Gastroenterology Flashcards
What does vomiting of undigested food indicate?
Achalasia
Delayed gastric emptying
Rumination
What does bilious vomiting suggest?
GI obstruction beyond the duodenum (e.g.,malrotation)
What is cyclic vomiting?
Cycles of vomiting
Strong FHx migraines
Median age onset ~ 5 years
Slight femalepredominance
The finding of “currant jelly” stool suggests what possible diagnosis?
Intussusception
True or false? Abdominal pain that is nonorganic in nature presents with growth and development problems in the child.
FALSE
What is the most common cause of abdominal pain in children?
Functional abdominal pain
What clues are useful in diagnosing functional abdominal pain?
Pain periumbilical
Growth is normal and appetite is not affected
Symptoms get better on weekends and during vacations
Worse in the morning before school or in the evening before bed
Social stressors - recent divorce or trouble at school
What clues suggest an organic cause for abdominal pain?
Vomiting Weight loss Hematochezia Diarrhoea Night time awakening from pain Fever, rash, oral ulcers, joint pain Melena
What is the most common cause of diarrhea in children?
Infectious
- Often Rotavirus
What are the indications for IV therapy in a child with diarrhea?
Shock
High stool output
Ileus
Monosaccharide intolerance
Do children with resolving diarrhea require special diets?
NO
When is diarrhea considered chronic?
3×/day for > 14 days
By what age does a patient with functional diarrhea (toddler’s diarrhea) typically obtain a normal stool pattern?
4 years of age
Is it rare for a breastfed infant to pass a stool less often than once every 5 days?
NO
Normal is 5-10days per BO
What is the treatment for infant dyschezia?
benign
Ressurance
no Tx
What is the most common cause of constipation in children?
Functional constipation
How do 90% of tracheoesophageal abnormalities present?
Blind upper EA
Fistual between lower oesophageal segment and the lower portion of the trachea, near the carina
What does VACTERL stand for?
V - Vertebral
A - Anal atresia
C - Cardiac (PDA, ASD, VSD)
T - TracheoEsophageal fistula
E - “ “
R - Renal (e.g, urethral atresia with hydronephrosis)
L - Limb anomalies (e.g, humeral hypoplasia, radial aplasia, hexadactyly, proximally placedthumb)
At the bedside, how do you diagnose esophageal atresia with distal tracheoesophageal fistula?
Failure to insert NGT
What is achalasia?
Disorder of the esophagus characterized by incomplete relaxation of the LES and a lack of normal esophageal peristalsis
MOTOR problem
True or false? Achalasia in infancy can be due to a congenital disorder?
TRUE
Is GE reflux a normal process for many infants?
YES
What is the initial treatment for GERD in infants?
Parental reassurance
Which children are at risk for having infection of the esophagus?
HIV
DM
Cancer
Long term glucocorticoid use