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1. Pediatrics > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

[GI/Sx/Melena]

Over the counter diarrhea medication that can cause black stool?

A

Bismuth subsalicylate

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2
Q

[GI/Liver/Hepatitis]

When to test infants of mother with hepatitis C infection?

A

Serologic test hepatitis C virus at 18 months of age

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3
Q

[GI/Sx/Vomiting]

Which disease, diagnosis and treatment?

After infectious gastroenteritis
Or static encephalopathy, diabetes type 1
Vomiting with undigested food at night

A

Gastroparesis

Diagnosis: gastric acid sintigraphy (gastric emptying study)

Treatment: erythromycin ethylsuccinate (for DM), supportive for postinfectious (self-resolves in 1-3 months)

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4
Q

[GI/Intestine]

Typical age for presentation?

Pyloric stenosis: ___
Malrotation: ___
Intussusception: ___

A

Pyloric stenosis: 3 weeks to 2 months
Malrotation: 1 month to 1 year
Intussusception: up to 36 months, peak at 9 months

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5
Q

[GI/Intestine/Absorption]

Which vitamin/mineral absorbed?

Duodenum: ___
Jejunum: ___
Ileum: ___

A

Duodenum: iron, folate, calcium (anemia, osteopenia)
Jejunum: protein (osmotic diarrhea, caloric deficit)
Ileum: water, sodium, vitamin B12, fat

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6
Q

[GI/Intestine/Celiac disease]

Name of disease?

Patients with celiac disease

A

Dermatitis herpetiformis

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7
Q

[GI/Intestine/Celiac disease]

Diagnostic test for Celiac disease?

≥ 2 years old: ___
< 2 years old: ___

A

≥ 2 years old: tTG and total IgA
< 2 years old: tTG and deaminated gliadin IgG

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8
Q

[GI/Intestine/IBD]

Characteristics of ulcerative colitis, comparison to CD?

Bowel involvement: ___
Involvement of lesions/tissue: ___
Gramulomas: ___
Weight loss, growth failure: ___
Hematochezia: ___
Perianal lesions, aphthous ulcers: ___
Imaging findings: ___

A

Ulcerative Colitis

Bowel involvement: colon only
Involvement of lesion/tissue: continuous, mucosal only
Gramulomas: No
Weight loss, growth failure: Rare
Hematochezia: Common
Perianal lesions, aphthous ulcers: Rare
Imaging findings: Colon dilatation, thumbprinting (loss of haustrations)

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9
Q

[GI/Intestine/IBD]

Characteristics of Crohn disease, comparison to UC?

Bowel involvement: ___
Involvement of lesions/tissue: ___
Gramulomas: ___
Weight loss, growth failure: ___
Hematochezia: ___
Perianal lesions, aphthous ulcers: ___
Imaging findings: ___

A

Crohn disease

Bowel involvement: anywhere from mouth to anus
Involvement of lesions/tissue: skip lesions, transmural
Gramulomas: Yes
Weight loss, growth failure: More common
Hematochezia: Less common
Perianal lesions, aphthous ulcers: Common
Imaging findings: String sign (luminal narrowing), mural thickening with dilatation

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10
Q

[GI/Intestine]

Which disease?

2nd to 4th weeks of life
Fever, explosive, foul-smelling stools, bloody diarrhea
ABX: dilated loops of bowel with air-fluid levels

A

Hirschsprung enterocolitis
(Due to overgrowth of colonic bacteria in an atonic distal colon)

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11
Q

[GI/Bilirubin]

Cause of Unconjugated hyperbilirubinemia (2)

A

Hemolysis:
- Hemoglobinopathies, RBC membrane disorders
- Enzyme defects (G6PD)

Inherited:
- Gilbert syndrome
- Crigler-Najjar syndrome

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12
Q

[GI/Bilirubin]

Cause of Conjugated hyperbilirubinemia (5)

A
  1. Infections: Hep A, B, C, D, E, EBV, CMV
  2. Biliary tract disease: choledochal cyst, Alagille syndrome, PSC
  3. Drug-induced: CTX, INH, MTX, erythromycin
  4. Metabolic liver disease: Wilson, AAT deficiency, DJS
  5. Autoimmune liver disease
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13
Q

[GI/Bilirubin]

Diagnosis?
Diagnostic test?

