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Gastroenterology Flashcards

0
Q

What are some radiographic findings of scurvy?

A 
White line of frankel
Wimberger ring
Tummerfeld zone of Lucent
Pelkan spur
Corner sign
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1
Q

What is the nutritional deficiency that causes “sugar baby” appearance?

A

Kwashiorkor

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2
Q

What nutritional deficiency can cause bitot spots of the cornea?

A

Vitamin A deficiency

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3
Q

Which vitamin d level in serum do you check for vitamin d deficiency?

A

25-OH D3 level is low

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4
Q

Which vitamin deficiency causes beri beri?

A

Thiamine B1

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5
Q

What are clinical manifestations of beri beri?

A 
Wernickes encephalopathy
Foot or wrist drop
Parasthesias
Ophthalmoplegia
Ataxia 
Confusion
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6
Q

Which vitamin deficiency is associated with cheilosis and sore tongue?

A

Riboflavin B2

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7
Q

What vitamin deficiency causes triad of dermatitis, dementia and diarrhea?

A

Pellagra - niacin B3 deficiency

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8
Q

What vitamin deficiency can cause acrodermatitis enteropathica and hypogeusia?

A

Zinc

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9
Q

What vitamin supplements are recommended for all vegan children?

A

Vitamin B12
Iron
Calcium
Zinc

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10
Q

What is Holliday segar formula for caloric intake?

A

100 kcal/kg for 1st 10 kg
50 kcal/kg for 2nd 10 kg
20 kcal/kg for rest of the weight

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11
Q

What is the best test for diagnosing chronic vomiting?

A

Endoscopy

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12
Q

What are 4 general contraindications to oral rehydration therapy in children with acute diarrhea?

A

Shock
Stool output > 10 ml/kg/hr
Ileus
Monosaccharide intolerance

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13
Q

What are common medications that cause pill induced esophagitis?

A 
NSAIDs
Tetracycline
Iron supplement
KCl
Aspirin
Doxycycline
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14
Q

What prenatal ultrasound finding can indicate the presence of a tracheoesophageal fistula?

A

Polyhydraminos

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15
Q

What will X-ray/KUB show if there is a distal tracheoesophageal fistula?

A

Dilated proximal esophagus with air dis tension of the entire GI tract

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16
Q

What condition often presents with dysphagia when solid foods are introduced to a child?

A

Esophageal stenosis

Web diaphragms

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17
Q

What syndrome is associated with achalasia in childhood, alacrima and adrenal insufficiency?

A

Allgrove (triple A) syndrome

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18
Q

At what age is spitting up in an infant abnormal?

A

Usually outgrown by 8 months old but some can take till 2 years old

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19
Q

What amount of rice cereal do you add to thicken formula for treatment of GERD?

A

1-2 tbsp per oz

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20
Q

What is main treatments for eosinophilic esophagitis?

A

Allergen avoidance
Amino acid based formula
Swallowed topical steroids

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21
Q

What type of necrosis does ingestion of an alkaline agent cause?

A

Liquefactive

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22
Q

Coins lie “face forward” on X-ray if ingested foreign body is in the trachea or esophagus?

A

Esophagus

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23
Q

What genetic conditions are associated with spontaneous esophageal perforation?

