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Pediatrics > Gastroenterology > Flashcards

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
Q

What type of contrast can you use to check for esophageal perforation?

A

Water soluble

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25
Q

What condition can lose haustral margins of the colon?

A

IBD

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26
Q

What condition has giant cells with granuloma on biopsy? Pathgnomonic

A

Crohn’s disease

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27
Q

What are risk factors supposed to be associated with pyloric stenosis?

A

1st born male infant
Low SES
Blood type B/O
Caucasians

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28
Q

What is a lactulose breath test used to diagnose?

A

Bacterial overgrowth like in blind loop syndrome or bypass surgery

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29
Q

What skin condition is associated with complete pyloric atresia?

A

Junctional epidermolysis bullosa

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30
Q

Which intestinal tumor is associated with H. Pylori infection?

A

MALT

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31
Q

What is menetrier disease?

A

Protein losing gastropathy due to CMV infection

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32
Q

When do you treat H. Pylori infection in children?

A

If PUD or MALT is present not just colonization

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33
Q

What endocrine disorder are gastrinomas associated with?

A

MEN-1

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34
Q

What type of intestinal atresia is associated with other congenital anomalies?

A

Duodenal atresia

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35
Q

What is the rule of 2s for Meckels diverticulum?

A 
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
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36
Q

What is the most common site of an intestinal duplication?

A

Ileum

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37
Q

What rise in hydrogen in a hydrogen breath test is positive for lactose deficiency?

A

Rise of 10-20 ppm in expired hydrogen

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38
Q

How do you treat sucrase-isomaltase deficiency?

A

Supplement with sacrosidase enzyme

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39
Q

Which congenital intestinal transport defect is associated with a pellagra like illness?

A

Hartnup disease -unable to transport amino acids

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40
Q

Which molecule can not be transported across the intestinal membrane in blue diaper syndrome?

A

Tryptophan

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41
Q

What molecule cannot be transported across intestinal membrane in Lowe syndrome?

A

Lysine and arginine

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42
Q

How does abetaproteinemia present?

A

FTT
Steatorrhea
Fat soluble vitamin deficiency
Low serum cholesterol

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43
Q

What defect causes abetaproteinemia?

A

Defect in ApoB protein

44
Q

What electrolyte transporter defects can result in a congenital electrolyte diarrhea?

A

Chloride
Sodium
Zinc

45
Q

What HLA types are associated with celiac disease?

A

DQ2

DQ8

46
Q

What is the skin condition that presents as itchy bullous lesions on extensor surfaces with or without GI symptoms?

A

Dermatitis herpetiformis

47
Q

What is the most common cause of congenital diarrhea?

A

Congenital microvillus inclusion disease?

48
Q

What area is tropical sprue endemic?

A

South America, Central America, Caribbean and Asia

49
Q

What is the cause of whipple disease?

A

Tropheryma whippelii

50
Q

What condition is associated with elevated anti saccharomyces antibodies?

A

Crohn disease

51
Q

Which IBD (UC or Crohns) is associated with a positive p-ANCA?

A

Ulcerative colitis

52
Q

What condition is associated with thumbprinting sign on KUB?

A

Ulcerative colitis

53
Q

How does one manage pouchitis or colonization of the remaining mucosa lined pouch after pull through surgery for UC?

A

Metronidazole

54
Q

When should screening colonoscopies be done for UC patients?

A

Biannually starting 7 years of having the disease

55
Q

What is the most common site involved in Crohn’s disease?

A

Terminal ileum

56
Q

Which IBD is associated with the NOD2 gene?

A

Crohn’s disease

57
Q

What 2 antibiotics are frequently used to treat crohn disease associated fistulas and perianal disease?

A

Metronidazole

Ciprofloxacin

58
Q

Which IBD responds well to bowel rest?

A

Crohns

59
Q

When do you start doing screening colonoscopies on patients with Crohns?

A

After 10 years of disease start annually

60
Q

What is Rovsing sign?

A

Abdominal palpating away from RLQ causes pain at McBurney’s point

61
Q

What modalities can be used to evaluate for appendicitis?

A

Ultrasound
CT abdomen
Barium enema

62
Q

What 3 conditions cause chronic appendiceal pain?

A

Chronic appendicitis
Recurrent appendicitis
Appendical pain

63
Q

What is classic presentation of a juvenile polyp?

A

4-6 year old child

Intermittent painless bleeding with bowel movements

64
Q

What is the name of the condition with achalasia, alacrima, and adrenal insufficiency?

A

Algrove syndrome

65
Q

What condition causes a Harrison grove (line under the ribs from retracted rib cage)?

A

Rickets

66
Q

What is a juvenile polyp?

A

Inflammatory polyp usually pedinculated hamartoma that look like a raspberry on a stock

67
Q

How many juvenile polyps do you need to monitor with serial colonoscopies?

A

5 or more

68
Q

What syndrome presents with GI hamartomatous polyps and mucocutaneous hyperpigmentation?

A

Peutz jeghers syndrome

69
Q

What types of cancer are associated with Peutz Jeghers syndrome?

A 
Colon
Breast
Cervix
Ovary
Testicle 
Pancreas
70
Q

When do you start colon cancer screening on Peutz jeghers syndrome?

A

10 years old

71
Q

What is PTEN-MATCHS syndrome?

A 
Microcephaly
Autosomal Dominant
Thyroid disease
Cancer
Hamartoma 
Skin abnormalities
72
Q

What syndrome is characterized by macrocephaly, pigmented penile lesions, hamartomatous intestinal polyps?

A

Ruvalcaba Myhre Smith syndrome

73
Q

What genetic syndromes present with multiple hamartomas?

A 
Peutz jeghers syndrome 
PTEN-MATCHS
Ruvalcaba Myhre smith syndrome
Crowen syndrome
Bannayan zonana syndrome
Bannayan Riley ruvalcaba syndrome
Proteus syndrome
74
Q

What types of timors are seen with Gardner syndrome?

A

Colon cancer
Soft tissue tumors
Osteomas

75
Q

When do you start colon cancer screening in Gardner syndrome?

A

Start age 10-12 years old, annually

76
Q

What is the most common malignant toe of the small intestine in childhood?

A

Lymphoma - usually Burkitts

77
Q

What is the most common location of carcinoid tumor?

A

Appendix

78
Q

What genetic syndrome is associated with omphalocele?

A

Beckwith-Wiedemamn

79
Q

What is VATER syndrome?

A 
Vertebrae
Anus
Trachea
Esophagus
Radius and Renal anomalies
80
Q

What is VACTERL syndrome?

A 
Vertebrae
Anus
Cardiac anomalies
TracheoEsohageal fistula
Renal anomalies
Limb anomalies
81
Q

What is the most common anorextal defect in male infants?

A

Rectourethral fistula

82
Q

What is the most common anorectal defect in female infants?

A

Vestibular fistula

83
Q

What genetic syndrome has a higher incidence of imperforate anus?

A

Down syndrome

84
Q

What are the most common causes of rectal prolapse?

A
  1. Constipation
  2. Diarrhea
  3. Cystic fibrosis
85
Q

What genetic syndromes have higher risk for Hirschsprung disease?

A

Down syndrome
Smith-Lemli-Opitz syndrome
Waardenburg syndrome

86
Q

What genes cause Hirschsprung’s disease?

A

Hox and Sox genes

87
Q

What is the most accurate tool for diagnosis of Hirschprungs?

A

Suction rectal biopsy

88
Q

What are two conditions that cause pseudo-Hirschprungs?

A

Hypoganglionosis

Intestinal neuronal dysplasia

89
Q

What disorder is characterized by exocrine pancreatic insufficiency, neutropenia, bifid thumbs, short stature?

A

Shwachman-Diamond syndrome

90
Q

What is Cullen sign?

A

Bluish discoloration around the bilious due to hemorrhagic pancreatitis

91
Q

What is Grey Turner sign?

A

Bluish discoloration of the flanks due to hemorrhagic pancreatitis

92
Q

What is the most common group affected by choleduchal cysts?

A

Asian females

93
Q

What genetic condition is associated with congenital hepatic fibrosis?

A

ARPCKD

94
Q

What condition is associated with congenital dilation of intrahepatic ducts and congenital hepatic fibrosis?

A

Caroli Disease

95
Q

What genetic condition is associated with chile stasis, butterfly vertebrae, peripheral pulmonary artery stenosis, abnormal radius/ulna, posterior embryotoxon?

A

Alagille syndrome

96
Q

What gene mutation causes Alagille syndrome?

A

JAG1

97
Q

What are Alagille syndrome children particularly prone to despite normal coags?

A

Intracranial bleeding

98
Q

What is the only hepatitis virus which is composed of DNA?

A

Hepatitis B

99
Q

What level do you check to see if you are in the “window” period of hepatitis B infection?

A

HBc IgM level

100
Q

What rheumatologic disorder is strongly associated with hepatitis B infection?

A

Polyarteritis nodosa (PAN)

101
Q

What is a possible toxicity of bismuth?

A

Salicylate toxicity

102
Q

What is typical stool pH in viral gastroenteritis?

A

< 6

103
Q

What is portal venous pressure which defines portal hypertension?

A

> 5 mmHg

Or hepatic to portal gradient > 10 mmgHg

104
Q

What are common pediatric diseases which can lead to portal vein thrombosis?

A

Umbilical vein catheterization
Omphalitis
Severe dehydration
blunt abdominal trauma

105
Q

What percent of a normal intake should you start if you are worried about refereeing syndrome in a malnourished child?

A

50%

106
Q

What is the cross reactivity of peanuts and tree nuts?

A

30-40%

107
Q

What mineral does soy/rice milk hinder absorption?

A

Zinc

Pediatrics (9 decks)

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