Brainscape's Knowledge GenomeTM

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


See full index

Pediatrics > Gastroenterology Pt. 2 > Flashcards

Gastroenterology Pt. 2 Flashcards

1
Q

What is the age of onset for inflammatory bowel disease?

A

Bimodal: Peak at 15-20 years of age and a second peak after 50 years of age

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

What are the clinical features of Ulcerative colitis?

A

Inflammation is diffuse, limited to the mucosa, and localized to the colon

UC usually begins in the rectum and extends proximally in a contiguous fashion

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

What is the clinical presentation of Mild, Moderate, and Severe disease?

A

Mild: Rectal bleeding, diarrhea, abdominal pain

Moderate: Nocturnal stooling, cramping, and tenesmus

Severe disease: More than 6 stools per day, fever, anemia, leukocytosis, and hypoalbuminemia

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

What are complications of severe UC?

A
  • Toxic megacolon: fever, abdominal distension, septic shock
  • Increased risk of colon cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the differences between Crohn’s disease (CD) and UC?

A
  • CD may involve any segment of the GI tract
  • In CD, inflammation is eccentric and segmental
  • Inflammation is transmural and may lead to sinus tracts, fistulas, and crypt abscesses
  • Most children have disease involving the terminal ileum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In Crohn’s disease, _______ disease often precedes the development of intestinal disease

A

Perianal disease

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

What labs are indicated in evaluation of inflammatory bowel disease?

A
  • CBC (shows anemia or leukocytosis)
  • ESR is elevated
  • Serum albumin and serum transaminases to assess nutritional status and liver disease
  • Serum antibody tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What imaging can be used to evaluate IBD?

What confirms the diagnosis of CD?

A

Abdominal US and CT imaging to visualize thickened bowel walls

Colonoscopy with biopsies of the colon and terminal ileum

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

What pharmacotherapy is indicated for IBD?

A
  • Sulfasalazine for mild disease
  • Corticosteroids
  • Immunosuppressive agents (useful in inducing long term remission)
  • Metronidazole is used in threatment of CD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

UC can be cured with a ______ ________

A

total proctocolectomy

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

Define the following…

  • Hematemisis
  • Hematochezia
  • Melena
A
  • Hematemisis: Vomiting of fresh or old blood, which may have “coffee ground” appearance from denaturing of hemoglobin
  • Hematochezia: Bright red blood passed per rectum
  • Melena: Dark tarry stools indicating upper GI bleed proximal to ligament of Treitz
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Occult bleeding from the GI tract is confirmed by positive ______ _______ of stool

A

guaiac testing

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

What is Guaiac testing of stool?

A

Guaiac is a colorless dye that changes color from the peroxidase activity of hemoglobin in the presence of hydrogen peroxide

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

What can cause a false positive guaiac test?

A
  • Ingested iron
  • Rare red meats
  • Beets
  • Foods with a high peroxidase content (cantaloupe, broccoli, cauliflower)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some causes of upper GI bleeding in children?

A
  • Newborns may swallow maternal blood during delivery or while nursing from a bleeding nipple
  • Gastritis or ulcers may occcur as a result of severe stress of illness
  • Mechanical injury to the mucosa from vomiting
  • Varices (less common)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is ongoing upper GI bleed assessed?

A

Nasogastric tube aspirate

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

When would plain film radiography be useful in an upper GI bleed?

A

May be useful if a foreign body or perforation is suspected

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

What is the management for upper GI bleed?

A
  • Stabilization of hypvolemia and anemia (IV access)
  • Medical therapy to control bleeding: Octreotide; antibiotics for H. pylori; H2 blockers, PPI for ulcers
  • Endoscopic therapy indicated for active bleeding or if rebleeding is likely
  • Arteriographic embolization
  • Surgical treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

________ _______ should be considered in any newborn who presents with rectal bleeding, feeding intolerance, or abdominal distension

A

Necrotizing enterocolitis

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

What is the most common cause of significant lower GI bleeding beyond infancy?

A

Juvenile polyps

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

What is Meckel’s diverticulum?

