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Phase 3a > Gastro > Flashcards

Gastro Flashcards

1
Q

WHAT IS THE DEFINITION OF TODDLER DIARRHOEA?

A

CHRONIC NON SPECIFIC DIAHRRHOEA

STOOLS OF VARYING CONSISTENCY

ITS THE MOST COMMON CAUSE OF CHRONIC DIARRHOEA IN PRESCHOOL CHILDREN

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2
Q

WHY DOES TODDLER DIARRHOEA OCCUR?

A

AN UNDERLYING DELAY IN MATURATION OF THE INTESTINE LEADING TO ‘INTESTINAL HURRY’

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3
Q

IS THERE MALABSORBTION OR FAILURE TO THRIVE IN TODDLERS DIAHRROEA

A

NO !

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4
Q

HOW WOULD YOU MANAGE TODDLERS DIARRHOEA?

A

REASURRANCE AND WATCH AND WAIT (FOR SIGNS OF MALNUTRITION)

A HIGH FAT DIET

A HIGH FIBER DIET

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5
Q

WHAT IS NOT RECCOMENDED IN LARGE AMOUNTS IN A DIET FOR TODDLERS DIARRHOEA AND WHY

A

FRUIT - CONTAINS LARGE AMOUNTS OF SORBITOL

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6
Q

WHY IS A HIGH FAT DIET RECCOMENDED IN TODDLERS DIAHORREA?

A

FAT SLOWS GUT TRANSIT

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7
Q

WHAT IS THE DEFINITION OF RECURRANT ABDO PAIN

A

PAIN SEVERE ENOUGH TO DISRUPT DAILY ACTIVITIES

LASTING OVER 3 MONTHS

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8
Q

HOW WOULD YO INVESTIGATE RECURRANT ABDO PAIN?

WHAT SIGN WOULD YOU BE CONCERED OF?

A

COMPREHENSIVE HISTORY AND EXAMINATION LOOKING FOR PERIANAL FISSURES (IBD)

START GROWTH CHARTS

URINE CULTURES

ULTRASOUND (LOOKING FIR GALLSTONES/OBSTRUCTION)

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9
Q

WHAT IS THE MANAGEMENT FOR RECURRANT ABDO PAIN

A

IF CAUSE FOUND TREAT THAT

OTHERWISE CHILDHOOD IBS

REASUURE AND EDUCATE

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10
Q

DEFINE IBS

A

ALTERED GASTRIC MOTILITY AND ABNORMAL SENSATON OF INTRA ABDOMINAL EVENTS

HAS PHYSICAL AND PSYCHOLOGICAL FACTORS

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11
Q

WHAT ARE THE SYMPTOMS OF IBS

A

ABDO PAIN RELIEVED BY DEFICATION

EXPLOSIVE LOOSE MUCUSY STOOLS

BLOATING

FEELING OF INCOMPLETE DEFICATION

ALTERNATING CONSTIPATION

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12
Q

HOW WOULD OU DIAGNOSE IBS

A

HISTORY

LACK OF PHYSICAL FINDINGS

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13
Q

WHAT ARE D.D OF IBS AND WHAT INVESTIGATIONS ARE USED TO CONFIRM THESE

A

US - GALLSTONES AND OBSTRUCTIONS

FLEXIBLE SIGMOSTCOPY / COLONOSCOPY - IBD

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14
Q

HOW WOULD YOU MANAGE IBS

A

SMALL FREQUENT FEEDS

LOW FAT HIGH FIBER DIET

PROBIOTICS

LAXATIVES IE FIBROGEL

CIMETROPIUM (AN ANTISPASMODIC)

