Gastroenterology Flashcards by Kyle Campbell | Brainscape

Q

What does bilious emesis indicate?

A

OBSTRUCTION = urgent evaluation

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Q

In what age group is Gastroesophageal Reflux Disease (GERD) considered common?

A

Infants <6 months

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Q

Differentiate GER from GERD

A

GER = “Happy Spitter”: NO complications or consequences; normal, declines with age
GERD = “Unhappy Spitter”: complications arise (FTT, esophagitis, resp. issues, irritable, dystonic neck posturing, feeding refusal, bloody stools)

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Q

If a patient simply has GER, what is the treatment?

A

Supportive

- Typically resolves within 9-12 months

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Q

What is the first line treatment for Gastroesophageal Reflux Disease (GERD) - give two examples?

A

Lifestyle modifications

Avoid tobacco
Upright position 30 minutes after feeds

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Q

If treatment of Gastroesophageal Reflux Disease (GERD) is refractory or case is complicated, what treatment may be considered (2)?

A

Omeprazole vs. Ranitidine

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Q

Which condition is associated with macrolide abx use during first weeks of life?

A

Infantile Hypertrophic Pyloric Stenosis

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Q

Which condition often involves the 1st born male?

A

Infantile Hypertrophic Pyloric Stenosis

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Q

If you have a 3-6-week-old infant with nonbilious “projectile” emesis immediately after feeds, what condition should be considered?

A

Infantile Hypertrophic Pyloric Stenosis

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Q

Which condition involves “olive-like” mass in RUQ?

A

Infantile Hypertrophic Pyloric Stenosis

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Q

Which condition involves US shows elongation, thickening of pylorus; UGI Barium contrast study showing string sign?

A

Infantile Hypertrophic Pyloric Stenosis

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Q

What is the recommended treatment for Infantile Hypertrophic Pyloric Stenosis?

A

Surgery (pyloromyotomy

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Q

What condition involves 1+ bowel segments absent/obstructed (duodenum is most common)?

A

Congenital Intestinal Atresia

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Q

Under what three conditions/diseases is there increased risk for Congenital Intestinal Atresia?

A

CF
Down syndrome
Maternal cigarette smoking

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Q

Which condition involves vomiting (bilious), abdominal distention +/- fail to pass meconium?

A

Congenital Intestinal Atresia

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Q

Which condition involves “double bubble sign”?

A

Congenital Intestinal Atresia

- Duodenal atresia

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Q

For what condition is withhold feedings to prepare for surgery; broad-spectrum abx to prevent post-op infection considered treatment?

A

Congenital Intestinal Atresia

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Q

Which condition involves abnormal intestine position?

A

Midgut Malrotation

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Q

What is small bowel twisting around Superior Mesenteric a. → small bowel ischemia and necrosis, and what condition is it often associated with?

A

Volvulus

- Often seen with Midgut Malrotation

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Q

Which condition involves sxs of hemodynamically unstable, vomiting (bilious)?

A

Midgut Malrotation +/- Volvulus

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Q

Which condition involves UGI Barium contrast study shows “corkscrew” duodenum?

A

Midgut Malrotation +/- Volvulus

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Q

Which condition involves Ladd procedure to prevent ischemia and recurrent sxs for treatment?

A

Midgut Malrotation +/- Volvulus

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Q

Which condition involves intestinal telescoping?

A

Intussusception

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Q

What is the most common abdominal emergency in kids <2 years?

A

Intussusception

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Q

Which condition involves possible etiology of Meckel diverticulum or from a form of Rotavirus vaccine (Rotashield)?

A

Intussusception

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Q

What is the hallmark symptom of Intussusception?

A

Abdominal pain (intermittent, severe, progressive)

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Q

Which condition involves a “sausage-shaped” mass?

A

Intussusception

Q

Which condition involves “currant jelly” stools?

A

Intussusception

Q

Which condition involves abdominal US shows “target sign”/“coiled spring”?

A

Intussusception

Q

What treatment for Intussusception is both diagnostic and therapeutic?

A

Hydrostatic/pneumatic enema

Q

What is the most common pediatric surgical emergency?

A

Appendicitis

Q

Which condition peaks in 2nd decade of life – rare before age 5?

A

Appendicitis

Q

Which condition involves vomiting AFTER pain onset, and migrating abdominal pain?

A

Appendicitis

Q

Which condition involves tender McBurney’s point? What other five findings may be present on PE?

A

Appendicitis

Guarding
Rebound
+Rovsing
+Obturator
+Iliopsoas

Q

What is the recommended diagnostic path for Appendicitis?

A

If classical presentation, consult THEN imaging (US)

Q

What is the recommended treatment for Appendicitis?

A

Appendectomy

- Also fluids, IV abx, analgesics

Q

What is the definition of diarrhea?

A

3+ loose or watery stools per day

Q

What is the most general etiology of diarrhea? Provide three examples

A

Viral most common

Norovirus
Rotavirus
Adenovirus

Q

What are six red flags for diarrhea?

A

Fever
Severe abdominal pain
Blood in stool
Recent abx
Persistent sxs
Dehydration

Q

What treatment is always recommended for acute diarrhea?

A

Hydration (PO vs. IV)

Q

What four etiologies should be considered for CHRONIC diarrhea?

A

Celiac disease
Allergic enteropathy
Malabsorption
Functional (Toddler’s) diarrhea

Q

Which condition peaks at 15-30 years?

A

Inflammatory Bowel Disease (Crohn Disease vs. Ulcerative Colitis)

Q

What is associated with 2x risk for Crohn disease?

A

SMOKING

Q

What condition involves a “step-up” for most patients vs. “top-down” for high risk patients approach to treatment?

A

Inflammatory Bowel Disease (Crohn Disease vs. Ulcerative Colitis)

Q

Which condition involves transmural inflammation (mouth to anus)?

A

Crohn Disease

Q

Which condition involves skip lesions on x-ray?

A

Crohn Disease

Q

Which condition involves a cobblestone appearance?

A

Crohn Disease

Q

Which condition involves continuous involvement of rectum and colon? What layer is ONLY affected?

A

Ulcerative Colitis

- Mucosal layer only

Q

Which condition involves diffuse/continuous edema, erythema, friability, ulceration?

A

Ulcerative Colitis

Q

What does Ulcerative Colitis put a patient at increased risk for?

A

Colon CA

Q

What is the most common congenital anomaly of GI tract?

A

Meckel’s Diverticulum

Q

Which condition involves the rule of 2’s, and what are they (4)?

A

Meckel’s Diverticulum

2% of pop.
2:1 M:F ratio
2% develop complications often before age 2 years
2 feet from ileocecal valve

Q

Which condition involves painless rectal bleeding (mucosal ulcers cause bleeding)?

A

Meckel’s Diverticulum

Q

Which condition involves using Technetium-99 for diagnosis? What is another name for this scan?

A

Meckel’s Diverticulum

- Meckel’s Scan

Q

What are the two general etiologies of constipation?

A

Functional: voluntary stool withholding due to psychological or psychosomatic; diet (low fiber, high dairy)
Organic: anal stenosis, hypothyroidism, Celiac disease, Hirschsprung, hypercalcemia, CF

Q

What is leakage of retained stool, and what might it be caused by?

A

Encopresis

- Can be caused by constipation

Q

Weight loss, anorexia, fever, hematochezia, vomiting, acute onset, failure to pass meconium, failure to respond to conservative treatments are all red flags for what, and what is the recommended treatment?

A

CONSTIPATION

- GI referral if any of these are present

Q

What are three treatments for constipation?

A

Fluids
Increase fiber intake
MiraLAX

Q

Which condition involves congenital aganglionic megacolon (absence of ganglion cells in mucosal layer of colon)?

A

Hirschsprung Disease

Q

In what population is Hirschsprung Disease most common?

A

males <6 weeks of age

Q

What condition is associated with increased risk for Hirschsprung Disease?

A

Down syndrome

Q

Which condition involves failure to pass meconium in first 48 hours of life?

A

Hirschsprung Disease

Q

Which condition involves tight anal sphincter, “squirt sign”?

A

Hirschsprung Disease

Q

What is the gold standard for diagnosis of Hirschsprung Disease?

A

Rectal biopsy (confirms lack of ganglion cells)

Q

What is the recommended treatment for Hirschsprung Disease?

A

Surgical resection of aganglionic colon segment