Gastro Flashcards
Things to do in suspected appendicitis
US and urine dip
Key signs of constipation
Less than 3 stools a week
Hard and large or rabbit droppings
Overflow spiling
Red flags of constipation in kids
Ribbon stool (anal stenosis)
Not passing meconium within 48 hours of birth (Cf or hirschprungs)
Abnormal anus or lower back
Failure to thrive
Neuro signs
Vomiting
How is constipation managed in the absence of red flags
Movicol - may regure disimpsctstion regime if impacted
If fails after 2 weeks add stimulant laxative
Give in addition to adequate fluids, fibre and excessive
Signs seen in appendicitis
Loss of appetite (anorexia)
Rosvigs sign- palpation of LIF causes RIF pain
Mcburnes point tenderness (1/3 way between ASIS and umbillicus)
Pathophysiology of hirshprungs disease
Failure of ganglion cells to migrate to hind gut. Leads to no ganglion cells in myenteric plexus, so not ability to perform peristalsis , leading to obstruction and bilious vomiting
What conditions is hirshprungs associated with
Downs and neurofibromatosis
Projectile vomiting seem in what condition
Pyloric stenosis treated with ramstedt procedure
Features seen in intusssception
Red currant jelly stool
Sausage shaped RUQ mass
Concurrent viral illness
What is the disease course of appendicitis like
Central abdominal pain which moves into the RIF
What are bad signs on abdo exam of peritonitis in appendicitis
Rebound tenderness and percussion tenderness
Investigations for appendicitis
Blood for a raised CRP
Urine dip to exclude UTI or DKA
US may be helpful in female patients
CT if diagnosis in question
History seen in constipation
Less than 3 stools a week, can be hard like rabbit droppings
Straining
Abdo pain
Abnormal posture
Overflow
What is the term for faecal incontinence and when is it pathological
Encoperisis and at age 4
History of mesenteric adenitis
Under 16 with RIF pain
Often has a preceding illness
May have fever vomiting and diarrhoea
