactant
Most common cause of viral gastroenteritis in children
Rotavirus
What is HUS
Commonest cause of AKI in children, destruction of red blood cells causing kidney damage
Causes of HUS
Atypical/sporadic or E.Coli 0157
Symptoms of HUS
Blood in diarrhoea, oliguria, haematuria, kidney failure
Diagnosis of HUS
FBC, gram film, PCR for E.Coli, stools microscopy + culture, U and Es, LFTs
Treatment of HUS
Monitor electrolytes + fluid balance, blood transfusion, treat hypertension
