Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Peds Rotation > Gastroenterology đŸ§» > Flashcards

Gastroenterology đŸ§» Flashcards

1
Q

Name some diarrhea red flags

A

Fever

Blood in stool

Dehydration

Leukocytosis

Persistent symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the big deal if a child holds their poop in

A

Stool may become impacted, and then encopresis may occur (poop builds up until it leaks out involuntarily)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 2 main types of inflammatory bowel disease?

A

Crohn

Ulcerative colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most common congenital anomaly of the GI tract?

A

Meckel’s diverticulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you treat constipation?

A

Fluids

Gradual increase in fiber

Juice for infants

If encopresis, relieve impact ion if present

Constipation meds miralax, lactulose, enemas, suppositories, etc

Counseling and positive reinforcement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When is diarrhea considered “chronic”

A

If it goes on for more than 1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the fiber recommendation for a children under 2?

A

5g/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes damage when someone has a meckel’s diverticulum?

A

Gastric acid is produced there and causes damage and bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common cause of infectious diarrhea?

A

VIRAL ****

(Norovirus, rotavirus, adenovirus, calcivirus)****

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which imaging study is diagnostic AND therapeutic for intussusception?

A

Hydrostatic/pneumatic enema

Unfolds telescoping 90% of the time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the first line treatment for GERD?

A

Lifestyle modifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you diagnose a Meckel’s diverticulum?

A

Technetium-99 scan (Meckel’s scan)**

Nuclear medicine scan identifies gastric mucosa in the places it’s NOT suppsed to be!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the clinical presentation of appendicitis?

A

Anorexia

Migrating abdominal pain (belly button to RLQ)

Pain increases with movement

Vomiting

Fever

Peritoneal signs- guarding, rebound tenderness, rovsing, obturator, iliopsoas signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What will you see on ultrasound of a baby with pyloric stenosis?

A

Elongation and thickening of the pylorus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How old are babies that get infantile hypertrophic pyloric stenosis?

A

3-6 weeks old

VERY YOUNG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the clinical presentations of meckels diverticulum?

A

PAINLESS rectal bleeding ***

Obstruction (volvulus or intussusception)

Diverticulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should you be thinking if the baby does not pass meconium

A

Bowel obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the RED FLAGS for a patient with constipation?

A

Weight loss/ FTT

Anorexia

Fever

Hematochezia

Vomiting

History of delayed meconium passage

Acute onset

Failure to respond to conservative measures

(This was in red)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Who is more likely to be affected by Hirschsprung disease?

A

Males

Down syndrome pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where do you need to start with imaging if you suspect midgut malrotation?

A

Abdominal X-Ray -rule out bowel perforation

If not perforated, then you’re good to go ahead and get an upper GI contrast study - gold standard for mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is another name for Hirschsprung Disease?

A

Congenital Aganglionic Megacolon*******

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What condition do “unhappy spitters” have?

A

GERD

Happy spitters have GER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Is reflux in babies common?

A

Yes common in infants 6 months and less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do you diagnose Hirschsprung disease?

A

Contrast enema

Rectal biopsy- GOLD STANDARD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What will you see on an abdominal x ray if the baby has intestinal atresia in the jejunoileal/colonic areas

A

Dilated loops of bowel with air-fluid levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What kind of a diet would cause a kid to develop functional constipation’/

A

No fiber

Too much dairy

Not enough water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Can congenital intestinal atresia be detected on ultrasound before the baby is born?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the initial test of choice when you suspect intestinal intussusception ?

A

Abdominal ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are some of the complications of infantile hypertrophic pyloric stenosis that may occur as the disease progresses

A

FTT

Dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the classic clinical presentation of midgut malrotation +/- volvulus

A

Vomiting- bilious green or fluorescent yellow

Abdominal pain

Hemodynamic instability

Hematochezia (sign of bowel ischemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How does smoking affect the risk for Crohn disease and UC?

A

2x increase risk for Crohn

50% decrease in risk of UC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What happens if your patient has intussusception and the hydrostatic enema didnt do anything

A

Must intervene surgically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Would you expect growth failure and delayed puberty to be signs of an inflammatory bowel disease?

A

Why yes you would

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What will you see on the upper GI contrast study if the patient has midgut malrotation?

A

Corkscrew appearance of duodenum**

Duodenal obstruction

Displacement of the duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the rule of 2’s regarding Meckel’s diverticulum?

A

2% of the population

2:1 M:F ratio

2% develop complications (usually before age 2)

2 feet from the ileocecal valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is a 2nd test you can order to diagnose pyloric stenosis if the ultrasound was non-diagnostic?

