Brainscape's Knowledge GenomeTM

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


See full index

Paediatrics > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What is the duration for constipation to be chronic?

A

Over 8 weeks

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

Encoperesis - what is it?

A

Soiling

Usually due to overflow diarrhoea

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

Red flag symptoms for constipation (+ conditions this indicates)

A

Failure to pass meconium = CF, Hirschprungs

FTT = CF, coeliac, hypothyroidism

Distension = Hirschsprungs

Sacral dimple above natal cleft = spina bifida

Perianal fistulae/ abscesses = Crohns

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

Constipation medical management

A

Disimpaction = macrogol laxatives

Escalating dose for 1-2 weeks

Add stimulant laxative after 2 weeks

Maintenance = lower dose macrogol

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

Gastroenteritis organisms, S+S

A

Usually rotavirus (infant) or noravirus (all kids), campylobacter (severe abdominal pain), shigella + salmonella (blood + mucus in stool)

Sudden onset

Fever Abdo pain Vomiting Shock

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

Gastroenteritis - investigations

A

Bloods, ABG if in shock

Stool sample if blood/ mucus in stools

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

Gastroenteritis management

A

Oral rehydration solution or fluid therapy 20mls per kg of NaCl = for bolus

UNLESS DKA, head injury, congenital heart problems (give 10mls per kg)

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

Gastroenteritis complications

A

Haemolytic uraemic syndrome = complication of E coli

IV fluids can cause decreased sodium concentration = cerebral oedema + seizures

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

Other causes of diarrhoea

A

Coeliac, IBS, IBD + toddlers diarrhoea

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

GORD - how common, when does it present, what causes it

A

Disease = only if symptomatic

40% of infants experience reflux

First 2 weeks of life

Due to incompetence of sphincter

Better with age due to solid food, time spent upright + strengthening sphincter

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

GORD S+S

A

Presenting as ‘vomiting’ - non-forceful regurg

Feeding difficulties - distress after feeding

Irritability

Resistance + arching with feeding

Usually put on weight gain fine - can get FTT

Apnoeas + cough + stridor

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

GORD complications

A

Oesophagitis = haematemesis, anaemia

Resp symptoms = cough, wheeze, aspiration pneumonia - can be life threatening FTT

Sandifers syndrome = associated with dystonic neck movements

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

GORD management

A

Conservative: avoid overfeeding, sit up (cot slanted, burping after)

Milk thickeners (for bottle fed) Gaviscon (for breast fed)

H2/ PPIs - can increase risk of NEC in preterms

Surgical - for kids with neuro problems

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

GORD investigations

A

Diagnosis is clinical

Potential investigations (for older kids) :

FBC - check for anaemia

24hr oesophageal pH study

Endoscopy - if oesophagitis suspected

Mamometry - assesses oesophageal motility + sphincter function

Barium meal

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

Vomiting in distal v proximal obstruction

A

Proximal = more bile stained vomit + more forceful

Distal = more abdo distension

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

Causes of vomiting

A

Feeding errors - faulty technique, dietary restrictions

Infections - GI, appendicitis, paraenteral

Obstruction

Raised ICP - meningitis, encephalitis, space occupying lesion

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

12 vomiting red flags (+ conditions they are associated with)

A

Bile stained = intestinal obstruction (duodenal atresia)

Haematemesis = oesophagitis, ulcers

Projectile = pyloric stenosis

Vomiting after coughing = whooping cough

Abdo tenderness = surgical abdo

Abdo distension = intestinal obstruction, inguinal hernia

Hepatosplenomegaly = liver disease

Blood in stool = intusseception, gastroenteritis

Severe dehydration = systemic infection, DKA

Bulging fontanelle/ seizures = raised ICP

FTT = reflux, coeliac

LOC = meningitis, infection

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

Causes of acute abdo pain in newborns

A

Intestinal obstruction (Hirschprungs, volvulus, pyloric stenosis)

Hernia

Necrotising enterocolitis

Reflux

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

Vomiting - medical reasons

A

Gastroenteritis, reflux, infection, intolerance, ulceration, migraine

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

Vomiting - surgical reasons

A

Intestinal obstruction, pyloric stenosis, duodenal atresia, intusseception, malrotation, volvulus, Hirschprungs

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

Causes of acute abdo pain in infants (<2)

A

Constipation Hernia Volvulus Intussusception Colic UTI

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

Causes of acute abdo pain in children 2-18 y/o

A

Appendicitis DKA Henoch-Schnolein Purpura UTI Mesenteric adenitis Gastritis Constipation Intestinal obstruction

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

Causes of acute abdo pain in adolescents

A

Dysmenorrhoea PID Ovarian torsion Testicular torsion Pregnancy

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

7 abdo pain red flags (+ conditions this indicates)

A

Bloody stool = UC, necrotising entercolitis, constipation, intussesception

Haematemesis = ulcers, gastritis

Bilious emesis = bowel obstruction

Jaundice = hepatic/ biliary obstruction

Joint pain = IBD, HSP

Skin lesions = IBD, HSP, liver disease

SOB = pneumonia

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

3 recurrent abdo pain causes

A

Pain lasting more than 3 months

Usually due to IBS, abdo migraine or functional dyspepsia

IBS: explosive stools, bloating, feeling of incomplete defecation, constipation, abdo pain