CBT

SSRI

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15
Q

WHAT PATHOGENS CAN CAUSE GASTROENTERITIS

A

E COLI

SHIGELLA

CHOLERA

CAMYLOBACTER JEJUNI

ADENOVIRUS

ROTAVIRUS

NOROVIRUS

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16
Q

WHAT IS A CLASSIC SIGN THAT THE GASTROENTERITIS IS BACTERIAL

A

BLOODY STOOLS

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17
Q

WHAT IS A CLASSIC SIGN THAT THE GASTROENTERITIS IS CAMPYLOBACTER JEJUNI

A

SEVERE ABDO PAIN

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18
Q

WHAT IS A CLASSIC SIGN THAT THE GASTROENTERITIS IS SHIGELLA

A

HIGH FEVER

PUS (AND BLOOD) IN STOOLS

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19
Q

WHAT IS A CLASSIC SIGN THAT THE GASTROENTERITIS IS CHOLERA/E COLI

A

PROFUSE DIAHORREA

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20
Q

WHAT ARE GENERIC SYMPTOMS OF GASTROENTERITIS

A

WATERY LOOSE STOOLS

VOMITING

DEHYDRATION

+/- SHOCK

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21
Q

HOW WOULD YOU DIAGNOSE AND ASSES GASTROENTERITIS

A

ASSESS DEHYDRATION

BLOODS: FBC, SODIUM (U+E)

STOOL AND BLOOD CULTURES

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22
Q

HOW WOULD YOU MANAGE GASTROENTERITIS

A

ENCOURAGE FLUID INTAKE + ORS

IF NEEDED IV FLUIDS (MAINTENENCE)

+/- NG TUBE

ZINC IF MALNURISHED

ANTI DIARRHOEAL (LOPERAMIDE)

ABX IF NEEDED

FULL FAT MILK AND SOLIDS AFTER REHYDRATION

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23
Q

HOW WOULD YOU AVOID CEREBRAL OEDEMA

A

FLUIDS OVER 48 HRS

SODIUM REPLACEMENT (HYPONATREMIC)

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24
Q

WHAT IS A CONTRAINDICATION OF ANTI DIAHORREAL

A

POSITIVE CULTURES ONLY GIVE AFTER OR IF CULTURES ARE CLEAN

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25
Q

WHAT ARE INDICATIONS OF AN ANTIBIOTIC

A

CHOLERA

SHIGELLA

C. DIFF

IMMUNOCOMPRIMISED (OR MALNURISHED)

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26
Q

WHAT CAN BE CONSEQUENCES OF GASTROENTERITIS ONCE IT HAS PASSED

A

TEMPORARY LACTOSE INTOLERANCE

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27
Q

WHAT IS INTRASUCCEPTION

A

AN INVAGINATION OF THE PROXIMAL BOWEL INTO DISTAL SEGMENT

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28
Q

WHERE DOES INTRACUEPPTION NORMALLY OCCUR

A

THROUGH ILEOCOECAL VALVE

ILLEUM -> CAECUM

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29
Q

WHAT IS THE PRESENTATION OF INTRACUSSEPTION

A

VOMITING (+BILE IF SEVERE)

RED CURRENT JELLY STOOLS

PAROXYSMAL SEVERE COLICKY PAIN

PERIOD OF RECOVERY WITH THEN A PERIOD OF LETHARGY

PALLOR AROUND MOUTH

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30
Q

AT WHAT AGE DIES INTRACUSSEPTION USUALLY OCCUR

A

3M -> 2Y

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31
Q

HOW WOULD YOU DIAGNOSE INTRUCUSSEPTION

A

X RAY - ABDOMINAL

US - ABDOMINAL

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32
Q

HOW WOULD YOU TREAT INTRUCUSSEPTION

A

FLUID RESUS

RECTAL AIR INFLATION

SURGERY

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33
Q

WHAT SIGNIFICANT ADVERSE EVENTS CAN OCCUR DUE TO INTRACUSSEPTION

A

VENOUS OBSTRUCTION CAUSING BLEEDING AND STRETCHING OF GASTRIC MUCOSA CAUSING FLUID LOSS AND PERFORATION

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34
Q

WHAT IS THE DEFINITION OF BOWEL ATRESIA

A

ANY CONGENITAL MALFORMATION OF THE INTESTINE CAUSING BOWEL OBSTRUCTION

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35
Q

DESCRIBE THE LOCATION CLASSIFICATIONS OF BOWEL ATRESIA

A

DUODENAL

JEJUNAL

ILLEAL

COLON

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36
Q

WHAT ARE THE MALFORMATION CLASSIFICATIONS OF BOWEL ATRESIA

A

WEB

  • COMPLETE
  • INCOMPLETE

BLIND END COMPLETE

MESENTERIC GAP

APPLE PEEL SYNDROME

MULTIPLE BLOCKAGES

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37
Q

WHAT CAUSES BOWEL ATRESIA

A

VASULAR EVENT EN UTERO CAUSING DECREASED PERFUSION AND TISSUE DEATH

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38
Q

WHAT IS THE PRESENTATION OF BOWEL ATRESIA

A

VOMITING (+BILE)

