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Pediatrics > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

What are GI causes of vomiting?

A

Appendicitis
Intussusception
Gastroenteritis
Obstruction

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2
Q

GU causes for vomiting in children?

A

UTI

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3
Q

What are the 2 categories for vomiting?

A

forcefulness

color

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4
Q

What are the 2 categories for forcefulness?

A

non projectile

projectile

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5
Q

What are the 2 categories for color?

A

bilious

nonbilious

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6
Q

What is non projectile d/t?

A

reflex

usually normal

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7
Q

What is projectile d/t?

A

obstruction

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8
Q

What color is pathologic?

A

green

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9
Q

What is bilious color d/t?

A

obstruction

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10
Q

What are the causes of non bilious vomit?

A

overfeeding
GER
GERD
pyloric stenosis

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11
Q

How does overfeeding cause non bilious vomit?

A

new parents think baby is crying b/c s/he is hungry

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12
Q

How many cal is recommended for babies?

A

100-120 kcal/kg/day

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13
Q

What is GER?

A

just spit up
NOT a pathological finding
usually d/t weak lower esophageal muscle

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14
Q

When is GER most common?

A

3-4 mo

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15
Q

GER-tx?

A

reassurance
sit up after feeds
change formula

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16
Q

GERD?

A

pathological changes take place

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17
Q

GERD-sx?

A

projectile vomit
fussy
wt loss

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18
Q

What is pyloric stenosis?

A

non bilious vomit BUT obstructive

the pylorus muscle becomes super big (hypertrophy) causing the stenosis to get narrow –> baby throws up

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19
Q

Pyloric stenosis - commonly seen when?

A

3-5 wks

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20
Q

Pyloric stenosis -cx?

A

maybe d/t macrolide that is used to treat chlamydia pneumonia

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21
Q

Color of pyloric stenosis vomit?

A

non bilious - coffee ground mix

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22
Q

Pyloric stenosis - PE?

A

b/c the pylorus muscle is big –> olive like mass felt on RUQ

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23
Q

Pyloric stenosis- labs?

A

b/c baby is throwing up all the time —> metabolic alkalosis (throwing up acid)

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24
Q

Pyloric stenosis - tx?

A

surgery

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25
Q

Pyloric stenosis - prognosis?

A

after surgery baby gets fat b/c it was not thriving before

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26
Q

What is a type of bilious vomit?

A

necrotizing enterocolitis
Midgut volvulus
Intussusception

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27
Q

What types of babies will you see necrotizing enterocolits?

A

SGA

short gestational age (complication d/t premature baby)

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28
Q

What is necrotizing enterocolitis?

A

inflammation of the intestinal wall

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29
Q

Necrotizing enterocolitis - labs?

A

KUB: dilated bowel and PNEUMATOSIS OF INTESTINE (gas cysts in wall)

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30
Q

Necrotizing etnerocolotis - tx?

A

surgery is required

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31
Q

What is Midgut volvulus?

A

bilious vomit
twisting of the intestine - Ladd’s bands narrows the mesenteric base causing a twist/malrotation of the small bowel –> small bowel becomes ischemic

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32
Q

Midgut volvulus - labs?

A

CT: corkscrew of the upper GI

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33
Q

Midgut volvulus- sx?

A

SUDDEN GI pain

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34
Q

Midgut volvus - onset of age?

A

any age

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35
Q

What is Intussusception?

A

the Si protrudes into the large intestine causing a “telescoping” of the intestines

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36
Q

Intussusception - onset of age?

A

<2yo

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37
Q

Intussusception - sx?

A

baby cries with legs curled up to chest

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38
Q

Intussusception - PE?

A

RUQ mass

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39
Q

What Gi has RUQ mass?

A

Intussusception

Midgut volvolus

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40
Q

What is a late finding of Intussusception?

A

RED CURRANT JELLY STOOL

41
Q

WHat is the CLASSIC sx of Intussusception?

A

vomit
RUQ mass
stomach pain

42
Q

How can you tell the difference between Midgut volvuls and Intussusception?

A

midgut: corkscrew finding
Intussusception: target sign which is telescoping

43
Q

Intussusception - tx?

A

first line: enema to push it out
second line: detelescoping via surgery
GOA: TO CATCH IT EARLY TO PREVENT SURGICAL REPAIR

44
Q

What is the main cause of Intussusception?

A

meckel’s diverticulum

45
Q

What is meckel’s diverticulum?

A

outpoutching of the small intestine

46
Q

Meckels diverticulum - sx?

A

PAINLESS BLEEDING of the rectal

47
Q

What are the rules of 2’s in meckels diverticulum?

A

2feet off the ileocecal valve
2in outpocketing
2yo

48
Q

What dz can cx bilious vomiting in premies?

A

NEC

49
Q

What dz can cause bilious vomiting in infants?

A

malrotation - midgut volvulus

Intussusception

50
Q

What ere the PE for appendix?

A 
Rosving sign
psoas sign
mcburneys' point
guarding
appy waddle
obturator sign
rebound tenderness
51
Q

What labs would you order to check for abdominal pain?

A 
CBC
glucose
ANA
CRP
BUN/Cr
LFT
lytes
UA
BC
pregnancy 
Stool
52
Q

What would you order for imaging?

A

US
CT
Xray
HIDA

53
Q

What defines diarrhea?

A

watery stools for more than 3x a day

54
Q

What is chronic diarrhea and acute diarrhea?

A

chronic: more than 2 wks

acute; less than 2 wks

55
Q

What are the types of diarrhea?

A 
MISO
Motility
Inflammatory
Secretory  
Osmotic
56
Q

What is motility diarrhea?

A

when the food passes through too fast and causes the body to NOT absorb anything

57
Q

What is inflammatory diarrhea?

A

diarrhea that is passed through has protein, blood, and mucus and the body is not able to absorb water and lytes

58
Q

What may causes inflammatory diarrhea?

A
  • EHEC
  • E. Coli – undercooked meat
  • Salmonella – Poultry
59
Q

What is secretoary?

A

when the water and lytes are excreted through the lumen

60
Q

What can cause secreatory diarrhea?

A

cholera
c diff
rotavirus
shigela

61
Q

What can cause osmotic diarrhea?

A

lactose intolerance

too much mannitol

62
Q

How to manage diarrhea?

A 
remove the agent that is causing the diarrhea 
OTC diarrhea does NOT help
rehydrate
abx AFTER finding out organism
give: high fiber and probiotics
63
Q

Why is important to find out the organism of the bug for diarrhea?

A

if it was E.coli (invasive) giving abx will put higher risk for HUS

64
Q

What is toddler’s diarrhea?

A

drinking too much juice!!
normal wt and growth
3+ passage of diarrhea during WAKING hrs

65
Q

What lab test should you do when baby has diarrhea?

A

SWEAT CL TEST - CF

66
Q

What is constipation?

A

3 small hard stools/wk

67
Q

What are the different types of constipation?

A

Functional
Hirschsprung dz
small left colon dz
celiac dz

68
Q

What is functional constipation?

A

baby experiences painful bowel movement so they voluntarily do NOT pass bowel –> constipate

69
Q

Functional constipation - PE?

A

anal sphincter dilates and the muscles lose tone

70
Q

Functional constipation - sx?

A

baby is not eating a lot fiber
baby has social stress
parents find soiled underpants
baby eats well

71
Q

Functional constipation - labs?

A

TSH for hypothyroidism

KUB for FOS

72
Q

Functional constipation - tx mild?

A

fiber
juice (maybe instigate diarrhea)
bowel training

73
Q

Functional constipation - tx severe?

A

enemas

NO MINERAL OILS

74
Q

What is Hirschsprung dz?

A

the colon gets really big d/t the nerve cells not being able to migrate to rectum and anus –> rectum and anus becomes super skinng

75
Q

Hirschsprung dz-PE?

A

ribbon like stool

not able to pass meconium during 24hrs of life

76
Q

Hirschsprung dz - tx?

A

surgical repair

77
Q

How to tell difference between Hirschsprung dz and Small left colon?

A

bx of the colon

78
Q

Hirschsprung dz - dx?

A

bx of then colon to find out if the nerve is developed

79
Q

Baby does not pass meconium w/24 hrs of life?

A

bx of colon - suspecting Hirschsprung dz

80
Q

Baby has pencil/ribbon like stools after 24 hrs of life?

A

suspect small left sx - do a barium enema

81
Q

Small left sx - tx?

A

surgery

82
Q

What is the bicarb if baby is dehydrated?

A

vomit: high bicarb
diarrhea: low bicarb

83
Q

What to check if baby is dehydrated?

A

tears

urine output

84
Q

Mild dehydration -tx?

A

oral fluids

85
Q

Moderate dehydration - tx?

A

IV bolus
no vomit/diarrhea - home
vomit/diarrhea - ER

86
Q

Severe dehydration - tx?

A

ER

87
Q

What is marasmus?

A

no calories, vitamins

88
Q

Marasmus - PE?

A

SKINNY
brittle hair/nails
hypothermia

89
Q

Kwashiorkor?

A

has enough calories but NO PROTEIN

90
Q

Kwashiorkor - PE?

A

edematous
hepatomegaly
poor wound healing

91
Q

Vita A deficiency?

A

blindness
brittle hair/nail
diarrhea
dry skin

92
Q

Vita D deficiency?

A

rickets

ALL BREAT FED BABIES NEED VITA D SUPPLEMENTS

93
Q

Vita E deficiency?

A

hypoflexia
peripheral: vision, neuropathy
hemolytic anemia

94
Q

Vita K deficiency?

A

bleeding disorders

95
Q

Thiamine deficiency?

A

alcoholics
beriberi
arrhythmias, neuropathies, muscle weakness

96
Q

Folate deficiency?

A

macro anemia

97
Q

Cobalamin deficiency?

A

pernicious anemia
macro anemia
neuropathies

98
Q

Vita C deficiency?

A

scurvy
SI dz
irritabilty, bleeding, bony abnormalities

99
Q

Zinc deficiency?

A

glossitis
photophobia
nail
acrodermatitis enteropathica

Pediatrics (12 decks)

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