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Pediatrics > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What are signs of dehydration in children

A 
Low urine output
Weight loss
Dryness (tears and mouth)
Sunken Fontanelle
Increased pulse, decreased VP, skin turgor
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2
Q

Treatment for dehydration in children

A

Fluid Bolus 20mL/kg ASAP, followed by maintenance fluids once stable

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3
Q

What are common causes of Appendicitis

A

Idiopathic or Fecalith

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4
Q

Sx of Appendicitis

A

Periumbilical and RUQ pain
Nausea, Vomiting
Rovsing, Obturator, Psoas, McBurney’s Point Tenderness

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5
Q

Dx of Appendicitis

A

CT and US

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6
Q

Tx of Appendicitis

A

Appendectomy

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7
Q

What is Colic

A

Rule of 3’s: Healthy 3 month old who cries over 3 hours/day for over 3 weeks

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8
Q

Sx of Colic

A

Rule of 3’s: Healthy 3 month old who cries over 3 hours/day for over 3 weeks

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9
Q

Tx of Colic

A

Reassurance and parent education that baby is not sick. Eliminate cows milk from mother’s diet if breastfeeding

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10
Q

What is Gastroesophegal Reflux (GER)

A

Recurrent postprandial emesis that resolves spontaneously and is normal

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11
Q

What is Gastroesophageal Reflux Disease (GERD)

A

Persistent sx of GER or esophgeal Inflammation

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12
Q

Tx for GERD

A

Acid Suppression via H2 blockers or PPI like Zantac
Smaller more frequent feedings
Thicken milk with rice cereal
Antireflux surgery in severe cases

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13
Q

What is Chronic Constipation

A 
Must have 2 or more:
Fewer than 3 BM/week
1+ episodes of encopresis (involuntary pooping)
Stool impaction in rectum
Large stools that clog toilet
Fecal Withholding
Pain with Defacation
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14
Q

Treatment for Constipation

A

Dietary Fiber and Fluids
Stool Softener: MiriLax
Laxatives: Senokot, Ex Lax

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15
Q

What is Pyloric Stenosis

A

Hypertrophy and Hyperplasia of the muscular layer of the pylorus causing a functional outlet obstruction

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16
Q

Sx of Pyloric Stenosis

A

Nonbilous vomiting, Regurgitation, Projective Vomiting, Emesis after eating
Usually starts 2-4 wks of age

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17
Q

What is a Physical exam finding of Pyloric Stenosis

A

Mobile, firm, non-tender Olive Shape pylorus about 1-2cm in diameter to the right of the umbilicus

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18
Q

Tx for Pyloric Stenosis

A

Phyloromyotomy

Cimetidine (acid blocker)

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19
Q

What is Intussusception

A

When an intestinal segment invaginates into the adjoining intestinal lumen leading to bowel obstruction

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20
Q

Where does Intussusception usually happen

A

Ileocolic junction

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21
Q

Sx of Intussusception

A

Vomiting, Abdominal Pain, Currant Jelly Stools (mucous and bloody)
Cyclical crying pattern, Colicky pain

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22
Q

Dx of Intussusception

A

Ultrasound

Barium Contrast Enema

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23
Q

Tx of Intussusception

A

Air or Barium Enema

IV Fluids, Surgery

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24
Q

What is Hirschsprung’s Disease

A

Congenital absence of Meissner’s and Auerbach’s Autonomic plexus

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25
Q

Where does Hirschsprung’s Disease usually occur

A

Retrosigmoid

26
Q

Sx of Hirschsprung’s Disease

A

Newborn fails to pass meconium

Constipation, Vomiting, Failure to Thrive

27
Q

Dx of Hirschsprugn’s Disease

A

Anal Monometry, Rectal Biopsy

28
Q

Tx of Hirschsprung’s Disease

A

Surgical Resection

29
Q

Sx of a foreign body

A

Dysphagia, Odynophagia, Drooling, Regurgitation, Chest/Abdominal Pain, Cough

30
Q

Tx of foreign body removal

A

Endoscopic or Miralax

31
Q

What is Encopresis

A

Repeated passage of stools in underwear, usually after 4 yrs of age

32
Q

What causes Encopresis

A

Constipation

33
Q

Tx for Encopresis

A

Support and Education, Establish good bowe habits

34
Q

What is Acute Bilirubin Encephalopathy

A

Lethargy, Poor Feeding, Irritable, High Pitched Cry, Arched Neck

35
Q

What is Kernicterus

A

Injury to the basal ganglia and brainstem due to severe hyperbilirubinemia

36
Q

Sx of Kernicterus

A

Movement disorder, strange gaze, auditory disturbances

37
Q

What is Gilbert’s Syndrome

A

Persistent jaundice without other abnormalities

38
Q

What is Breastfeeding Jaundice

A

Appears within first few weeks of life when baby is not getting adequate milk supply

