gastroesophageal reflux

Question 1

gastroesophageal reflux

• freq
• et

Answer 1

common GI problem (50%)

neuromuscular et

Question 2

GER patho

Answer 2

reflux via lowr esophageal sphincter

-gastric contents->esoph->esophagitis

Question 3

complication/problem from GER

Answer 3

growth problems

Question 4

GER tx

Answer 4

mostly self limiting (may need PPI or H2RA)

• modify feeding (small meals, thicken, positon)
• fundoplication

Question 5

Hirschsprung disease

• incidence
• et

Answer 5

1/5000

-RET gene mutation on chr 10 (it codes for the proteins involved in cell signalling (neural tissue))

Question 6

Hirschprung disease patho

possible complic

Answer 6

area of colon lack parastympathetic ganglia->no peristalsis (localized)->accum of contents->colon distension->abdm distension

-risk of perforation and peritonitis

Question 7

intussesception is

usually occurs where

Answer 7

intestine invaginates into adjoining part

usually at ileocecal valve. (the ileum enters the cecum)

Question 8

incidence of intussusception

Answer 8

1-4/1000 births

Question 9

patho of intussusception

Answer 9

invagination->obstr->inflm->edema (into the lumen)->edema->ischemia

Question 10

possible complic of intussusception

Answer 10

necrosis
perforation
peritonitis
all possibl

Question 11

tx of intussuscpetion

Answer 11

• hydrostatic reduction (using a contrast medium that is water soluble and air pressure
• some require sx

Question 12

influenza is

Answer 12

acute viral infection in URT

-seasonal

Question 13

how is the flu divided

Answer 13

TYpes A B C

A is most prevalent (and the cause of outbreaks)

Question 14

flu incubation

Answer 14

1-4 days

Question 15

who is susceptible to the flu

Answer 15

elderly
young (defenses arent fully established)
health care workers
chronically ill

Question 16

influenza patho

Answer 16

viral injury to epith cells in URT

• inflm and tissue damage
• if it extends to LRT can cause bronchial and alveolar damage

Question 17

flu complic

Answer 17

2’ bacterial infection??

bronchitis or pneumonia??

Question 18

mnfts of influenza

Answer 18

cough (good for expectorating mucus. 140-160km/hr)

• fever
• lethargy, myalgia

Question 19

tx of flu

Answer 19

immunization prohylaxis
prevent spread
-symptomatic eg pain meds
limit infect to URT
-antivirals?? Amantadine (1st generation antiviral. Antivirals have a narrow window that they can be taken in within 24-48hrs)

Question 20

immuniation for flu

what is the challenge

Answer 20

usually giving an attenuated vaccine in which an Ag from virus is inactivated and given in small quantity.

problem is predicting which strain will ome next. It doesnt always match the strain. Vaccines for flu always contain multiple strains

Question 21

how does amantadine work

Answer 21

inhibits uncoating. it is best for a and b strains

Question 22

relenza

Answer 22

inhibits replication and prevents release of…

Question 23

Pneumonia aka pneumonitis

Answer 23

inflm of alveoli and bronchioles

infectious and noninfectious forms (eg from bact/viruses can classify based on et and on location)

Question 24

et of pneumonia

Answer 24

usuall bact (oppotunitic infection often from during flu)

• viruses
• fungi
• aspiration
• noxious fumes

Question 25

pahto of pneumonia

Answer 25

impaired pulmonary defenes (such as the mucociliary blanket)
-agent enters resp tract and proceeds to lungs
-inflm->pulm edema->impaired gas exchange
(youll have systemic hypoxi, hypercapnea)

Question 26

what is atypical and typical pneumonia

Answer 26

typical is bact (this will be in the alveolar space)

atypical is viral (this will be in the cels)

Question 27

how are lobar and bronchopneumonia different

Answer 27

lobar is restricted to a lobe

broncho is diffuesed. There are many areas of consolidation that contain exudate, inflm debris, bact, host defence cells