Around 0 to 6 years old
Japanese girl
Abdominal pain, jaundice, palpable RUQ mass
Fever, vomiting, pancreatitis

A

Choledochal cysts

  • Test:
    abdominal US, MRCP
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14
Q

[GI/Bilirubin]

Diagnosis?

Patients with AR polycystic kidney disease
Older children/adults
Cirrhosis, esophageal varices, splenomegaly, cholangitis

A

Congenital hepatic fibrosis

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15
Q

[GI/Bilirubin]

Diagnosis?

Recurrent cholangitis, abscesses
Liver biopsy: hepatic fibrosis

A

Caroli disease
(Congenital dilatation of intrahepatic bile ducts)

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16
Q

[GI/Liver/Hepatitis]

Which infectious state?

HBsAg +
Anti-HBs IgG -
Anti-HBc IgG -
Anti-HBc IgM +
HBeAg +

17
Q

[GI/Liver/Hepatitis]

Which infectious state?

HBsAg -
Anti-HBs IgG -
Anti-HBc IgG -
Anti-HBc IgM +
HBeAg -

A

Acute HBV window

18
Q

[GI/Liver/Hepatitis]

Which infectious state?

HBsAg +
Anti-HBs IgG -
Anti-HBc IgG +
Anti-HBc IgM -
HBeAg +

A

Chronic active HBV

19
Q

[GI/Liver/Hepatitis]

Which infectious state?

HBsAg -
Anti-HBs IgG +
Anti-HBc IgG +
Anti-HBc IgM -
HBeAg -

A

Remote (immune) HBV

20
Q

[GI/Liver/Hepatitis]

Autoimmune associated with HCV infection (3)?

A
  1. Small vessel vasculitis with glomerulonephritis and neuropathy
  2. Mixed cryoglobulinemia
  3. Porphyria cutanea tarda
21
Q

[GI/Liver/Bilirubin]

Dubin Johnson vs Rotor

Mild conjugated hyperbilirubinemia
No hepatocellular injury
Bilirubin transporter defect
Black liver
Treatment not needed

A

Dubin Johnson syndrome

22
Q

[GI/Liver/Bilirubin]

Dubin Johnson vs Rotor

Chronic conjugated, unconjugated hyperbilirubinemia
Bilirubin re-uptake defect
Normal liver biopsy
Treatment not needed

A

Rotor syndrome

23
Q

[GI/Liver]

Which disease?

Asthma, bronchiectasis
Neonatal jaundice, juvenile cirrhosis, chronic hepatitis
PAS positive staining in liver biopsy

A

α1-antitrypsin deficiency
(M: normal allele, S: mildly low, Z: severly low, ZZ homozygous most severe)

24
Q

[GI/Liver]

Which disease?

Severe pruritis
Severe cholestasis, hyperbilirubinemia
Normal GGT

A

Progressive familial intrahepatic cholestasis

25
Q

[GI/Liver/AIH]

Type 1 vs Type 2 autoimmune hepatitis

Female>male, between 10-20s, 40-70s
Anti-smooth muscle antibiotics +/- ANA

A

Type 1 autoimmune hepatitis

26
Q

[GI/Liver/AIH]

Type 1 vs Type 2

Younger children
Anti-liver-kidney microsomal-1 antibodies (anti-LKM-1 Ab)
Anti-liver cytosol antigen antibodies (ALC-1 Ab)

A

Type 2 autoimmune hepatitis

27
Q

[GI/Liver]

Which disease?

Patients with ulcerative colitis
Jaundice, hepatosplenomegaly, itching
High ALP, GGT
Low titers for anti smooth muscle, anti-LKM
MRCP beading biliary tree

A

Primary sclerosing cholangitis

28
Q

[GI/Liver]

Which disease?

RUQ pain with palpable mass
Fever, vomiting, jaundice
After Kawasaki disease, strep pharyngitis, TPN, IgA vasculitis
US: dilated, stone-free gallbladder

A

Hydrops of gallbladder

29
Q

[GI/Liver/hepatitis]

Extrahepatic manifestations of hepatitis B infection (4)?

A
  1. Arthritis
  2. Gianotti-Crosti syndrome (papular acrodermatitis)
  3. Polyarteritis nodosa (PAN)
  4. Gromerulonephritis (GN)
30
Q

[Liver/Acute Liver Failure]

Markers for acute liver failure (3)?

A

Prothromin time (factor 7)
Factor 5
Albumin

1. Pediatrics (22 decks)

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