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Pediatrics Board Exam > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

Optimal oral rehydration fluids should contain how much sodium and how much glucose?

A

2% glucose and 90 mEq sodium

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2
Q

“Traveler’s diarrhea”, when to treat and with what

A

Enterotoxigenic E.coli; Tx when sx persist >7days and shiga toxin is negative. Tx with Bactrim

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3
Q

2 days after picnic, green malodorous diarrhea

A

Salmonella

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4
Q

Treatment of salmonella typhi

A

Ceftriaxone or cefotaxime

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5
Q

Watery diarrhea and fever several days after exposure, bloody diarrhea develops after fever resides. Tx?

A

Shigella; tx with bactrim

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6
Q

Watery/bloody diarrhea with crampy periumbilical pain relieved by defecation 2-4 days after exposure. Tx?

A

Campylobacter; tx azithromycin

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7
Q

Most common cause of chronic diarrhea in children up to age 3

A

Toddler’s diarrhea

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8
Q

Infant with eczema, asthma, cow milk protein intolerance. When does this resolve?

A

Age 2

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9
Q

Infant with hx polyhydramnios, low birth weight and progressively worsening non-bilious vomiting. How to dx? tx?

A

Antral web; dx with US, tx with surgery

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10
Q

Metabolic derangements in pyloric stenosis

A

Hypochloremic hypokalemic metabolic alkalosis, hyponatremia

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11
Q

US findings in pyloric stenosis

A

pylorus length >14 mm or muscle thickness >4 mm

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12
Q

Bilious vomiting, XR with gastric and duodenal dilatation, decreased intestinal air and corkscrew appearance of duodenum

A

Volvulus

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13
Q

How to dx malrotation

A

upper GI series

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14
Q

Treatment of ranula

A

Excision; make sure it’s not ectopic thyroid first

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15
Q

X-linked disorder with underdeveloped or absent teeth. How to dx?

A

Ectodermal Hypoplasia; Dx with Skin biopsy = lack of sweat pores

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16
Q

Sydrome with underdeveloped, small teeth

A

Hallerman Streiff Syndrome

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17
Q

Syndrome associated with too many teeth

A

Gardner’s Syndrome

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18
Q

Best diagnostic study for PUD

A

Urea breath test, fecal antigen (gold standard but too invasive: Upper GI endoscopy)

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19
Q

Tx PUD

A

PPI + 2 abx (clarithromycin + amox; OR clarithromycin + flagyl)

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20
Q

Child with bulky, pale, frothy, foul smelling stools, proximal muscle wasting. How to dx?

A

Screen with IgA Ab to TTG or IgA ab to endomysium. Confirm with biopsy

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21
Q

Extra teeth, polyps that are pre-malignant in large and small intestine, osteomas. Inheritance? Tx?

A

Gardner’s Syndrome. Autosomal dominant; tx with surgery

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22
Q

Mucosal pigmentation of the lips and gums, colon polyps

A

Peutz-Jeghers Syndrome

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23
Q

Teenager with chronic crampy lower abdominal pain, with or without bloody stools. Continuous inflammation of the colon. Tx?

A

Ulcerative colitis; ASA is first line, then steroids. Colectomy eliminates risk for cancer, but does not stop progression of AS (HLA-B27+)

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24
Q

If suspect infection in patient with UC, what abx?

A

Flagyl

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25
Q

Weight loss, erythema nodosum, arthritis, uveitis, liver disease and renal sones are all manifestations of what disease?

A

Crohn’s disease

26
Q

Skip lesions on XR, transmural lesions, non-caseating granulomas

A

Crohn’s Disease

27
Q

Perianal fistulae/oral aphthous ulcers. TX?

A

Crohn’s Disease. Steroids induce remission but do not change long term course, high rate of relapse

28
Q

Crampy severe periumbilical pain. What organism?

A

Yersinia

29
Q

What to rule out in child >6 that has intussusception

A

Lymphosarcoma

30
Q

First step when intussusception highly suspected

A

Air contrast enema

31
Q

Natural hx of anal stenosis

A

resolves by age 1

32
Q

How to confirm dx of E. histolytica? Tx?

A

Serology; tx with flagyl for colitis/liver abscess and iodoquinol for asymptomatic disease

33
Q

Older child with painless rectal bleeding

A

Juvenile polyposis

34
Q

> 1 month old with elevated direct bilirubin. First test?Treatment?

A

Biliary atresia. Dx with US followed by HIDA scan. Tx Kasai if under 2 months

35
Q

What deficiency in Gilbert syndrome?

A

Glucuronyl transferase deficiency

36
Q

Child with recent URI, admitted to PICU with elevated LFTs and ammonia

A

Reye’s Syndrome 2/2 aspirin

37
Q

Most specific test to dx pancreatitis? Best test to determine underlying cause?

A

Ultrasound to dx; Check serum lipids

38
Q

Abdominal pain that radiates to shoulder is likely to be 2/2 to what organ?

A

Gallbladder

39
Q

Child with shoulder pain, nausea, vomiting, fever, and lethargy. How to dx?

A

Cholecystitis dx with ultrasound

40
Q

Child with jaundice, palpable RUQ mass or HSM, nasea/vomiting, and abdominal pain. How to dx?

A

Cholelithiasis

41
Q

Which Hep B marker indicates high viral load

A

HBeAg, HBV-DNA

42
Q

What does a +IgM anti-HBc indicate?

A

Recent infection with Hep B. Can remain elevated up to 6 months after infection

43
Q

How to dx acute Hep B infection?

A

Check for HBsAg, HBV-DNA, HBeAg, and IgM anti-HBc

44
Q

Most common bloodborne infection in the US

A

Hepatitis C

45
Q

First detected with ingestion of solids: Diarrhea, pain, poor growth. Inheritance? Dx? Tx?

A

Sucrase-isomaltase deficiency. Autosomal recessive. Dx. Must do acid hydrolysis of stool, or hydrogen breath testing. Tx. restriction of sucrose

46
Q

Pancreatic insufficiency, cyclic neutropenia, bone abnormalities. Inheritance?

A

Swachmann-Diamond Syndrome. Autosomal recessive.

47
Q

Electrolyte disturbances in refeeding syndrome

A

Hypophosphatemia, hypokalemia, hypomagnesemia, HYPERnatremia, hyperglycemia

48
Q

Neonate with fulminant liver failure, succinylacetone in the urine

A

Tyrosinemia (autosomal recessive)

49
Q

Neonate with onset of liver failure after introducing fruit juices

A

Fructosemia

50
Q

Which types of hepatitis typically has transaminases >1000s

A

Hepatitis A and B

51
Q

The only etiology of hepatitis that causes splenomegaly

A

EBV

52
Q

Teenage female with hepatitis, high serum protein and low serum albumin (hypergammaglobulinemia). What tests will aid in diagnosis?

A

Autoimmune hepatitis

Check for anti-microsomal Ab, anti-smooth muscle, anti-mitochondrial Ab

53
Q

Triangular facies, pulmonary stenosis, TOF, paucity of intrahepatic bile ducts, butterfly vertebrae

A

Alagilles Syndrome (Autosomal dominant)

54
Q

Female school-aged child with RUQ mass, pain, and intermittent jaundice. Dx? Tx?

A

Choledochal cyst. Dx with US, Tx surgery

55
Q

Most common primary liver tumor of childhood

A

Hepatoblastoma

56
Q

Patient with signs of cholestasis and pancreatitis. Next imaging study?

A

Magnetic resonance cholangiopancreatography or endoscopic ultrasonography (ERCP should not be attempted in the presence of pancreatitis)

57
Q

Initial treatment of eosinophilic esophagitis

A

6 food elimination diet or elemental diet

58
Q

When should a negative stool culture precede return to daycare in a child with diarrheal illness?

A

Shiga toxin-producing Escherichia coli, Shigella species, or Salmonella serotype typhi

59
Q

When should an umbilical hernia be repaired?

A

IF symptomatic, if the hernia is still present at age 5–6 years, or it increases in size between 1 and 2 years of age

60
Q

Shwachmann Diamond. How to diagnose?

A

Abdominal US or other imaging would show fatty infiltration of the pancreas

Pediatrics Board Exam (23 decks)

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