A

An outpouching of the bowel in the terminal ileum that occurs in 2% of infants; Important cause of lower GI bleed in infants and children

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

How does Meckel’s diverticulum lead to lower GI bleeding?

A

Diverticulum contains ectopic gastric mucosa that produces acid; this acid damages adjacent intestinal mucosa causing painless, acute rectal bleeding

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

What is hemolytic uremic syndrome?

A

A vasculitis characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure; intestinal ulceration and infarction of the bowel may cause bleeding

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

What is Henoch-Schonlein purpura?

A

An IgA-mediated vasculitis that presents with a palpable, purpuric rash on the buttocks and lower extremities, large joint arthralgias, renal involvement and GI bleeding from complications such as bowel perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What hepatocellular enzymes can be elevated with liver injury? Which is most specific for liver disease?
* AST * ALT (most specific for liver disease) * LDH
26
What biliary enzymes are elevated in biliary disease?
* Alkaline phosphatase * Gamma glutamyl transpeptidase (GGTP) * 5'-nucleotidase (5NT) - more specific than GGTP for biliary tract damage
27
What can lead to elevated bilirubin?
* Increased heme load * Decreased capacity for excretion * Obstruction to bile flow
28
How is synthetic function of the liver assessed?
* Protein production (prealbumin, albumin, PT) * Serum chemistries (glucose, cholesterol) * Toxin clearance (lactate, ammonia)
29
Wht is cholestatic jaundice and what values are associated with it?
Retention of bile within the liver; occurs when the direct component of bilirubin is \> 2 mg/dL or \> 15% of the total bilirubin
30
Jaundice typically begins ______ and extends ______ as bilirubin increases
begins cranially and extends caudally
31
What lab evaluation is necessary in all patients with suspected jaundice?
Measurement of direct and total bilirubin
32
What imaging can be ordered in patients with jaundice?
Imaging often includes abdominal US with doppler evaluation of the hepatic vessels
33
What is inspisated bile syndrome?
Associated with hemolysis or with a very large hematoma Biliary system overwhelmed by increased bilirubin; unconjugated hyperbilirubinemia predominates early, conjugated hyperbilirubinemia develops as hepatocellular function increases to meet demand
34
What are the three types of UDP-glucuronyl transferase deficiency?
* Gilbert's syndrome: 50% of enzyme activity is absent * Crigler-Najjar type 1: Autosomal recessive disoder in which 100% of enzyme activity is absent * Crigler-Najjar type 2: Autosomal dominant disorder in which 90% of enzyme acitivty is absent
35
What are possible causes of cholestasis disease of infancy?
* Infections * Metabolic derangements * Extrahepatic mechanical obstruction * Intrahepatic mechanical obstruction * Idiopathic * α1-antitrypsin deficiency * TPN associated disease
36
What are the clinical features of cholestasis?
* Jaundice * Acholic or light stools * Dark urine * Hepatomegaly * Bleeding * FTT
37
What is neonatal hepatitis?
Idiopathic hepatic inflammation during the neonatal period Most common cause of cholestasis in the newborn
38
What are the clinical features of neonatal hepatitis? What are the presenting features in the first week of life?
* Symptoms range from transient jaundice to liver failure * Presenting features in 1st week of life: Jaundice and hepatomegaly in 50% of patients
39
What is the management for neonatal hepatitis?
Management is supportive * Nutritional support (TPN if growth is problematic) * Ursodeoxycholic acid (enhances bile flow) * Liver transplantation in cases of severe liver failure
40
What is biliary atresia?
Progressive fibrosclerotic disease that affects the extrahepatic biliary tree
41
Two thirds of patients with biliary atresia present between the ages of __ and __ weeks with jaundice, dark urine, and acholic stools
4-6 weeks
42
How are bilirubin levels affected in biliary atresia?
Moderately elevated
43
What imaging is used in biliary atresia to rule out other causes of cholestasis? What imaging technique can confirm the diagnosis of biliary atresia?
Abdominal US, radionucleotide imaging and liver biopsy rule out other causes of cholestasis Intraoperative cholangiogram with laparotomy to examine the biliary tree confirms diagnosis
