Brainscape's Knowledge GenomeTM

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


See full index

Paeds > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What are the medical causes of abdominal pain

A

Constipation

UTI

Coeliac disease

IBD

IBS

Mesenteric adenitis

Abdominal migraine

Pyelonephritis

Henoch-Schonlein purpura

Tonsillitis

Diabetic ketoacidosis

Infantile colic

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

What are the medical causes of abdominal pain specific to teenage girls

A

Dysmenorrhoea

Mittelschmerz

Ectopic pregnancy

PID

Ovarian torsion

Pregnancy

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

What are the surgical causes of abdominal pain

A

Appendicitis

Intussusception

Bowel obstruction

Testicular torsion

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

What are the red flags for abdominal pain

A

Persistent or bilious vomiting

Severe chronic diarrhoea

Fever

Rectal bleeding

Weight loss

Faltering growth

Dysphagia

Night time pain

Abdominal tenderness

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

What is the management for recurrent abdominal pain

A

Careful explanation

Reassurance

Distract child

Advise parents not to ask about pain

Probiotic supplements

Avoid NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are abdominal migraines

A

Central abdominal pain lasting more than 1 hour

Associated with: nausea, vomiting, anorexia, pallor, headaches, photophobia, aura

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

What is the management for acute attacks of abdominal migraine

A

Low stimulus environment

Paracetamol

Ibuprofen

Sumatriptan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the preventative management for abdominal migraines

A

Pizotifen (serotonin antagonist)

Propranolol

Cyproheptadine (antihistamine)

Flunarizine (CCB)

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

How might a child with constipation present

A

< 3 stools per week

Hard stools, difficult to pass

Rabbit dropping stools

Straining

Pain on passing stool

Abdominal pain

Abnormal posture

Rectal bleeding

Faecal impaction

Overflow diarrhoea

Hard stool palpable in abdomen

Loss of sensation of need to open bowels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the red flags for constipation

A

Not passing meconium within 48 hours

Neurological signs or symptoms

Vomiting

Ribbon stool (anal stenosis)

Abnormal anus

Abnormal lower back or buttocks

Failure to thrive

Acute severe abdominal pain and bloating

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

What is encopresis

A

Faecal incontinence

Not pathological until age 4

Sign of chronic constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the lifestyle factors contributing to constipation

A

Habitually not opening bowels

Low fibre intake

Poor fluid intake and dehydration

Sedentary lifestyle

Psychosocial problems

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

What is the management for constipation

A

Correct reversible contributing factors

High fibre diet

Good hydration

Laxatives (movicol first line)

Disimpaction (high dose laxatives)

Encourage and praise visiting toilet

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

What are the complications of constipation

A

Pain

Reduced sensation

Anal fissures

Haemorrhoids

Overflow and soiling

Psychosocial morbidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is gastro-oesophageal reflux

A

Contents of stomach reflux through lower oesophageal sphincter

Babies have immature LOS

Normal for babies for have GOR until age 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How might a patient with gastro-oesophageal reflux present

A

Chronic cough

Hoarse cry

Distress, crying, or unsettled after feed

Reluctant to feed

Pneumonia

Poor weight gain

Over 1s: heartburn, acid regurgitation, retrosternal or epigastric pain, bloating, nocturnal cough

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

What is the general advice given to parents of babies with gastro-oesophageal reflux

A

Small, frequent meals

Burping after feeds

Not over-feeding

Keep baby upright after feed

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

What management can be used in problematic cases of gastro-oesophageal reflux

A

Gaviscon mixed with feeds

Thickened formula or milk

Ranitidine

Omeprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Sandifer’s syndrome

A

Associated with gastro-oesophageal reflux

Resolves as reflux resolves

Get torticollis (forceful contraction of neck muscles, twisting of neck) and dystonia (abnormal muscle contractions)

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

What is pyloric stenosis

A

Hypertrophy of pyloric sphincter

Prevents food from travelling from stomach to duodenum

Get forceful peristalsis of stomach

Have projectile vomiting

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

How might a patient with pyloric stenosis present

A

Hungry baby

Projectile vomiting

Thin

Pale

Failure to thrive

Hypertrophic muscle of pylorus on abdominal palpation

Hypochloremic metabolic alkalosis on blood gas

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

What investigation is needed in pyloric stenosis

A

Abdominal ultrasound (thickened pylorus)

