Gastroenterology Flashcards
What dose vomiting of undigested food indicated?
Achlasia
Delayed gastric emptying
Rumination
What does bilious vomiting suggest?
GI obstruction beyond duodenum eg malrotation
What is cyclic vomiting?
Paroxysms of vomiting followed by intervals of complete health
Assoc. with migraine headaches
Normal exam
The finding of red current jelly suggests what?
Intussusception
What is the most common cause of abdominal pain in children?
Functional abdominal pain
What clues are useful in diagnosing functional abdominal pan?
Periumbilical
Normal growth
Better on weekends / vacation
Worse before school / before bed
What clues suggest an organic cause for abdominal pain?
Abdo pain AND:
- vomiting
- weight loss
- hematochezia
- diarrhoea
- night-time awakening from pain
- fever, rash, oral ulcers or joint pain
- melena
Most common cause of diarrhoea in children?
Infectious agent - most common rotavirus
Indications for IV therapy in diarrhoea child?
Shock
Stool output >10ml/kg/hr
Ileus
Monosaccharide intolerance
When is diarrhoea considered chronic?
3x/day for >14 days
Treatment for infant dyschezia?
Reassurance, no treatment
Most common cause of constipation in children?
Functional constipation
How do 90% of tracheoesophageal abnormalities present?
Blind upper EA with fistula between lower oesophageal segment and the lower portion of the trachea near the carina.
(EA + distal TOF)
What does VACTERL stand for?
Vertebral Anal atresia Cardiac Tracheo-oesophageal fistula Renal Limb abnormalities
How do you diagnose eosophageal atresia with distal tracheoesophageal fistula?
NG tube, blind pouch prevents its passage
What is achalasia?
Incomplete relaxation of the LES and lac of normal oesophageal peristalsis
- motor problem, not anatomic problem
True or false? Achalasia in infancy can be due to a congenital disorder?
May be a congenital disorder
Is GE reflux a normal process for many infants?
Yes
Which children are at risk of having infection of the oesophagus?
HIV, diabetes, cancer, long term high dose steroid use
What is the initial treatment for reflux in infants?
Reassurance
How long after ingestion of a caustic substance should upper endoscopy be performed?
12 - 24 hours
What disorders is spontaneous eosophageal perforation increased in frequency?
Ehlers-Danlos
Marfan
What type of acid-base disorder is seen with pyloric stenosis?
Hypochloremic metabolic alkalosis
Hypokalaemia (exchange of hydrogen/potassium ions in kidney)
What causes stress gastropathy?
Severe physiologic stress
- shock, metabolic acidosis, sepsis, burns, head injury
(think sick ICU patient with GI bleed)