44
What is the Kasai portoenterostomy? When is success highest with this procedure?
The treatment of choice to establish bile flow in patients wtih biliary atresia Success is highest if the procedure is performed by 50-70 days of age
45
What is Alagille syndrome?
Autosomal dominant disorder characterized by paucity of intrahepatic bile ducts and multiorgan involvement
46
What are the clinical features of Alagille syndrome?
* Features of cholestatic liver disease * Pruritis (can be debilitating) * Cardiac disease often include pulmonary outflow obstruction * Renal disease * Eye anomalies include posterior embyotoxon * Growth failure and short stature * Pancreatic insufficiency
47
Most viral hepatitis infections during infancy and childhood are \_\_\_\_\_\_\_
asymptomatic
48
What type of virus is Hepatitis A?
Picornavirus
49
How is hepatitis A transmitted?
Transmission is by the fecal-oral route through contaminated foods and water or by contact with contaminated individuals
50
What is the incubation period for hepatitis A? Who is more likely to have symptomatic infection?
Incubation period is 2-6 weeks Older children and adults are more likely to have symptomatic infection
51
What serology indicates HAV infection?
Elevated IgM anti-HAV: presents early and can persist for 6 months after infection Elevated IgG anti-HAV: also occurs early in infection and confers lifelong immunity
52
How is hepatitis B infection transmitted?
Transmission is by * Perinatal vertical exposure from infected mother to fetus * Parenteral route through exposure to infected blood products * Tattooing needles * IV drug use * Exposure to infected body secretions
53
How long is the incubation period for hepatitis B? What are the acute symptoms?
Incubation period is 45-160 days Acute symptoms range from asymptomatic infection to nonspecific systemic illness
54
Chronic HBV infection is most common in _____ \_\_\_\_\_\_\_
young infants
55
Chronic HBV infection increases the risk for .....
hepatocellular carcinoma
56
What is the significance of the following antigens/antibodies in HBV infection... * HBV surface antigen: * HBV surface antibody: * HBV core antibody: * HBV envelope antigen: * HBV envelope antibody:
* HBV surface antigen: pathognomonic for active disease * HBV surface antibody: protective and results from vaccination or natural infection * HBV core antibody: Persists lifelong and results from natural infection (not vaccine) * HBV envelope antigen: rises early in active infection * HBV envelope antibody: Rises late in infection
57
What is used to diagnose HBV as well as assess response to therapy?
HVB PCR
58
What type of virus is Hepatitis C?
An RNA virus in the flavivirus family
59
How is Hepatitis C virus transmitted?
Perinatal vertical route from mother to fetus Parenteral exposure
60
Chronic HCV infection occurs in \_\_% of patients
80%
61
How is HCV diagnosed?
HCV PCR or by demonstrating HCV antibody in the blood (non-chronic)
62
What does Hepatitis D virus require for replication?
HBsAg
63
Hepatitis E is responsible for \_\_% of acute hepatitis in young adults in developing countries and is associated with \_\_\_% mortality in infected pregnant women
50%; 20%
64
What is autoimmune hepatitis?
Destructive and progressive liver disease characterized by elevated serum transaminases, hypergammagloulinemia, and circulating autoantibodies
65
What are the two categories of autoimmune hepatitis?
* Type 1 disease (more common): Characterized by presence of antinuclear antibody (ANA) or anti-smoth muscle antibody * Type 2 disease: Characterized by anti-liver kidney microsome antibody or anti-liver cytosol type 1 antibody
66
Autoimmune hepatitis occurs predominantly in \_\_\_\_\_\_\_
females
67
What are the clinical features of autoimmune hepatitis?
* 50% of patients present with acute hepatitis * Jaundice (mild to moderate) * Nonhepatic signs include fatigue, anorexia, arthritis, rash, nephritis, and vasculitis
68
\_\_\_\_\_ _______ is generally preformed to evalutate for cirrhosis, to grade disease activity, and to exclude other diagnoses in patients with autoimmune hepatitis
liver biopsy
69
What is the management for autoimmune hepatitis?
* Generally supportive * Corticosteroids for inital control of hepatic inflammation * Immunosuppressive agents (azathioprine or 6-mercaptopurine) * Liver transant for severe liver disease

Pediatrics (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions