Gastro Conditions Flashcards

1
Q

Commonest cause acute abdomen in child

A

Appendicitis

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2
Q

Commonest age group appendicitis

A

> 5 (difficult to diagnose under 2y)

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3
Q

What is the natural progression of appendicitis

A

Obstructed by often faecolith. Vague central abdominal pain. 6-12h full thickness appendix involved. 24-36h appendix gangrenous and will perforate

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4
Q

Appendicitis presentation

A

Periumbilical pain –> RIF when peritoneal irritation

Anorexia

Reluctance to move

Mild fever

Vomiting

Guarding

Rebound tenderness

Rovsings sign

Any change in bowel habits

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5
Q

6w old baby non bilious projectile vomiting after feeds. Not gaining weight well.

A

Pyloric stenosis

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6
Q

Abdo signs in pyloric sten

A

Olive mass

Visible peristalsis

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7
Q

Pyloric stenosis Rx

A

Surgery

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8
Q

Pyloric stenosis investigations

A

test feed

blood gas (hypochlor, hypokal met acidosis)

USS

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9
Q

6m old with spasms of colic, drawing legs up. Distended abdo and later bilous vomit

A

Intusussception

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10
Q

When can’t you do air enema in intussusception and why? What instead?

A

If got to redcurrant jelly phase or <24h as risk perf, so do laparotomy

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11
Q

3m old child who vomits after feeds. Is being fed >200ml/kg milk a day and is otherwise well

A

Regurg secondary to overfeeding

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12
Q

Bilous vomit means the obstruction is ____ to the sphincter of oddi

A

Distal

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13
Q

Duodenal atresia xray sign

A

Double bubble

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14
Q

Duodenal vs jejunal atresia distinction?

A

Duodenal double bubble xray

Jejunal abdo distention as more distal

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15
Q

What predisposes a child to volvulus?

A

Malrotation

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16
Q

What can show double bubble sign other than duodenal atresia?

A

Volvulus

17
Q

What will be dilated in volvulus

A

Stomach and duodenum

18
Q

Dx volvulus

A

Upper GI contrast study

19
Q

Rx volvulus

A

Laparotomy (?Ladds procedure if bowel healthy)

20
Q

1w old baby with bilious vomit, looks toxic, tender abdomen

A

Volvulus

21
Q

3 day old baby who didn’t pass meconium. Abdo distention, bilious vomiting.

A

Hirschprungs

22
Q

Can babies with NEC continue to be fed?

A

Stop enteral feed for 10 days + broad spec Abx

23
Q

A baby with VACTERL problems presents with choking and cyanotic spells after feeding

A

Oesophagel atresia

24
Q

A three week old baby presents with jaundice which is shown to have increased conjugated fraction

A

Biliary atresia

25
Q

A 5yo boy with central abdo pain and preceding fever and coryzal symptoms for 3 days

A

Mesenteric adenitis