SWOLLEN, SOFT ABDOMEN

NO MECONIUM

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39
Q

HOW WOULD YOU DIAGNOSE BOWEL ATRESIA

A

CAN BE DIAGNOSED EN UTERO VIA US

(INDICATED IN POLYHYDRAMNIOUS)

X RAY (+- CONTRAST +- ENEMA)

LAPROSCOPY

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40
Q

HOW WOULD YOU TREAT BOWEL ATRESIA

A

LAPROSTOMY WITH A TEMPORARY STOMA BAG TO ALLOW FOR HEALING

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41
Q

WHAT IS APPENDICITIS

A

ACUTE APPENDICITIS IS A COMMON CAUSE OF ABDOMINAL PAIN IN CHILDREN

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42
Q

AT WHAT AGE DIES APPENDICITIS USUALLY OCCUR

A

3Y <

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43
Q

WHAT IS THE PRESENTATION OF APPENDICITIS IN OLDER CHILDREN

A

ABDO PAIN

  • CENTRAL -> R ILLIAC FOSSA
  • TENDERNESS AT MCBURNEYS POINT
  • WORSE ON COUGHING AND MOVEMENT

ANOREXIA

VOMITING

FLUSHED FACE

ORAL FETOR

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44
Q

WHAT IS THE PRESENTATION OF APPENDICITIS IN YOUNGER CHILDREN

A

IRRITABLE

GENERALISED PRESENTATION

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45
Q

WHAT SIGN CAN BE FORUND ON X RAY OF APPENDICITIS IN YOUNGER CHILDREN

A

FAECOLITHS

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46
Q

WHAT IS A SERIOUS COMLICATION OF APPENDICITIS IN YOUNGER CHILDREN AND WHY DOES IT OCCUR

A

PERFORATION

OMENTUM IS LESS WELL DEVELOPED

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47
Q

HOW WOULD YOU DIAGNOSE APPENDICITIS

A

US

  • INCREASED THICKNESS OF APPENDIX
  • ABCESSES AND MASSES

X RAY

  • FAECOLITHS

BLOODS

  • NEURTOPHILLIA

URINE DIPSTICK

  • WBC AND NITRATES

LAPSROSCOPY

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48
Q

WHAT IS THE CLASSIC SIGN OF A RETROCELE APPENDIX

A

ABSENT GUARDING

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49
Q

WHAT IS THE DIFFEENCE IN PRESENTATION OF A PELVIC APPENDIX

A

FEW ABDO SIGNS

PAIN IN PELVIC AREA

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50
Q

HOW DO YOU MANAGE APPENDICITIS

WHEN WOULD YOUR MANAGEMENT BE DIFFERENT AND HOW WOULD YOU MANAGE THAT APPENDICITIS

A

ABX AND LAPEROTOMY

UNLESS THERES A PALPABLE MASS WITH NO GENERALISED PERITONITIS THEN ONLY GIVE IV ABX

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51
Q

WHAT IS HIRSPRIGS

A

BIRTH DEFECT RESULTING IN A LACK OF INNERVATION OF THE INTESTINES

52
Q

WHAT GENETIC DIFECT IS HIRSPRUNGS ASSOCIATED WITH

A

DOWNS

53
Q

WHAT HAPPENS EN UTERO FOR HISPRUNGS TO DEVELOP

A

NEURAL CREST CELLS DONT MIGRATE TO INNERVATE INTESTINE MEANING THERE IS A LACK OF NERVE PLEXUSES

54
Q

WHAT PART OF THE INTESTINE IS MOST COMMONLY AFFECTED IN HIRSPRUNGS

A

RECTOSIGMOID COLON

55
Q

WHICH NERVE PLEXUS IS AFFECTED

A

MESENTERIC NERVE PLEXUS

56
Q

HOW DO YOU DIAGNOSE HIRSPRUNGS

A

BARIUM ENEMA

SUCTION BIOPSY

HYSOLOGICAL SAMPLE

57
Q

WHAT IS THE PRESENTATION OF HIRSPRUNGS

A

VOMITING

CONSTIPATION

ABDO PAIN

NO FLATULENCE

NO MECONIUM IN FIRST 24HRS AND GROSS ABDO DISTENSION

58
Q

HOW DO YOU MANAGE HIRSPUNGS

A

SURGERY

  • REMOVAL OF ABNORMAL BOWEL AND INSERTION OF COLONOSTOMY BAG

WHEN CHILD IS OLDER A NEW FUNCTIONAL COLON IS CREATED

59
Q

WHAT IS COLIC

A

A SYMTOM COMPLEX WHICH OCCURS IN FIRST FEW MONTHS OF LIFE

60
Q

WHAT IS THE PRESENTATION OF CHOLIC

A

PAROXYSMAL INCONSOLABLE CRYING

DRAWING OF KNEES

PASSAGE OF XS FLATULANCE

WORSE IN EVENINGS

61
Q

WHAT ARE RISKS OF CHOLIC

A

INCREASE RISK OF NON ACCIDENTAL INJURY AND POSTNATAL DEPRESSION

62
Q

HOW DO YOU TREAT CHOLIC

A

REASSURE

SUPPORT

63
Q

WHEN DOES CHOLIC USUALLY RESOLVE

A

4M

64
Q

IF CHOLIC PERSISTS WHAT COULD THAT MEAN

A

GORD

COWS MILK PROETIN ALLERGY

65
Q

WHAT IS THE INVESTIGATION OF COWS MILK PROETIN ALLERGY

A

2 WEEKS TRIAL OF WHEN HYDROLYSATE FORMULA

FOLLOWED BY TRIAL OF ANTI REFLEX MEDS

66
Q

WHAT IS MECKELS DIVERTICULUM

A

A REMENENT OF THE VITELLOUS INTESTINAL DUCT

CONTAINING ECTOPIC GASTRIC MUCOSA OR PANCREATIC TISSUE

67
Q

WHAT IS THE PRESENTATION OF MECKELS DIVERTICULUM

A

USUALLY ASYMPTOMIAC

BUT:

  • RECTAL BLEEDING WHICH CAN BE SEVERE AND LIFE THREATNING
  • INTRUCUSSEPTION
  • SYMPTOMS OF APPENDICITIS (CENTRAL TO RIGHT ILLIAC FOSSA PAIN W N+V)
68
Q

HOW WOULD YOU DIAGNOSE MECKELS DIVERTICULUM

A

A TECHNETIUM SCAN

69
Q

HOW WOULD YOU TREAT MECKELS DIVERTICULUM

A

SURGICAL RESECTION

70
Q

WHAT IS GORD

A

INE INVOLUNTARY PASSAGE OF GASTRIC CONTENTS INTO THE OESOPHAGUS

71
Q

WHAT IS THE PATHOLOGY OF GORD

A

INAPROPRIATE RELAXATION OF THE LOWER OESOPHAGEAL SPHINCTER DUE TO FUNCTIONAL IMMATURITY

72
Q

WHAT ARE SOME RISK FACTORS OF GORD

A

A FLUID DIET

A HORIZONAL POSTURE

A SHORT INTRAABDOMINAL OESOPHAGUS

73
Q

WHAT IS THE MANAGEMENT OF GORD

A

REASSURANCE

USUALLY SPONTANEOUSLY RESOLVES AT 12M AS CHILD GROWTH

74
Q

WHAT ARE CAUSES OF SEVERE GORD

A

NEUROLOGICAL DISORDERS (CEREBRAL PAULSEY)

PREM BABY

POST OPERATIVE (ESPECIALLY PREM BABY) FOR DIAPHRAGMATIC HERNIA OR BRONCHOPULMONARY DISPLASIA

75
Q

(GORD) WHEN WOULD YOU WANT TO PERFORM A ENDOSCOPY AND BIOSPY OF THE OESOPHAGUS

A

IS THERE ARE COMPLICATIONS PRESENT SUCH AS

  • FAILURE TO THRIVE
  • OESOPHAGITIS
  • HAEMATEMESIS
  • ANAEMIA
  • ASPIRATION
  • PNEUMONIA
76
Q

HOW WOULD YOU MANAGE SEVERE GORD

A

THICKENING AGENTS TO FEED

RANITADINE (H2 RECEPTOR AGONIS)

OMEPRAZOLE (PPI)

SURGERY IF THERES AN OESOPHAGEAL STRICURE

77
Q

WHAT IS PYLORIC STENOSIS

A

HYPERTROPHY OF PYLORIC MUSCLE CAUSING GASTRIC OBSTRUCTION

78
Q

WHAT ARE THE RISK FACTORS FOR PYLORIC STENOSIS

A

FIRST BORN CHILD

MALE

MATERNAL FAMILY HX

79
Q

WHAT IS THE PRESENTATION OF PYLORIC STENOSIS

A

VOMITING

  • MORE FREQUENT AND FORCEFUL OVER TIME

DEHYDRATION

  • LOSS OF INTEREST IN FEEDS, LETHARGY

WEIGHT LOSS

80
Q

AT WHAT AGE DOES PYLORIC STENOSIS TEND TO PRESENT

A

2 - 7 Y

81
Q

WHAT IS A COMPLICATION OF PYLORIC STENOSIS

A

HYPOCHLORAEMIC METABOLIC ACIDOSIS

LOW SODIU M AND LOW POTASSIUM

82
Q

WHAT IS THE INVESTIGATION OF PYLORIC STENOSIS

A

OBSERVE A TEST FEED

ABDO EXAM

US - ABDOMEN

83
Q

WHAT MAY YOU OBSERVE WHILST THE BABY IS FEEDING

A

PYLORIC STENOSIS CANBE SEEN AS A WAVE MOVING FROM LEFT TO RIGHT

84
Q

WHAT IS A KEY FINDING ON AN ABDOMINAL EXAMINATION OF PYSLORIC STENOSIS

A

MASS IN UPPER RIGHT ABDOMINAL QUADRANT

85
Q

HOW WOULD YOU MANAGE PYLORIC STENOSIS

A

IV FLUIDS + POTASSIUM

PULOROMYOTOMY (SURGERY)

86
Q

WHAT ARE KEY DIFERENCES BETWEEN CHRONS AND ULCERATIVE COLITIS

A

CHRONS

  • MOUTH TO UNUS
  • SKIP LESIONS
  • TRANSMURAL

UC

COLON

CONINOUS PATTERS

SUBMUCOSAL AND MUCOSAL LAYERS

87
Q

WHAT IS THE PRESENTATON OF CHRONS

A

FAILURE TO THRIVE

FEVER, LETHARGY, WEIGHT LOSS

ABDO PAIN

DIARRHOEA

ORAL LESIONS AND PERIANAL SKIN TAGES

ANT. UVEITIS

ARTHRALGIA

ERYTHEMA NODOSUM

88
Q

WHAT IS THE PRESENTATION OF ULCERATIVE COLITIS

A

DIARRHOEA

RECTAL BLEEDING

COLIC LIKE PAIN

WEIGH LOSS, FAILURE TO THRIVE (ALTHOUGH LESS DIGNIFICANT THAN CHRONS)

89
Q

WHAT ARE THE INVESTIGATIONS REQUIRED FOR IBD

A

BLOODS

  • FBC, IRON STUDIES, ESR ERP, PLATELETS, SERUM ALBIMUN

ENDOSCOPY +/- ILEO COLONOSCOPY

SMALL BOWEL IMAGING (FOR CHRONS)

90
Q

WHERE IS MOST COMMONLY AFFECTED IN CHRONS

A

DISTAL ILEUM

91
Q

WHERE IS MOST COMMONLY AFFECTED IN ULCERATIVE COLITIS

IN ADULTS

IN CHILDREN

A

ADULTS = DISTAL COLON

CHILDREN = PANCOLITIS

92
Q

WHEN WOULD YOU FIND NON CAESATING EPITHELIAL GRANULOMAS

A

IN CHRONS

HISTOLOGICAL BIOPSY

93
Q

WHEN YOULD YOU SEE FISTULAS AND STRICUTRES

A

IN CHRONS

(ON ILEOCOLONOSCOPY AND SMALL COWEL IMAGING)

94
Q

WHEN WOULD YOU SEE CRYPT DAMAGE

A

ULCERATIC COLITIS

ILEOCOLONOSCOPY BIOPSY

95
Q

WHAT IS THE MANAGEMENT FOR IBD

A

BOWEL REST

  • POLYMERIC DIET FOR 6-8 WEEKS

AMINOSALICATES (BALSALAZIDE)

SYSTEMIC STEROIDS (PREDNISOLONE)

IMMUNO SUPPRESSION (METHOTREXATE AND AZOTHIOPRINE)

ANTI TNF (INFLIXIMAB)

SURGERY

96
Q

HOW DO AMINO SALICATES WORK

A

RELEASE 5 ASA TO CONTROL INFLAMMATION

97
Q

WHAT IS FULMINATING ULCERATIVE COLITIS

A

A RAPID AND SERIOUS IMMUNE RESPONSE AFFECTING THE ENTIRE COLON

98
Q

WHAT IS THE PRESENTATION OF FULMINATING UC

A

SEVEERE PAIN AND DIARRHOEA

DEHYDRATION

SHOCK

RAPID ONSET

99
Q

HOW DO YOU MANAGE FULMINATING UC

A

IV FLUIDS

IV STERIODS

CICLOSPORIN (IMMUNOSUPPRESSANT)

100
Q

WHY IS REGULAR COLONOSCOPIC SCREENING REQUIRED IN IBD

HOW OFTEN IS SCREENING

A

INCREASED RISK OF ADENOCARCINOMA

EVERY 10Y

101
Q

WHAT IS THE ASSESMENT FOR DEHYDRATION

A

capillary refill

conciousness level

hr

bp

mucus membranes

eyes sunken?

fontanelles sunken?

urine output

weigh loss

stool cultures

blood cultures

102
Q

WHAT ARE SIGNS OF MILD DEHYDRATION

A

ALERT CHILD

CAP REFILL <2S

NORMAL HR BP

MUCOUS MEMBRANES MAY BE DRY

NON SUNKEN EYES AND FONTANELLE

NORMAL URINE OUTPUT

103
Q

WHAT ARE SIGNS OF MODERATE DEHYDRATION

A

IRRATABLE CHILD

SLOWED CAP REFILL

TACHYCARDIA

HYPOTENSION

DRY MUCOUS MEMBRANES

NON SUNKEN EYES

SUNKEN FONTANELLES

URINE OUTPUT

104
Q

WHAT ARE SIGNS OF SEVERE DEHYDRATION

A

LETHARGY

V SLOW CAP REFILL

FAST TACHYCARDIA

SEVERE HYPOTENSION

PARCHED MUCOUS MUMBRANES

SUNKEN EYES

V SUNKEN FONTANELLE

LITTLE TO NO URINE OUTPUT

105
Q

WHAT % DEHDRATION IS NEEDED TO BE CLASSED AS MILD

A

5%

106
Q

WHAT % DEHDRATION IS NEEDED TO BE CLASSED AS MODERATE

A

10%

107
Q

WHAT % DEHDRATION IS NEEDED TO BE CLASSED AS SEVERE IE SHOCK

A

15%

108
Q

WHAT IS THE MANAGEMENT OF MILD DEHYDRATION

A

ENCOURAGE FLUID INTAKE AND ORS

109
Q

WHAT IS THE MANAGEMENT OF MODERATE DEHYDRATION

A

IV FLUIDS FOR 4 HOURS

MAINTENENCE FLUIDS

ORS

NASOGASTRIC TUBE

110
Q

WHAT IS THE MANAGEMENT OF SEVERE DEHYDRATION

A

IV FLUIDS 0.9% SODIUM CHLORIDE

IV MAINTENENCE FLUIDS 0.9% NACL + DEXTROSE

+ZINC IF MALNURISHED

POST REHYDRATION FULL FAT MILK AND SOLIDS

111
Q

WHAT IS HYPONATREMIC DEHYDRATION

A

DECREASED PLASMA DOSIUM BECAUSE OF SODIUM LOSS

112
Q

WHAT IS THE MANAGEMENT OF HYPONATREMIC DEHYDRATION

A

FLUID REPLACEMENT OVER 48H NOT 24 TO AVOID CEREBRAL OEDEMA

113
Q

WHAT IS KWASHIORKOR

A

PROTEIN MALNUTRITION CAUSING SEVERE OEDEMA

114
Q

THE WEIGHT HEIGHT RATIO OF A MALNURISHED CHILD IS NORMAL WHAT TYPE OF MALNURESHMENT IS THIS

A

KWASHIOKUR

(DUE TO INCREASED FLUID)

115
Q

WHAT IS MARASMUS

A

SEVERE PROTEIN AND ENERGY MALNUTRITION

116
Q

WHAT IS THE PRESENTATION OF MARASMUS

A

WAISTED ELDERLY APPEARENCE

NO OEDEMA

MIDARM CIRCUMFERENCE IS LOW

REDUCED SKIN FOLD THICKNESS

WITHDRWARN AND APATHETIC CHILD

117
Q

WHAT ARE THE SYMPTOMS OF KWASHIOKUR

A

OEDEMA AND DISTENDED ABDOMEN

SEVERE WAISTING

DESQUAMATING SKIN AND HYPERKERATOSIS

ENLARGED LIVER

ANGULAR STOMATOSIS

DIAHORREA

HYPOTENSION AND BRADYCARDIA

HYPOTHERMIA

118
Q

HOW DO YOU MANAGE MALNUTRITION

A

GLUCOSE AND DEXTROSE

FLUIDS

ELECTROLYTES NA, K, CL,

MICRONUTRIENTS A D E K

SMALL AND OFTEN FEEDS

119
Q

WHAT ARE CAUSES OF MALNUTRITION

A

IBD

COELIAC

CHOLESTATIC LIVER DISEASW

SHORT BOWEL SYNDROME

EXOCRINE PANCREATIC DYSFUNCTION

120
Q

HOW DOES CHOLESTATIC LIVER DISEASE AFFECT ABSORBTION

A

BILE SALTS NO LONGER REACHING DUODENUM

DECREASED FAT AND VITAMIN ABSORBTION

121
Q

WHAT ENZYMES ARE AFFECTED IN PANCREATIC DISFUNCTION

A

LIPASE

PROTEASE

AMYLASE

122
Q

WHAT IS COELIAC DISEASE

A

AN ENTEROPATHY

GLIADIN CAUSES IMMUNE RESPNSE DAMAGING PROXIMAL SMALL INTESTINE

CAUSING VILLOUS ATROPHY

123
Q

WHAT IS THE PRESENTATION OF COELIAC DISEASE

A

FAILURE TO THRIVE

BUTTOCK WAISTING

DIARRHOEA

ABDOMINAL DISTENSION

ANAEMIA

124
Q

HOW WOULD YOU DIAGNOSE COELIAC

A

LOOK AT IgA

  • TISSUE TRANSGLUTAMINASE ANTIBODIES

ENDOMIPIAL ANTIBODIES

ENDOSCOPY LOOKING AT MUCOSAL CHANGES

GLUTEN CHALLENGE

125
Q

WHAT MUCOSAL CHANGES ARE PRESENT IN COELIAC

A

INTRAEPITHELIAL LYMPHOCYTES

VILLOUS ATROPHY

CYST HYPERTROPHY

126
Q

WHAT ARE RISK FACTORS FOR COELIAC

A

AUTOIMMUNE PEOPLE

  • T1 DM
  • THYROID IE HASHIMOTOS

ALSO

DOWNS

1ST DEGREE RELATIVES

127
Q

HOW WOULD YOU MANAGE COELIAC

A

DIETICIAN

EXPLAIN RISK OF SMALL BOWL MALIGNANCY FOR NON ADHERENCE

Phase 3a (22 decks)

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