39
Q

What is Crigler-Najjar Syndrome

A

Rare disease that presents a few days after birth and persists

40
Q

Sx of Crigler-Najjar Syndrome

A

Problem with UDPGT which makes bilirubin water-soluble for clearance. Jaundice

41
Q

What is Biliary Atresia

A

An obstruction of extrahepatic biliary system

Presents from birth-8wks

42
Q

Sx of Biliary Atresia

A

Jaundice, dark urine, hepatosplenomegaly, acholic stools

43
Q

What is Duodenal Atresia

A

Congenital duodenal obstruction. There is an absence of closure of a portion of duodenum

44
Q

Sx of Duodenal Atresia

A

Bilous vomiting within a few hours after birth

Normal meconium

45
Q

Dx of Duodenal Atresia

A

X-Ray: Double bubble sign

US: Can see prenatally with polyhydramnios

46
Q

Tx for Duodenal Atresia

A

Stomach decompression and electrolyte correction/fluids and surgery

47
Q

What is a non-communicating Inguinal Hernia

A

Peritoneal fluid is trapped. The intestine goes through the inguinal ring when the processes vaginallus fails to obliterate.

48
Q

What is a communicating Inguinal Hernia

A

When the processus remains open and bowel contents and fluids may be forced inside

49
Q

What is an Umbilical Hernia

A

Associated with congential hypothyroidism in neonates. Common in full term infants, African American

50
Q

Tx for Umbilical Hernia

A

Surgical Repair when over 4 yrs old. Most regress spontaneously

51
Q

Where do we get Niacin (B3). A diet rich in what is associated with Niacin Deficiency?

A

Tryptophans. Diet rich in corn is associated with Niacin deficiency

52
Q

Niacin Deficiency leads to what disorder

A

Pellagra: 4 D’s

Diarrhea, Dementia, Dermatitis (stocking/glove pattern), Death

53
Q

What is Vitamin A good for

A

Vision, Immune Function

54
Q

Vitamin A Deficiency leads to what

A

Vision Loss, Night Blindness ,Bitot Spots, Xerophthalmia (dry eye), Squamous Metaplasia

55
Q

Vitamin C Deficiency leads to what disorder

A

Scurvy: 3H’s

Hyperkeratosis, Hemorrhage (gum, skin, joints), Hematologic (anemia)

56
Q

Where do we get Vitamin C

A

Raw Citrus and Green Veggies

57
Q

Vitamin D Deficiency leads to what disorder

A

Rickets: Softening of the bones, Bowing deformity, fractures, muscle weakness

58
Q

What is the intervention for Foreign Body Ingestion

A

80-90% pass spontaneously. Can help move things along with polyethylene glycol solution (Miralax).
If dangerous object (battery): Endoscopic removal

59
Q

Dx for Intussusception

A

Abdominal Ultrasound is #1

Barium Contrast Enema (can be dx and tx)

60
Q

Dx for Hirschsprung Disease

A 
Anal Monometry (no relaxation of sphincter)
Rectal Biopsy (no nerves)
61
Q

Tx for Constipation

A 
Dietary fiber and fluids
Osmotic Stool Softeners: Miralax
Laxatives: Sneokot or Ex Lax
Encorporesis: Disimpaction with phosphate, saline enemas, or mineral oil + regular stool softners
Stretch anal sphincter to loosen
62
Q

Tx for Gastroesophageal Reflux

A

GER: Normal
GERD: Trial of H2 blockers or PPI
Smaller, more frequent meals or thicken formula/milk with rice, rice cereal
Keep baby upright
Antireflux Surgery (Nissen Fundoplication) for refractory cases

Pediatrics (12 decks)

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