A

Ehlers-Danlos

marfan

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24
What type of contrast can you use to check for esophageal perforation?
Water soluble
25
What condition can lose haustral margins of the colon?
IBD
26
What condition has giant cells with granuloma on biopsy? Pathgnomonic
Crohn's disease
27
What are risk factors supposed to be associated with pyloric stenosis?
1st born male infant Low SES Blood type B/O Caucasians
28
What is a lactulose breath test used to diagnose?
Bacterial overgrowth like in blind loop syndrome or bypass surgery
29
What skin condition is associated with complete pyloric atresia?
Junctional epidermolysis bullosa
30
Which intestinal tumor is associated with H. Pylori infection?
MALT
31
What is menetrier disease?
Protein losing gastropathy due to CMV infection
32
When do you treat H. Pylori infection in children?
If PUD or MALT is present not just colonization
33
What endocrine disorder are gastrinomas associated with?
MEN-1
34
What type of intestinal atresia is associated with other congenital anomalies?
Duodenal atresia
35
What is the rule of 2s for Meckels diverticulum?
``` 2% of population Within 2 feet of ileocecal junction 2 inches in length 2 cm in diameter 2:1 male to female ratio Usually presents with in 2 years of age ```
36
What is the most common site of an intestinal duplication?
Ileum
37
What rise in hydrogen in a hydrogen breath test is positive for lactose deficiency?
Rise of 10-20 ppm in expired hydrogen
38
How do you treat sucrase-isomaltase deficiency?
Supplement with sacrosidase enzyme
39
Which congenital intestinal transport defect is associated with a pellagra like illness?
Hartnup disease -unable to transport amino acids
40
Which molecule can not be transported across the intestinal membrane in blue diaper syndrome?
Tryptophan
41
What molecule cannot be transported across intestinal membrane in Lowe syndrome?
Lysine and arginine
42
How does abetaproteinemia present?
FTT Steatorrhea Fat soluble vitamin deficiency Low serum cholesterol
43
What defect causes abetaproteinemia?
Defect in ApoB protein
44
What electrolyte transporter defects can result in a congenital electrolyte diarrhea?
Chloride Sodium Zinc
45
What HLA types are associated with celiac disease?
DQ2 | DQ8
46
What is the skin condition that presents as itchy bullous lesions on extensor surfaces with or without GI symptoms?
Dermatitis herpetiformis
47
What is the most common cause of congenital diarrhea?
Congenital microvillus inclusion disease?
48
What area is tropical sprue endemic?
South America, Central America, Caribbean and Asia
49
What is the cause of whipple disease?
Tropheryma whippelii
50
What condition is associated with elevated anti saccharomyces antibodies?
Crohn disease
51
Which IBD (UC or Crohns) is associated with a positive p-ANCA?
Ulcerative colitis
52
What condition is associated with thumbprinting sign on KUB?
Ulcerative colitis
53
How does one manage pouchitis or colonization of the remaining mucosa lined pouch after pull through surgery for UC?
Metronidazole
54
When should screening colonoscopies be done for UC patients?
Biannually starting 7 years of having the disease
55
What is the most common site involved in Crohn's disease?
Terminal ileum
56
Which IBD is associated with the NOD2 gene?
Crohn's disease
57
What 2 antibiotics are frequently used to treat crohn disease associated fistulas and perianal disease?
Metronidazole | Ciprofloxacin
58
Which IBD responds well to bowel rest?
Crohns
59
When do you start doing screening colonoscopies on patients with Crohns?
After 10 years of disease start annually
60
What is Rovsing sign?
Abdominal palpating away from RLQ causes pain at McBurney's point
61
What modalities can be used to evaluate for appendicitis?
Ultrasound CT abdomen Barium enema
62
What 3 conditions cause chronic appendiceal pain?
Chronic appendicitis Recurrent appendicitis Appendical pain
63
What is classic presentation of a juvenile polyp?
4-6 year old child | Intermittent painless bleeding with bowel movements
64
What is the name of the condition with achalasia, alacrima, and adrenal insufficiency?
Algrove syndrome
65
What condition causes a Harrison grove (line under the ribs from retracted rib cage)?
Rickets
66
What is a juvenile polyp?
Inflammatory polyp usually pedinculated hamartoma that look like a raspberry on a stock
67
How many juvenile polyps do you need to monitor with serial colonoscopies?
5 or more
68
What syndrome presents with GI hamartomatous polyps and mucocutaneous hyperpigmentation?
Peutz jeghers syndrome
69
What types of cancer are associated with Peutz Jeghers syndrome?
``` Colon Breast Cervix Ovary Testicle Pancreas ```
70
When do you start colon cancer screening on Peutz jeghers syndrome?
10 years old
71
What is PTEN-MATCHS syndrome?
``` Microcephaly Autosomal Dominant Thyroid disease Cancer Hamartoma Skin abnormalities ```
72
What syndrome is characterized by macrocephaly, pigmented penile lesions, hamartomatous intestinal polyps?
Ruvalcaba Myhre Smith syndrome
73
What genetic syndromes present with multiple hamartomas?
``` Peutz jeghers syndrome PTEN-MATCHS Ruvalcaba Myhre smith syndrome Crowen syndrome Bannayan zonana syndrome Bannayan Riley ruvalcaba syndrome Proteus syndrome ```
74
What types of timors are seen with Gardner syndrome?
Colon cancer Soft tissue tumors Osteomas
75
When do you start colon cancer screening in Gardner syndrome?
Start age 10-12 years old, annually
76
What is the most common malignant toe of the small intestine in childhood?
Lymphoma - usually Burkitts
77
What is the most common location of carcinoid tumor?
Appendix
78
What genetic syndrome is associated with omphalocele?
Beckwith-Wiedemamn
79
What is VATER syndrome?
``` Vertebrae Anus Trachea Esophagus Radius and Renal anomalies ```
80
What is VACTERL syndrome?
``` Vertebrae Anus Cardiac anomalies TracheoEsohageal fistula Renal anomalies Limb anomalies ```
81
What is the most common anorextal defect in male infants?
Rectourethral fistula
82
What is the most common anorectal defect in female infants?
Vestibular fistula
83
What genetic syndrome has a higher incidence of imperforate anus?
Down syndrome
84
What are the most common causes of rectal prolapse?
1. Constipation 2. Diarrhea 3. Cystic fibrosis
85
What genetic syndromes have higher risk for Hirschsprung disease?
Down syndrome Smith-Lemli-Opitz syndrome Waardenburg syndrome
86
What genes cause Hirschsprung's disease?
Hox and Sox genes
87
What is the most accurate tool for diagnosis of Hirschprungs?
Suction rectal biopsy
88
What are two conditions that cause pseudo-Hirschprungs?
Hypoganglionosis | Intestinal neuronal dysplasia
89
What disorder is characterized by exocrine pancreatic insufficiency, neutropenia, bifid thumbs, short stature?
Shwachman-Diamond syndrome
90
What is Cullen sign?
Bluish discoloration around the bilious due to hemorrhagic pancreatitis
91
What is Grey Turner sign?
Bluish discoloration of the flanks due to hemorrhagic pancreatitis
92
What is the most common group affected by choleduchal cysts?
Asian females
93
What genetic condition is associated with congenital hepatic fibrosis?
ARPCKD
94
What condition is associated with congenital dilation of intrahepatic ducts and congenital hepatic fibrosis?
Caroli Disease
95
What genetic condition is associated with chile stasis, butterfly vertebrae, peripheral pulmonary artery stenosis, abnormal radius/ulna, posterior embryotoxon?
Alagille syndrome
96
What gene mutation causes Alagille syndrome?
JAG1
97
What are Alagille syndrome children particularly prone to despite normal coags?
Intracranial bleeding
98
What is the only hepatitis virus which is composed of DNA?
Hepatitis B
99
What level do you check to see if you are in the "window" period of hepatitis B infection?
HBc IgM level
100
What rheumatologic disorder is strongly associated with hepatitis B infection?
Polyarteritis nodosa (PAN)
101
What is a possible toxicity of bismuth?
Salicylate toxicity
102
What is typical stool pH in viral gastroenteritis?
< 6
103
What is portal venous pressure which defines portal hypertension?
> 5 mmHg | Or hepatic to portal gradient > 10 mmgHg
104
What are common pediatric diseases which can lead to portal vein thrombosis?
Umbilical vein catheterization Omphalitis Severe dehydration blunt abdominal trauma
105
What percent of a normal intake should you start if you are worried about refereeing syndrome in a malnourished child?
50%
106
What is the cross reactivity of peanuts and tree nuts?
30-40%
107
What mineral does soy/rice milk hinder absorption?
Zinc

Pediatrics (9 decks)

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