Gastro Flashcards
extraintestinal signs
mouth ulcers =
perianal fistulas =
mouth ulcers = coeliac
perianal fistulas = Crohn’s
IgA deficiency but ?Coeliac
send IgG samples
haematemesis in CF
due to cirrhosis and varices
give octreotide to reduce portal HTN and transfer for banding
jaundice in congenital CMV
conjugated
treatment of pouchitis following colectomy
PO cipro or metro
hernia’s vs hydroceles
hernias are usually indirect and may transilluminate in babies
hydroceles always transilluminate and may require ligation of the patent processes vaginalis to prevent recurrence
treatment for baby if mum is Hep B +ve with antibodies
6 doses Hep B vaccine (not immunoglobulin)
additional are <24h birth, 4 weeks and 1 yr
Which babies need Hep B immunoglobulin?
1) Mother is antigen positive but antibody e negative
2) had acute Hep B in pregnancy
3) infant weighing <1500g
initial management of neuroblastoma
watchful waiting - may resolve on its own
initial management of intussusception
IVI bolus
IV abx
NG
then insufflation
Peutz Jeghers inheritance and symptoms
AD
pale patches of skin and mucosa
GI polyps causing PR bleeding
3 tests for carbohydrate malabsorption
double peaked H breath test (bowel bacterial overgrowth)
stool pH <5.5
reducing substances >0.25% in stool
part of bowel most likely to be affected in UC
pancolitis
when should umbilical hernia be repaired?
age 4
5 reasons for a stool MC+S
bloody diarrhoea
foreign travel
sepsis
diarrhoea >7/7
immunocompromised
which test is most accurate for H pylori
endoscopy with biopsy
conditions for using the breath test for h pylori
no PPI within 2 weeks
no abx within 4 weeks
bilirubin level/rate for kernicterus
340
rise of 8.5/hour
how does neuroblastoma cause HTN
renal artery compression
management of hydrocele
delay surgery for 12 months
management of inguinal hernia
surgical repair (won’t heal by itself)
slightly high GGT vs very high GGT
slightly = liver
very = biliary atresia
management of a recurrent episode of malrotation with volvulus due to adhesions
most respond to conservative, if not then surgery
Down’s syndrome + distended abdomen
Hirshprung’s
location of biliary atresia
intra and extrahepatic
N+V in IBD
UC
how many times a day should a baby <7 days poo
4
how many times a day should a one year old poo
two
diagnostic criteria for impaction
palpable mass
overflow soiling
severe symptoms
disimpaction regime
movicol plain
add senna if needed
maintenence after disimpaction
movicol plain at half disimpaction dose
add senna if necessary
appendicitis mimic
Yersinia
dehydration in gastroenteritis
hyponatraemia (drinking lots)
gastroenteritis, not dehydrated
encourage PO fluids
gastroenteritis, dehydrated, not shocked
<5yo: 50ml/kg ORS plus ORS maintenance (breastfeeding can continue)
> 5yo: 200ml (400 for teens) ORS after each loose stool plus normal fluids
gastroenteritis, shocked
bolus at 10mg/kg + replacement + maintencene
H pylori treatment
amoxicillin and clarithromycin and omeprazole for one week#
(omeprazole for 4 weeks if large ulcer, haematemesis or perf)
(metro if treatment failure or recent macrolide use)
Ix for volvulus
contrast XR
UGI endoscopy criteria
?Sandifer syndrome (?hiatus hernia)
Overt regurg with faltering growth or feed aversion
Dysphagia
No improvement in GORD >1yr
melaena or haematemesis
Unexplained IDA
only absolute CI to breastfeeding
maternal HIV
presentation of volvulus
usually <1yo
bilious vomiting
absolute constipation
bird beak sign
where do PPIs act
Parietal cells
