Gastrointestinal

Question 1

Common causes of infectious diarrhoea

Answer 1

Salmonella enteritidis- within 12-72 hr of contaminated food or drink

E.Coli- contaminated food and dairy products known as haemorrhagic colitis

Shigella- can cause bloody diarrhoea particularly preschool

Campylobacter- most common bacterial can cause bloody diarrhoea

Question 2

Intussusception clinical feature

Answer 2

Paroxysmal severe colicky pain 
Sausage shaped mass
Abdominal distension 
May vomit 
Blood stained mucus in stool

Question 3

Tx of Crohn’s disease

Answer 3

Azathioprine
Mercaptopurine, methotrexate

Anti-TNF: infliximab, adalimumab

Enteral feeds
Surgery

Question 4

Tx of Ulcerative colitis

Answer 4

Aminosalicylate: mesalazine

Steroids

Infliximab or ciclosporin if infected
Surgery

Question 5

Red flag symptoms with constipation

1. Failure to pass meconium in first 24hr
2. Faltering growth
3. Gross abdominal extension
4. Abnormal lower limb neurology
5. sacral dimple, discoloured skin, hairy patch
6. perianal bruising or multiple fissures
7. perianal fissures, fistulas or abscesses

Answer 5

1. Hirschsprung disease
2. Hypothyroidism, ceoliac and more
3. Hirschsprung
4. lumbosacral pathology
5. Spina bifida
6. Sexual abuse
7. Crohn’s disease

Question 6

Causes of jaundice <24hr

Answer 6

Haemolytic disorders

Rhesus incompatibility
ABO incompatibility
G6PD deficiency
Spherocytosis

Question 7

Causes of jaundice 24hr to 2 weeks

Answer 7

Physiological

Breast milk jaundice
Infection
Bruising
Polycythaemia

Question 8

Causes of jaundice >2 weeks

Answer 8

Unconjugated
Breast milk 
Infection
Hypothyroidism 
G6PD deficiency 
High GI obstruction: pyloric stenosis 

Conjugated
Bile duct obstruction
Neonatal hepatitis

Question 9

Calculating maintenance fluid

Answer 9

First 10kg 100ml/Kg
Second 10kg 50ml/Kg
Subsequent Kg 20ml/Kg