Gastrointestinal 2

Question 1

Hirschsprung Disease

Answer 1

congenital absence of ganglion cells in wall segment of rectum + colon
>stops peristalsis
>inadequate motility
>caus obstruction in intestines

Question 2

Hirschsprung Disease is assoc w…

Answer 2

• congenital heart defects
• down syndrome
• urinary tract anomalies

Question 3

Hirschsprung Disease
manifestations

Answer 3

• ab distention
• bilious vomiting
• failure to pass meconium w/in first 24-48 hr after birth
• foul smelling diarrhea w blood
• severe chronic constipation

Question 4

Hirschsprung Disease
diagnosis

Answer 4

rectal biopsy for ganglion cells

Question 5

Hirschsprung Disease
treatment

Answer 5

• remove aganglionic portion
• colostomy

Question 6

Congenital Diaphragmatic Hernia

Answer 6

abdominal contents protrude into thoracic cavity thru diaphragm

Question 7

Congenital Diaphragmatic Hernia, ab contents are pushed against…

Answer 7

LUNGS
>20-35% mortality rate
> barrel-shaped chest
>sunken abdomen

Question 8

Congenital Diaphragmatic Hernia
best position for infants

Answer 8

head + thorax higher than abdomen
>to facilitate downward mvmt of ab organs

Question 9

Umbilical Hernia

Answer 9

weak or imperfectly closed umbilical ring

Question 10

Umbilical Hernia
pushed thru when…

Answer 10

• coughing
• crying
• straining

Question 11

Umbilical Hernia
reduced when…

Answer 11

pushing bowel back thru fibrous ring

-sometimes spontaneous improvement

Question 12

Umbilical Hernia requires surgery if…

Answer 12

strangulation occurs or defects lasts 4-5 years

Question 13

Appendicitis

Answer 13

inflammation by obstruction of appendiceal lumen

Question 14

ruptured appendix + peritonitis is causes by…

Answer 14

edema continues>
>vasc supply is compromised
>bacteria invades

Question 15

main sign of appendicitis

Answer 15

ab pain in RLQ or mcburney point

Question 16

most common cause of emergency surgery in kids

Answer 16

appendicitis

Question 17

sign of perforated appendix

Answer 17

sudden relief of pain

Question 18

Appendicitis
nursing mgmt

Answer 18

start IV
draw labs
imaging
symptom relief

Question 19

Appendicitis
labs

Answer 19

elevated WBC
elevated neutrophils

Question 20

Appendicitis
imagine

Answer 20

appendix U/S
CT w contrast

Question 21

Necrotizing Enterocolitis

Answer 21

inflammatory disease caused by ischemia or hypoxemia
>>produce vasc compromise of bowel mucosa + necrotic patches
>>interferes w digestion

Question 22

Necrotizing Enterocolitis
mortality rate

Answer 22

5-24%

Question 23

Necrotizing Enterocolitis is most common in..

Answer 23

premature infants

Question 24

Necrotizing Enterocolitis is caused by…

Answer 24

>intestinal ischemia
>bacterial/viral infection
>immature GI mucosa

Question 25

Necrotizing Enterocolitis
symptoms occur….

Answer 25

2nd week of life

Question 26

Necrotizing Enterocolitis
manifestations

Answer 26

• incr gastric residual
• vomiting
• irritability
• ab distention
• blood diarrhea

Question 27

if Necrotizing Enterocolitis is untreated…

Answer 27

progress to sepsis

Question 28

Necrotizing Enterocolitis requires prompt treatment

Answer 28

• bowel rest
• gastric decompression
• abx therapy

Question 29

Meckel’s Diverticulum

Answer 29

outpouching of ileum near the ileocecal alve
>poush contains gastric contents causes ulceration

Question 30

Meckel’s Diverticulum
etiology

Answer 30

• appear by 2 y.o.
• most common GI malformation

Question 31

Meckel’s Diverticulum

manifestation

Answer 31

• ulceration
• bowel obstruction
• perforation
• peritonitis

Question 32

Meckel’s Diverticulum
diagnosis

Answer 32

• bleeding diverticulum
• occult blood stool test

Question 33

Meckel’s Diverticulum
treatment

Answer 33

surgical removal of diverticulum + involved bowel

Question 34

2 types of Inflammatory Bowel Disease

Answer 34

1 Crohn disease
2 Ulceritive Colitis

Question 35

Crohn disease
targets which portion

Answer 35

randomly throughout GI tract

(like mouth + anus)

Question 36

Crohn disease
manifestation

Answer 36

enteric fistulas bw loops of bowels + nearby organs

Question 37

Crohn disease
diagnosis

Answer 37

radiologic + biopsy exams

Question 38

Ulcerative colitis
targets which portion

Answer 38

entire length of bowel

(large intestine + rectal mucosa)

Question 39

Ulcerative colitis

manifestations

Answer 39

• ESR
• CRP
• hypo-albuminemia

Question 40

Risk of cancer is greater in _____ and slightly increased in _____

Answer 40

Crohn;
Ulcerative Colitis

Question 41

Risk of cancer is greater in _____ and slightly increased in _____

Answer 41

Crohn;
Ulcerative Colitis

Question 42

Gastroenteritis

Answer 42

inflammation of stomach + intestines

Question 43

Crohn disease puts children at risk for…

Answer 43

dehydration
hypovolemic shock

Question 44

T/F bowel patterns vary widely

Answer 44

TRUE

Question 45

Constipation

Answer 45

ineffective rectal filling or ineffective rectal emptying

Question 46

Constipation
therapy

Answer 46

• incr fluids
• bowel training
• incr high fiber

Question 47

Constipation cycle

Answer 47

>child dislikes feelingof passing stools> holds it> stool hardens> makes it harder> more painful to pass

Question 48

Crohn vs Ulcerative Colitis

1 Anal or perineal lesions

2 anorexia

3 diarrhea

4 growth retardation

5 pain

6 rectal bleeding

7 weight loss

Answer 48