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

What is the management for pyloric stenosis

A

Laparoscopic pyloromyotomy (incision of pyloric smooth muscle)

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

What is gastroenteritis

A

Inflammation of stomach and intestines

Nausea, vomiting, diarrhoea

Common in children

Usually viral

Need to isolate patients

Main concern in dehyrdration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the differentials for diarrhoea

A

Gastroenteritis

IBD

Lactose intolerance

Coeliac disease

Cystic fibrosis

Toddler’s diarrhoea

IBS

Antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the causes of viral gastroenteritis

A

Rotavirus

Norovirus

Adenovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the causes of bacterial gastroenteritis

A

E coli

Campylobacter jejuni

Shigella

Salmonella

Bacillus cereus

Yersinia enterocolitica

Staph aureus toxin

28
Q

What are the investigations for gastroenteritis

A

Stool microscopy, culture and sensitivity

29
Q

What is the management for gastroenteritis

A

Good hygiene

Barrier nursing

Infection control

Stay off school for 48 hours after resolution

Maintain hydration

Avoid antidiarrhoea and antiemetic medications

Antibiotic use guided by sensitivity testing

30
Q

What are the complications of gastroenteritis

A

Lactose intolerance

IBS

Reactive arthritis

Guillain-Barre syndrome

31
Q

What is coeliac disease

A

Gluten exposure causes inflammation of small intestine

Usually develops in early adulthood

Key autoantibodies: anti-TTG, anti-EMA

Autoantibody levels correspond with disease severity

Mainly affects jejunum

Closely linked with type 1 diabetes

32
Q

How might a patient with coeliac disease present

A

Often asymptomatic

Failure to thrive

Diarrhoea

Fatigue

Weight loss

Mouth ulcers

Anaemia

Dermatitis herperiformis (itchy rash on abdomen)

Neurological symptoms (peripheral neuropathy, cerebellar ataxia, epilepsy)

33
Q

What investigations are needed for coeliac disease

A

To be investigated when patients still eating gluten

Total IgA levels

Coeliac-specific antibodies (anti-TTG, anti-EMA)

Endoscopy and intestinal biopsy (crypt hypertrophy, villous atrophy)

34
Q

What is the management for coeliac disease

A

Lifelong gluten free diet

35
Q

What are the complications of coeliac disease

A

Vitamin deficiency

Anaemia

Osteoporosis

Ulcerative jejunitis

Non-Hodgkin lymphoma

Small bowel adenocarcinoma

36
Q

How might a patient with inflammatory bowel disease present

A

Profuse diarrhoea

Abdominal pain

Bleeding

Weight loss

Anaemia

Systemically unwell during flare ups

37
Q

What are the characteristic features of Crohn’s disease

A

NESTS

No blood or mucus

Entire GI tract

Skip lesions on endoscopy

Terminal ileum affected, transmural

Smoking is a risk factor

38
Q

What are the characteristic features of ulcerative colitis

A

CLOSE-UP

Continuous inflammation

Limited to colon and rectum

Only superficial mucosa affected

Smoking is protective

Excrete blood and mucus

Use aminosalicylates

Primary sclerosing cholangitis

39
Q

What are the extra-intestinal manifestations of inflammatory bowel disease

A

Clubbing

Erythema nodosum

Episcleritis and iritis

Inflammatory arthritis

Primary sclerosing cholangitis

40
Q

What investigations are needed for inflammatory bowel disease

A

Bloods

Faecal calprotectin

Endoscopy with biopsy (gold standard)

Imaging to look for complications

41
Q

What is the management for Crohn’s disease

A

Inducing remission:

  • Steroids (oral prednisolone, IV hydrocortisone)
  • Immunosuppressants

Maintaining remission:
- Immunosuppressants

Surgery

42
Q

What is the management for ulcerative colitis

A

Inducing remission:
- Corticosteroids

Maintaining remission:
- Aminosalicylate, azathioprine

Surgery

43
Q

What is biliary atresia

A

Section of bile duct narrowed or absent

Get cholestasis

Get prevention of excretion of conjugated bilirubin

44
Q

How might a patient with biliary atresia present

A

Shortly after birth

Significant jaundice (high conjugated bilirubin levels)

Lasting jaundice (> 14 days in term babies, >21 days in preterm babies)

45
Q

What investigations are needed for biliary atresia

A

Serum conjugated and unconjugated bilirubin levels (expect high levels of conjugated form)

46
Q

What is the management for biliary atresia

A

Surgery (Kasai protoenterostomy, attach section of small intestine to opening of liver)

Liver transplant

47
Q

What does intestinal obstruction lead to

A

Vomiting

Absolute constipation

48
Q

How might a patient with intestinal obstruction present

A

Persistent vomiting (may have bright green bile)

Abdominal pain and distension

Failure to pass stool or wind

Abnormal bowel sounds

49
Q

What are the causes of intestinal obstruction

A

Meconium ileus

Hirschsprung’s disease

Oesophageal atresia

Duodenal atresia

Intussusception

Imperforate anus

Volvulus

Strangulation hernia

50
Q

What investigation is needed for bowel obstruction

A

Abdominal X-ray

51
Q

What is the management for bowel obstruction

A

Keep NBM

Insert NG tube

IV fluids

Surgery

52
Q

What is Hirschsprung’s disease

A

Congenital condition

Nerves of myenteric plexus absent in distant bowel and rectum

Length of colon without innervation can vary

Aganglionic section of bowel not able to relax

Loss of movement of faeces

Get intestinal obstruction

53
Q

What conditions are associated with Hirschsprung’s disease

A

Down’s syndrome

Neurofibromatosis

Multiple endocrine neoplasia type II

54
Q

How might a patient with Hirschsprung’s disease present

A

Acute intestinal obstruction shortly after birth

Delayed meconium passing

Chronic constipation since birth

Abdominal pain and distension

Vomiting

Poor weight gain

Failure to thrive

55
Q

What is Hirschsprung’s-associated enterocolitis

A

Inflammation and obstruction of intestines

20% of neonates with Hirschsprung’s

Life threatening

Within 2-4 weeks of birth

Presentation: fever, abdominal distension, diarrhoea, features of sepsis

Can lead to toxic megacolon and perforation of bowel

Management: urgent antibiotics, fluid resuscitation, decompression of obstruction

56
Q

What are the investigations for Hirschsprung’s disease

A

Abdominal X-ray (for obstruction)

Rectal biopsy (absence of ganglionic cells)

57
Q

What is the management for Hirschsprung’s disease

A

IV antibiotics (if have enterocolitis)

Surgical removal of aganglionic bowel

58
Q

What is intussusception

A

Bowel invaginated and telescopes into itself

More common in boys

Usually at 6 months - 2 years

59
Q

What are the conditions associated with intussusception

A

Concurrent viral illness

Cystic fibrosis

Intestinal polyps

Meckel diverticulum

60
Q

How might a patient with intussusception present

A

Severe, colicky abdominal pain

Pale, lethargic, unwell child

Redcurrant jelly stools

RUQ mass (sausage shaped)

Vomiting

Intestinal obstruction

61
Q

What are the investigations for intussusception

A

Ultrasound

Contrast enema

62
Q

What is the management for intussusception

A

Therapeutic enemas

Surgical reduction

Surgical resection of bowel (if gangrenous or perforated)

63
Q

What are the complications of intussusception

A

Obstruction

Gangrenous bowel

Perforation

Death

64
Q

How might a patient with appendicitis present

A

Central abdominal pain, then localises to right iliac fossa

Tenderness over McBurney’s point (1/3 from anterior superior iliac spine to umbilicus)

Loss of appetite

Nausea and vomiting

Rovsing’s sign (palpating LIF causes pain in RIF)

Guarding

Rebound tenderness

Percussion tenderness

65
Q

What are the investigations for appendicitis

A

Raised inflammatory markers

CT scan

Diagnostic laparoscopy

66
Q

What are the key differentials for appendicitis

A

Ectopic pregnancy

Ovarian cyst

Meckel’s diverticulum

Mesenteric adenitis

Appendix mass

67
Q

What is the management for appendicitis

A

Appendicectomy

Laparoscopic surgery

Paeds (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions