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CP2 PAEDS > Gastroenterology part 2 > Flashcards

Gastroenterology part 2 Flashcards

1
Q

Why do 50% of all newborns become jaundiced?

A

Incr release of Hb from breakdown of RBC
Shorter RBC lifespan in children
Hepatic bilirubin metabolism less effective 1st few days life

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2
Q

What serious condition can neonatal jaundice lead to

A

Kernicterus

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3
Q

What is kernicterus

A

Unconjugated bilirubin is deposited in BG –> encephyalopathy as can cross BBB

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4
Q

Sx acute kernicterus

A

Lethargy

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5
Q

Sx severe kernicterus (2)

A

Irritability

Seizures

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6
Q

What condition can kernicterus lead to

A

Cerebral palsy

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7
Q

Causes of neonatal jaundice - <24hrs old (5)

A 
Rhesus 
ABO incompatibility 
G6DP deficiency 
Spherocytosis 
Infection - TORCH/Rubella/CMV, HSV
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8
Q

How can ABO incompatibility lead to neonataljanudice>

A

Group O women’s IgG’s haemolyse RBC of group A infants

or group B

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9
Q

Causes of jaundice - 24h to 2w (7)

A 
Physiological 
Breast milk jaundice 
Infection 
Haemolysis 
Bruising 
Polycythaemia 
Crigler-nijjar
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10
Q

Causes of jaundice - conjugated - >2 weeks (3)

A

Bile duct obstruction
Neonatal hepatitis
Biliary atresia

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11
Q

Causes of jaundice - unconjugated - >2w (6)

A 
Physiological/breast milk 
Infection - UTI 
Hypothyroidism 
Haemolytic - G6PD 
GI obstruction - pyloric stenosis 
Crigler Nijjar
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12
Q

Ix neonatal jaundice

A

Serum bilirubin - is it conjugated or unconjugated
FBC
Coombs
Infection screen prn

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13
Q

Mx neonatal jaundice

A

Correct dehydreation
Phototherapy - UV light 450nm. Cover infants eyes and repeat serum biliruin levels at 4-6hrs
exchange transfusion if severe via art line

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14
Q

What will happen if you perform phototherapy on a conjugated hyperbilirubinaemia baby

A

baby will get macular rash and bronzed skin

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15
Q

What is biliary atresia

A

Progressive fibrosis and obliteration of extrahepatic and intrahepatic biliary tree

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16
Q

What happens if you do not intervene with biliary atresia?

A

Chronic liver disease and death within 2 years

17
Q

PS biliary atresia (5)

A 
Mild jaundice 
Pale stools 
Faltering growth 
Hepatomegaly 
Splenomegaly
18
Q

Ix biliary atresia (4)

A

LFTs
Abdo USS
ERCP
Liver biopsy

19
Q

What would you see on an abdominal USS - biliary atresia

A

Contracted/absent GB

20
Q

Tx biliary atresia

A

Palliative surgery

If fails offer liver transplant

21
Q

What age does coeliac disease PS

A

8-24m (when gluten intro;d to diet)

22
Q

PS coeliac disease (5)

A 
FTT
ABdo distention 
Buttocks wasting 
irritable 
Anaemia
23
Q

Ix Coeliac (3)

A

+ve IgA antibodies serology
Flat mucosa jejunal biopsy
Resolution of Sx once gluten withdrawn

24
Q

Mx coeliac (3)

A

Gluten free diet
Annual review to check height + W
Gluten challenge

25
Q

What is a 1’ food allergy

A

Child fails to devlop immune tolerance against food

26
Q

What is a 2’ food allergy

A

Initially tolerate but becomes allergic due to cross reactivity betw proteins + those in allergens

27
Q

Sx IgE med food allergies (3)

A

Anaphylaxis
Facial swelling
10-15mins post ingestion

28
Q

Sx non-IgE mediated food allergy (3)

A

Diarrhoea
Vom
Abdo pain

29
Q

RF food allergy (4)

A 
FHx
Atopy
PMHx
Age
Asthma
30
Q

What is T2HS?

A

Neutrophils bind to substance, lytic enzymes are released –> tissue damage

31
Q

Mx T1 HS

A

Child must be able to manage attacks

Anti-histamines/epipen

32
Q

Mx T2HS allergy

A

Avoid food

33
Q

Def malabsoprtion

A

Subnormal intestinal absorption of dietary constituents w/ XS faecal nutrient loss

34
Q

DDx malabsorption - intraluminal (5)

A 
Lactose intolerance 
CF
Pancreaitits 
Pernicious anemia 
Protein E malnutrition
35
Q

DDx malabsorption - mucosal abnormality (4)

A

Coeliac
Short bowel syndrome
CMPA
IBD

36
Q

Ix malabsorption

A

bloods
coeliac ab
stools MCS
If still unclear - endoscopy/biopsy/ sweat test a1-antitrypsin etc

37
Q

What is colic? (3)

A

Paroxysmal insolable crying
Drawing up of knees
Excessive flatulence

38
Q

What % of babies suffer w/ oclic

A

40%

39
Q

Mxc colic

A

Entirely benign
Visit GP if worried
HV/Cry-SIS - give support to parents

CP2 PAEDS (18 decks)

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