Gastrointestinal Flashcards
TEF is associated with what syndrome?
Vertebral Anorectal Cardiac Trachea Esophagus Renal Limb
Loss of normal peristalsis in the body of the esophagus and failure of LES to relax in response to swallowing
Achalasia
Barium swallow: Bird’s beak (air fluid level in the dilated esophagus
Achalasia
Gold standard for Achalasia
Esophageal manometry
This microbe can cause achalasia
Trypanosoma cruzi
Tx for Achalasia
Nifedipine: poor surgical candidate
Intersphincteric injection of botulinum toxin
Heller myotomy
Non bilious vomiting at 3rd week of life
Pyloric stenosis
String sign
Pyloric stenosis
Chron’s disease
Ovoid Olive-shaped mass
Pyloric stenosis
Double tract sign
Pyloric stenosis
Shoulder sign
Pyloric stenosis
TOC Pyloric stenosis
Ramstedt pyloromyotomy
Triad of Gastric Volvulus
Sever epigastric pain
Intractable retching with emesis
Inability to pass a tube into the stomach
Failure to recanalize the lumen after the solid phase if the intestinal development during the 4th abd 5th week AOG
Duodenal atresia
Prematurity, down syndrome, malrotation, esophageal atresia, CHD, polyhydramnios
Duodenal atresia
Double bubble sign
duodenal atresia
Ground glass appearance in the right lower quadrant with trapped bubbles of air within the obstructing meconium
Meconium ileus
Meconium ileus is associated with what genetic disorder
Cystic fibrosis
Soap bubble sign
Meconium ileus
Soap bubble sign
Meconium ileus
Most common congenital GI anomaly
Meckel diverticulum
Pathophysio of Meckel diverticulum
Persistence of omphalomesenteric or vitelline duct
Painless rectal bleeding stool, brick colored or currant jelly
Meckel’s diverticulum
Hernia within a Meckel’s diverticulum
Littre’s hernia
Aganglionic megacolon
Hirschprung disease
Definitive diagnosis of Hirschprung disease
Deep rectal biopsy
Rectal Suction Biopsy
GI conditions associated with Down’s syndrome
Duodenal atresia
Hirschprung disease
Most common cause of intestinal obstruction between 3 months anf 6 years of age
Intussusception
Most common type of intussusception
Ileocolic (iliocecal) intussusception
Most common type of intussusception
Ileocolic (iliocecal) intussusception
Dance’s sign
Intussusception
Abdominal retraction on the right iliac fossa
Sausage-shaped mass
Intussusception
Coiled spring sign
Instussusception
Prolonged elevated levels if cobkugated bilirubin after 14th day of life. Usually presents with jaundice, hepatomegaly, normal or acholic stools.
Neonatal cholestasis
Enzyme that catalyzes conversion of hemoglobin to biliverdin
Heme oxygenase
Enzyme that catalyzes conversion of bilirubin to conjugated bilirubin
Glucuronyl transferase
Conjugated bilirubin to urobilinogen
Beta-glucoronidase
Chloramphenical causes grey baby syndrome due to lack of what enzyme in babies
Glucuronyl transferase
Inherited form of non-hemolytic anemia
Crigler-Najjar syndrome
More severe type of Crigler-Najjar Syndrome
Type 1
Most common hereditary cause of increased bilirubin
Gilbert (-Meulengracht) syndrome
DiRect bilirubinema
Conjugated hyperbilirubinemia
Kernicterus
Dubin-Johnson syndrome
Rotor Syndrome
Defect of ability of hepatocytes to secrete conjugated bilirubin into the bile
Dubin Johnson syndrome
Increased conjugated bilirubin without elevation of liver enzymes
Dubin Johnson Syndrome
Rare, relatively benign autosomal recessive.
Non-itching jaundice
Rotor Syndrome
Young, cirrhotic, non-alcoholic, SEVERE PRURITUS
Primary Biliary Cirrhosis
PBC gene problem
Anti-mitochondrial antibody
PBC gene problem
Anti-mitochondrial antibody
Bilirubin encephalopathy
Kernicterus
Level of bilirubin for kernicterus
20 mg/dl
Level of bilirubin for icteric sclerae
2-3 mg/dl
Level of bilirubin that requires phototherapy
15 mg/dl
Bilirubin has predilection to what part of the brain
Basal ganglia
Drugs that can be used for kernicterus
Phenobarbital
Metalloporphyrins
Last resort for resistant kernicterus
Exchange transfusion
