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#DAY4_PEDIATRICS > GASTROENTEROLOGY > Flashcards

GASTROENTEROLOGY Flashcards

1
Q

Cholelithiasis in children is usually due to:

A

Hemolytic dyscrasia

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2
Q

If you are suspecting biliary atresia, what is the gold standard for diagnosis of this disease?

A

Direct Cholangiography

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3
Q
  • prolonged elevation of the serum levels of conjugated bilirubin beyond the 1st 14 days of life
  • Mechanical Obstruction of bile flow
    • Biliary Atresia
  • Functional impairment of hepatic excretory function and bile secretion
A

NEONATAL CHOLESTASIS

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4
Q

cone-shaped fibrotic mass cranial to the bifurcation of the portal vein, may be seen in patients with biliary atresia

A

Triangular Cord sign

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5
Q

gold standard for the diagnosis of biliary atresia. To determine the presence and site of obstruction

A

Cholangiography

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6
Q

Biliary atresia vs neonatal hepatitis

A
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7
Q

The most common cause of viral gastroenteritis in infants is:

A

Rotavirus

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8
Q

By definition acute diarrhea DOES NOT last longer than ___days?

A

14

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9
Q

ACUTE DIARRHEA definition

A
  • excessive loss of fluid and electrolyte in the Stool
  • sudden onset of excessively loose stools of >10 mL/kg/day in infants and >200 g/24 hr in older children, which lasts <14 days
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10
Q

Patients presenting with non-inflammatory diarrhea

A
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11
Q

DRUGS USED IN CHOLERA

A
  • Tetracycline 12.5 mg/kg/dose 4x day PO qid for 3 days (max 2 g/day); not for <9 yrs old; or
  • Doxycycline 5 mg/kg PO single dose (max 200 mg/day)
  • Alternatives: TMP-SMX 8-10 mg/kg/day bid PO; Erythromycin 40 mg/kg/day every 6 hours max. 2g/day; or Furazolidone 5-8 mg/kg/day max 400 mg/day
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12
Q

What is the mechanism behind the bleeding diarrhea in shigella?

A

invasion of the intestinal epithelium

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13
Q

Bloody diarrhea

Abdominal cramps, tenesmus, abundant pus and WBC in stool

A

Shigella

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14
Q

Bloody diarrhea

High fever, headache, drowsiness, confusion, meningismus, seizures, abdominal distention History of eating eggs, poultry, unpasteurized milk

A

Salmonella

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15
Q

severe abdominal pain, high fever, emesis, anorexia, generalized toxicity, painful defecation, urgency

A

Shigellosis

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16
Q

WHO recommendation for all patients with bloody diarrhea irrespective of age

A

Ciprofloxacin 30 mg/kg/day in 2 divided doses

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17
Q

improves immune response to Shigella

A

Zinc 20 mg/day for 14 days

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18
Q

Most common cause of intestinal obstruction between 3 months - 6yrs.old; M > F

A

INTUSSUSCEPTION

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19
Q

Barium enema. what condition is this seen?

A

INTUSSUSCEPTION

coiled-spring sign (thin rim of barium trapped around the invaginating part within the intussuscipiens; edematous mucosal folds of the returning limb of intussusceptum outlined by the contrast)

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20
Q

UTZ. What condition is this seen?

A

INTUSSUSCEPTION​

tubular mass & a doughnut or target sign (98-100% sensitivity)

21
Q
  • Ultrasound is confirmatory: pyloric thickness >4mm or length >14mm
  • Barium: elongated pyloric channel, a bulge of the pyloric muscle into the antrum (shoulder sign) & streaks of barium in the narrowed channel (double tract sign)
A

PYLORIC STENOSIS

22
Q
  • Hallmark: bilious vomiting without abdominal distention usually noted on the 1st day of life
  • Polyhydramnios in 50% due to failure of absorption of amniotic fluid in the distal intestine
  • Jaundice in 1/3 of patients
A

DUODENAL ATRESIA

23
Q

Most common cause of lower intestinal obstruction in neonates; M>F

A

HIRSCHSPRUNG DISEASE

24
Q

Arrest of neuroblast migration from the proximal to distal bowel – absence of ganglion cells in the bowel wall beginning in the internal anal sphincter

A

HIRSCHSPRUNG DISEASE

25
Q

gold standard for dx of HIRSCHSPRUNG DISEASE

A

rectal suction biopsy

26
Q

Absence of Meissner & Auerbach plexus & hypertrophied bundles with high concentrations of acetylcholinesterase between the muscular & submucosa layers

A

HIRSCHSPRUNG DISEASE

27
Q

Patients presenting as obstruction

A
28
Q

According to the Rome criteria for functional constipation in children less than 4 years of age, how many criteria must be met in order to diagnose functional constipation?

A

2

29
Q

delay or difficulty in defecation present for 2 wk or longer and significant enough to cause distress to the patient.

A

Constipation

30
Q

o voluntary or involuntary passage of feces into inappropriate places at least once a month for 3 consecutive months once a chronologic or developmental age of 4 yr has been reached

A

Encopresis

31
Q

Chronic constipation: ROME III Criteria

A
32
Q

DIFFERENCE BETWEEN OSMOTIC & SECRETORY DIARRHEA:

A
33
Q

Mechanisms of diarrhea

A
34
Q

Liquid alkali produces what type of necrosis

A

liquefaction necrosis

35
Q

Acidic agents produces what type of necrosis

A

coagulation necrosis

36
Q

Dilution by water/milk is recommended in caustic ingestions. True or false.

A

TRUE

37
Q

• Abdominal x ray:

o Sentinel loop

o Dilated transverse colon (cutoff sign)

o Ileus o

Blurring of the left psoas margin

o Peripancreatic extraluminal gas bubbles

A

Acute pancreatitis

38
Q

HBsAg (+), Anti-HBc (+), IgM Anti-HBc (+), Anti-HBs (–)

A

acute hepatitis B infection

39
Q

First clinical evidence of HBV infection is elevation of

A

ALT levels which occurs about 6-7 wks after exposure

40
Q

most valuable single serologic marker of acute HBV infection because it is present as early as HbsAg and continues to be present later in the course of the disease when HBsAg has disappeared

A

Anti-HBcAg

41
Q

inner portion of the virion that encodes the viral DNA

A

HBcAg

42
Q

serves as a marker of active viral replication; identification of infected people at increased risk of transmitting HBV

A

HBeAg

43
Q

first serologic marker to appear & its rise coincides with the onset of symptoms; detection of acutely or chronically infected people; antigen used in hepatitis B vaccine

A

HBsAg

44
Q

identification of people who have resolved infections with HBV; determination of immunity after immunization

A

Anti-HBs

45
Q

identification of infected people with lower risk of transmitting HBV

A

Anti-HBe

46
Q

identification of people with acute, resolved, or chronic HBV infection

A

Anti-HBc

47
Q

identification of people with acute or recent HBV infections (including HBsAg-negative people during the “window” phase of infection)

A

IgM anti-HBc

48
Q

Hepa profile and interpretations.

MEMORIZE!!

A

#DAY4_PEDIATRICS (15 decks)

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