A

Upper GI Barium contrast study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are you thinking:
-bile stained vomiting in first 48 hrs of life

  • Abdominal distention
  • failure to pass meconium
A

Congenital intestinal atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What will you find on physical exam on a baby with infantile hypertrophic pyloric stenosis

A

An “Olive like” mass in RUQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the FIRST line treatment for relieving a fecal impaction for a constipated kid with encopresis?

A

Polyethylene glycol (Miralax)

**THIS HAD A BLUE STAR*****

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What pat of the GI tract is affected by Crohn disease?

A

TRANSMURAL inflammation from your mouth to your asshole

The ~entire!~ GI tract may be affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are some possible causes of chronic diarrhea?

A

Celiac disease

Allergies

Malabsorption (ex Cystic fibrosis)

Toddlers diarrhea (fruit juice)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What kind of vomiting will a baby with infantile hypertrophic pyloric stenosis have?

A

Nonbilious (obstruction is before biliary grr)**

Projectile vomiting**

RIGHT AFTER eating**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What will you see on an abdominal x ray if a baby has intestinal atresia in the ~duodenum~?

A

Double Bubble Sign **

Due to gas and dilation in both stomach and duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

You’re working in the ER and a 12 year old rolls in and you take one look at him and say, “slam dunk its appendicitis”

Can you send him to surgery without even doing any imaging?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Do we do surgery for kids with IBD

A

Yes for refractory cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

When are kids most likely to start refusing to poop and causing themselves to get functional constipation?

A

Intro to solid foods or cows milk

Toilet training

Starting kindergarten

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the surgical treatment for midgut malrotation?

A

Ladd procedure

Bowel is untwisted and repositioned in abdomen which creates “adhesions” that hold the bowel in place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the most common cause of intestinal emergency in kids under 2

A

Intussusception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What should you be worried about if a baby is irritable, has dystonic neck posturing, refusing feeding, FTT, respiratory complications and may have occult blood in stool?

A

GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are some diarrhea red flags? (This might be more than something viral)

A

Fever

Severe abdominal pain

Blood in stool

Recent antibiotics

Persistent symptoms

Dehydration

Leukocytosis

Growth and development affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Who are the “hungry vomiters”?

A

Babies with infantile hypertrophic pyloric stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

How do you diagnose celiac disease?

A

IgA antibodies to tissue transglutaminase

Small bowel biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Leakage of retained stool seen commonly in kids with chronic constipation=?

A

Encopresis

54
Q

What is the definition of diarrhea?

A

> 3 loose watery stools/day

đŸ§»đŸšœđŸ’§

55
Q

What is the most common pediatric surgical emergency?

A

Appendicitis

56
Q

What would you see if you looked at the intestines of someone affected by Crohn disease?

A

Cobblestone appearance***

Skip lesions*

Perianal fissures/fistulas

57
Q

What are some of the medications that may be used for treating inflammatory bowel diseases?

A

Aminosalicylates: 5-ASA (Sulfasalazine, Mesalamine)

Immunomodulating agents (Mercaptopurine, azathioprine, methotrexate) or Biologics (Remicade, Inflixamad)

Steroids- especially in acute flare

+/- antibiotics

58
Q

Who is most likely to get infantile hypertrophic pyloric stenosis?

Males/females

First born/second born

A

First born males

59
Q

Is constipation a common problem for kids

A

Yes, it affects 30%of children

60
Q

What kind of tissue is in meckel’s diverticulum?

A

Intestinal epithelium

Gastric epithelium (WTF wait what you mean you have stomach tissue in your small intestine that is producing gastric acid in a totally inappropriate spot?!?!?!?!)

61
Q

What is the treatment for a meckels diverticulum?

A

Surgical resection (excellent prognosis)

62
Q

What are some possible causes for organic constipation (aka the kid isn’t holding it in on his own and its not his diet)

A

Anal stenosis

Hypothyroidism

Celiac disease

Hirschsprungs

HYPERkalemia

Cystic fibrosis

63
Q

What does encopresis mean?

A

SEEPING STOOL*****

64
Q

What will you find on physical exam of a pt with Hirschsprung disease?

A

Abdominal distention

TIGHT ANAL SPHINCTER*****

Postive squirt sign 👉

65
Q

Continuous, red, friability in rectum and large colon=

A

Ulcerative colitis

66
Q

What age group is most likely top get appendicitis?

A

10-20 yr olds

RARE before 5

67
Q

Is it possible for inflammatory bowel diseases like Crohn and UC to affect places other than the intestines?

A

Yes.

Mouth, skin, joints, liver, eye, etc

68
Q

TRANSMURAL inflammation from mouth to anus, skip lesions=

A

Crohn disease

69
Q

Embryonic remnant of the vitelline duct that can cause GI bleed=

A

Meckel’s diverticulum

70
Q

When are most cases of Hirschsprung disease discovered?

A

Before 6 weeks of age

71
Q

What is the prognosis for GERD?

A

Usually goes away in 9-12 months because the baby is sitting up when its fed

72
Q

What kind of vomiting will a bay with congenital intestinal atresia have?

A

Bile-stained within the first 48 hours of life

73
Q

Is the classic triad of intestinal intussusception seen in every patient?

A

No, less than 15% of patients with intussusception have the triad

74
Q

Why is bilious vomit an emergency?

A

It indicates an OBSTRUCTION

Malrotation, or congenital intestinal atresia

75
Q

Which one is an emergency:
Bloody vomit

Bilious vomit

A

Bilious

76
Q

What can cause midgut malrotation?

A

Incomplete rotation of the midget during embryonic development

77
Q

What the HELL is Hirschsprung disease?

A

There are NO ganglion cells in the colon which causes:

Spasm and abnormal motility

Colon does not relax= obstruction

Rectum and sigmoid colon are constricted

Areas behind the constriction get swollen

78
Q

What are skip lesions and what type of IBD are they associated with?

A

Areas in the intestine that look totally NORMAL (not really a lesion at all)

Associated with Crohn

79
Q

What kinds of lifestyle mods may be helpful for GERD?

A

UPRIGHT positioning for 30 min after feeding (sitting STRAIGHT up, not in a bouncer or whatever)

Hypoallergenic diet

Don’t overfeed

Avoid cigarette smoke

Thickened milk with cereal

80
Q

What will you see on contrast enema in Hirschsprung disease?

A

A “transition zone” where the narrowed aganglionic segment dilated to the proximal colon

81
Q

What will you see on rectal biopsy of Hirschsprung disease?

A

Absence of ganglion cells

82
Q

What causes the bleeding when someone has a meckels diverticulum?

A

Mucosal ulceration

83
Q

How do you manage congenital intestinal atresia?

A

Withhold feeding

Antibiotics

Surgery

84
Q

Are routine stool cultures recommended for most cases of diarrhea?

A

NO *****

85
Q

How do you treat acute diarrhea?

A

HDYRATION ALWAYS

Antibiotics sometimes

Anti-motility agents rarely

86
Q

What the F is a squirt sign?

A

If a finger is inserted into the rectum of a pt with hirschsprungs, the obstruction is relieved and there is an explosive release of gas and stool when the finger is removed đŸ„œ

87
Q

Periumbiuliucal pain, +rovsings, obturator, Psoas, McBurney’s point tenderness =

A

Appendicitis

88
Q

What is the recommended fiber intake for kids over 2?

A

(Childs age) + 5-10g

So a 10 year old should be getting 15-20g of fiber/day

89
Q

What is the classic presentation of Hirschsprung disease?

A

Newborn failing to pass meconium in first 48 hours of life*****

Bilious vomiting

Abdominal distention

90
Q

How do older children present with Hirschsprung disease?

A

Chronic constipation

FTT

(The later the diagnosis, the less severe the disease)

91
Q

One or more segments of bowel may be absent or obstructed at birth=?

A

Congenital intestinal atresia

92
Q

Is the treatment of inflammatory bowel diseases like crohn and UC a “one size fits all” approach?

A

NO
“Choice of treatment varies based on the severity of disease”

This was written twice in blue

93
Q

Which part of the bowel is most commonly affected by congenital intestinal atresia?

A

Duodenum

94
Q

What will you see on an UGI Barium contrast study in a baby with pyloric stenosis

A

“String sign”

Which is the narrowed lumen of the pylorus

95
Q

Should we give kids with diarrhea Imodium?

A

Not recommended

96
Q

What would you expect to see if you looked at the rectum and colon of someone with UC?

A

CONTINOUS (no skip lesions) edema, erythema, friability, and ulceration

97
Q

What are the thoughts on giving antibiotics to well-appearing children who have acute bloody diarrhea?

A

Should NOT be used unless a specific pathogen has been isolated (don’t want to induce HUS)

98
Q

What part of the GI tract is affected by ulcerative colitis?