Abdo migraine = headaches + abdo pain

Functional dyspepsia = bloating, early satiety, reflux

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

Functional dyspepsia management (+ H pylori treatment)

A

H pylori = amoxicillin + metronidazole

PPIs

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

Appendicitis - S+S, investigations + management

A

Vomiting

McBurnys point - RIF pain + guarding

Rovsing’s sign - pressure in L side gives pain in R side

Faecalith = preschool children = blocks appendix

USS

Appendicectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Coeliac disease - pathology, presentation, investigations, management, complications

A

Gluten provokes damaging response in proximal small intestinal mucosa

Villi become shorter and absent, leaving flat mucosa

HLA-DQ2/8

Presents as malabsorption at 8-24 months

Loose stools, FTT, abdominal distension, short stature, anaemia

Serology testing - IgA tissue transglutaminase antibodies

Endoscopy + biopsy = villous atrophy, crypt hypertrophy

Associated w/ Downs, Turners + T1DM

Gluten free diet

Complications: anaemia, osteoporosis, malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Undescended testicles - types, management

A

Normally descend on 36th week

Retractile = testis can be manipulated into the scrotum but then retract

Palpable = testis can be palpated in groin

Impalpable = no testis felt

Review at 6-8 weeks

Review at 3 months - If still undescended - do orchidopexy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Inguinal hernia - cause, S+S, management

A

Usually indirect - due to patent processus vaginalis

Common in premature babies

S+S: intermittent swelling in groin, firm and tender

Opioid analgesia + compression

Surgery after 24-48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Intussusception pathology + causes

A

Invagination of proximal bowel into distal segment

Commonly = ileum passing into caecum

Causes: change in diet, viral infection

Causing hypertrophy of Peyer’s patches - causes obstruction + ischaemia

32
Q

Intussusception S+S + who does it commonly affect?

A

Colicky paroxysmal pain

Pale, draws legs up

Refusing feeds

Vomiting - may be bile stained

Redcurrent jelly stool

Commonl boys, 5-10 months

33
Q

Intussusception investigations, management + complications

A

Investigations: examination = sausage shaped mass

AXR (bowel dilation), then USS showing target sign

NBM, NGT, rectal air insufflation/ enema

DON’T DO AIR ENEMA if there is a prolonged hx (>24hrs) or already showing signs of peritonitis = may cause perforation

Complication: stretching + constriction of mesentery causing venous obstruction = leads to bowel perforation, peritonitis + gut necrosis - on AXR may have football sign

34
Q

Causes of unconjugated jaundice

A

Breast milk jaundice Infection (UTI)

Haemolytic anaemia

Hypothyroidism

High GI obstruction

Crigler-Najjar obstruction

35
Q

Causes of conjugated jaundice

A

Bile duct obstruction

Neonatal hepatitis (Hep A)

36
Q

S+S jaundice

A

Pale stools, dark urine, bleeding, FTT

37
Q

Mesenteric adenitis - what is it, differentiation with appendicitis

A

Inflamed lymph glands in abdo - cause abdo pain

Usually due to viral infection

High fever (whereas appendicitis is low grade fever)

Accompanied by URTI with cervical lymphadenopathy

Resolves within 48 hours

38
Q

Pyloric stenosis - what is it, onset, S+S, management

A

Hypertrophy of muscle causing gastric outlet obstruction

Presents between 2-7 weeks

S+S: vomiting, increasing in forcefulness

Dehydration, FTT Visible peristalsis

Palpable abdo mass in RUQ

Hypocholoraemic metabolic alkalosis - low sodium + potassium

Management: pyloromyotomy

39
Q

Testicular torsion - RF, S+S, management

A

RF: high insertion of tunica vaginalis = bell clapper testis with horizontal lie

S+S: sudden onset severe pain, often comes on during sport, N+V, acute swelling

Surgery within 12 hours

40
Q

Biliary atresia - what is it, S+S, management, complications

A

Destruction of biliary tree + ducts

S+S: FTT, jaundice (prolonged), pale stools + dark urine, hepatosplenomegaly

Surgically bypass fibrotic ducts (hepatoportoenterostomy = Kasai procedure)

Post op complications: cholangitis, malabsorption of fats + fat soluble vitamins, portal HTN

41
Q

Duodenal atresia - cause, S+S, investigations

A

Double bubble on XR

Bilious vomiting

Congenital

42
Q

Hepatitis S+S

A

N+V Abdo pain Lethargy Jaundice Large tender liver Splenomegaly Increased liver transaminases

43
Q

Hep A - cause, S+S, diagnosis, management

A

RNA virus spread by faecal oral route

Common cause of childhood jaundice

Prodrome (week 1) then jaundice for week 2-3

Raised bilirubin, AST + ALT

Diagnose with IgM antibody to virus

Give prophylaxis with immunoglobulin to close contacts or vaccinate within 2 weeks

44
Q

Hep B - cause, transmission from mother to baby

A

DNA virus - usually passed on from mothers

Asymptomatic carriers if infected perinatally

IgM ab (anti-HBc) are +ve in acute infection +ve HBsAg = ongoing infection

45
Q

Hep C - transmission from mother to baby

A

Vertical transmission - causes children to be carriers with progression to cirrhosis

46
Q

Crohns - pathology, S+S, management

A

Transmural inflammatory disease with non-caseating epitheloid cell granulomata

S+S: abdo pain, diarrhoea, rectal bleeding, growth failure, raised crp polymeric diet for 6-8 weeks, immunosuppressant meds

47
Q

UC - pathology, S+S, management

A

Inflammatory + ulcerating disease - mucosal inflammation, crypt damage, ulceration

S+S: rectal bleeding, diarrhoea, colicky pain, weight loss, growth failure

Treat with aminosalicylates, steroids + immunosuppression

48
Q

Volvulus - causes, S+S, management

A

Malrotation = failure of gut to rotate + return to abdo

Causes obstruction with bilious vomiting + ischaemia manage surgically

49
Q

How much milk should babies have in a day?

A

150ml/kg/ day

50
Q

RF for GORD

A

More common in floppy babies eg Downs/ neuro problems (CP)

Preterm Hypotonic

Males

Cows milk

Obesity

51
Q

What are the downsides of breastfeeding?

A

Increased frequency of feeds

Less vitamin D - may need a supplement

52
Q

What is the most common cause of PR bleeding in neonates?

A

Swallowing blood from CS or placental abruption

Cows milk protein allergy - causes pink frothy stools

53
Q

S+S cows milk protein allergy

A

D +V Abdo pain

Blood in stools

Hives/ eczema

Wheezing, irritability, facial swelling FTT

54
Q

What is oesophageal atresia + tracheosophageal fistula + RF?

A

Atresia = doesn’t connect with stomach, ends in pouch

Fistula = connects with trachea

RF: polyhydraminos

55
Q

What is Crigler Najjar syndrome?

A

Causes non-haemolytic jaundice causing high unconjugated bilirubin in neonates

LFTs normal

Autosomal recessive

Needs liver transplant

56
Q

What is Gilbert’s syndrome?

A

Common cause of unconjugated high bilirubin

Jaundice precipitated by illness, stress etc

57
Q

Prolonged constipation (for years), distended bowel, faecal loading (on AXR), failure to pass meconium for a few days - what is it?

A

Hirschprungs

58
Q

What is Hirschprungs?

A

Absence of myenteric + submucosal ganglia cells in rectum

Due to failure of neural crest cells to migrate in week 8-12

Results in aganglionic section that is unable to relax

59
Q

RF for Hirschprungs

A

Boys more common

Downs + other inherited conditions

60
Q

S+S of Hirschprungs

A

Abdo distension, vomiting, constipation, delayed meconium, FTT, poor nutrition

61
Q

Investigations + management of Hirschprungs

A

AXR - faecal loading + dilated bowel

Barium enema + biopsy

Surgery = removal of segment with end-end anastomosis OR removal of aganglionic segment + colostomy to allow decompression of dilated bowel

62
Q

Complications of Hirschprungs

A

Soiling

Enterocolitis - can become life threatening - stool sample to be sent to check for viral causes

Incontinence

Constipation

Stricture

Obstruction

63
Q

What are Peyer’s patches?

A

Lymph nodes in bowel

Commonly involved in intusseception in young children (due to recent viral illness causing inflammation of Peyer’s patches)

64
Q

What defects are tracheo-oesophageal fistulas associated with?

A

horseshoe kidney, AV septal defects + imperforate anus, also oesophageal atresia – common in genetic disorders

65
Q

How does a tracheo-oesophageal fistula present?

A

choking + coughing during for during feeds, abdo distension + LRTIs

66
Q

What is VACTERL?

A

Verterbral anomalies

Anorectal anomalies

Cardiac anomalies

TOF + oesophageal atresia

Renal tract abnormalities

limb anomalies

67
Q

What is Meckel’s diverticulum, how does it present + what is the rule of 2s? What scan is diagnostic?

A

Vitelline duct remnant

Rule of 2s – 2% of people, 2cm long, 2ft from end of gut

Can cause rectal bleeding, discharge from umbilicus + bowel obstruction/ intussecption in older children.

Presents like appendicitis.

T99 scan is diagnostic

68
Q

When should you repair umbilical hernias by?

A

4-5 years

69
Q

What is a torted hydatid?

A

testicular pain, pea sized blue swelling

70
Q

What is a hydrocele?

A

Fluid in the scrotum leading to swelling

71
Q

What is phimosis?

A

Tight foreskin

72
Q

What is epididymitis?

A

inflammation causing pain, dysuria, frequency + scrotal pain, swelling – STI related

73
Q

What is epispadias?

A

urethral meatus on dorsal aspect

74
Q

What is priapism?

A

Painful + prolonged erection

75
Q

What is cryptorchidism?

A

Undescended testes - common in preterms

Should descend by 6 months - if not, fix by 1 year

76
Q

What is the coffee bean sign?

A

Large bowel obstruction that folds itself double

Paediatrics (19 decks)

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