A

Rectum and large colon

Mucosal layer ONLY

(Inflammation STARTS at the rectum and moves proximally into the colon)

99
Q

What is the gold standard test to detect midgut malrotation

A

Uppper GI contrast study

100
Q

What kids of findings suggest that constipation is from an organic cause and not functional?

A

Failure to pass meconium

FTT

Abdominal distention

Lumbosacral problems

Neurological abnormalities

Anteriorly placed anus ?

Occult blood in stool

101
Q

What is the DEFINITIVE MANAGEMENT of pyloric stenosis?

A

Surgery- “pyloromyotomy”

102
Q

What are you supposed to feed a baby that is allergic to milk or soy?

A

A hydrolyzed or free amino acid based formula (Ex: Nutramigen)

103
Q

Why don’t we pump kids with IBD full of steroids

A

Concern for bone density, growth and development

104
Q

What is the most common cause of a “lead point” that causes intestinal intussusception

A

Meckels diverticulum

105
Q

What is congenital intestinal atresia?

A

One or more segments of bowel are absent or obstructed at birth

106
Q

There is an association between infantile hypertrophic pyloric stenosis and ______________

A

Macrolide antibiotics during the first few weeks of life

Azithromycin, erythromycin, clarithromycin in case you forgot

107
Q

Which is bad:

GER or GERD

A

GERD is bad

GER is normal happy babies spitting up

108
Q

6 month old with abdominal pain and currant jelly stools=

A

Intussusception

109
Q

What will you see on ultrasound if patient has intussusception?

A

Target Sign

Coiled Spring

110
Q

What is the cause of 95% of pediatric constipation?

A

Functional constipation (psychological or diet reasons)

111
Q

How do you treat Hirschsprung disease?

A

Surgical resection of the aganglionic segment of colon.

Overall a good prognosis

112
Q

Abnormal position of the intestines in the abdomen that increase the risk of volvulus

A

Midgut malrotation

113
Q

What are some possible signs and symptoms that a kid might have celiac disease, other than diarrhea?

A

FTT*

Anemia

Foul smelling stools

114
Q

What is the classic triad of intestinal intussusception?

A

Abdominal pain

Abdominal mass (sausage shaped)

Currant jelly stools (blood + mucus)

****this was red and had a blue star

115
Q

What is a major risk of a malrotation?

A

Volvulus- where the small bowel twists around the superior mesenteric artery= HUGE RISK of small bowel ischemia!!!

EMERGENCY!!!!***

116
Q

What is this:

“Vitelline duct (embryonic remnant) leads to formation of a congenital outpouching of the small intestine”

A

Meckel’s diverticulum

117
Q

After surgery for midgut malrotation, is recurrence common?

A

No

118
Q

Which rotavirus vaccine was taken off the market due to a 22x risk of intussusception

A

Rotashield

🛡

119
Q

What kinds of things in a kid’s diet might cause diarrhea?

A

Fruit juice- Functional “Toddler’s” diarrhea

Milk/soy enteropathy (allergy)

120
Q

What kinds of medications are used for GERD in kids who don’t get better with lifestyle mods?

A

PPI (Omeprazole)

H2 blocker (Ranitidine)

121
Q

Congenital aganglionic megacolon, rectal biopsy is the gold standard=

A

Hirschsprung

122
Q

What is this:

“Immune mediated inflammatory disease of the small intestine caused by gluten sensitivity”

A

Celiac disease

123
Q

What should you do if your patient has GER?

A

Nothing, because it is a normal physiologic process that declines with age without ANY complications or consequences

124
Q

If you see a test question that has a 1st born 3 week old baby boy, who is always hungry, and projectile vomits immediately after eating, what is the answer

A

Infantile hypertrophic pyloric stenosis

125
Q

Intestinal atresia is more common in patients with these two conditions:

A

Cystic fibrosis

Down syndrome

126
Q

What causes intestinal intussusception?

A

Idiopathic 75% of the time

“Lead point” 25% - lesion/variation in the intestine gets dragged by peristalsis into a distal segment.

127
Q

What is the TEST OF CHOICE for diagnosing infantile hypertrophic pyloric stenosis?

A

Ultrasound

128
Q

How do you diagnose crohn disease

A

Colonoscopy*

129
Q

5 week old, hungry, with projectile vomiting=

A

Pyloric stenosis

130
Q

Is there an increased risk of colon cancer if you have UC?

A

Yes

131
Q

Whyyyyyyyyy do you need to evaluate a child with constipatin

A

You need to rule out an anatomic or biochemical cause

Peds Rotation (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions