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Year 4: Paediatrics > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

what is oesophageal atresia

A

birth defect where oesophagus ends in a pouch

  • often occurs alongside a tracheo-oesophageal fistula
  • associated with polyhydramnios in utero
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2
Q

presentation of oesophageal atresia

A

excessive oral secretions
aspiration / regurgitation when fed
episodes of cyanosis

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3
Q

persistent crying/discomfort in a healthy thriving infant, particularly at night/ after feeds is most likely to be ?

A

colic

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4
Q

advice for management of colic

A

small frequent meals – avoid overfeeding
burping regularly to help milk settle
keep baby upright post feed

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5
Q

what treatment options are available for infants with problematic colic? i.e. poor weight gain, refusing feeds

A

gaviscon mixed with feeds

ranitidine (H2 inhibitor)

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6
Q

what is pyloric stenosis

A

hypertrophy of the pyloric sphincter causing narrowing of the pylorus
- prevents food from passing from stomach to duodenum normally

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7
Q

presentation of pyloric stenosis

A

projectile milky vomit after every feed

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8
Q

blood gas result in pyloric stenosis

A

hypochloric metabolic alkalosis

- baby is vomiting hydochloric acid from the stomach

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9
Q

investigation + management of pyloric stenosis

A

abdo USS - visualise thickened pylorus

tx - laparoscopic pyloromyotomy (Ramstedt operation)

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10
Q

what is coeliacs disease

A

autoimmune reaction to gluten causing inflammation in the small intestine
- usually presents in early childhood but can present at any age

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11
Q

antibodies in coeliacs disease

A

IgA anti-tissue transglutamase (Anti-TTG)
anti-endomysial (Anti-EMA)
- important to test for total IgA levels, as patients with low IgA will be negative for these antibodies even if they have the disease

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12
Q

symptoms of coeliacs disease

A

failure to thrive

  • diarrhoea
  • fatigue
  • weight loss
  • mouth ulcers
  • anaemia

dermatitis herpetiformis rash

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13
Q

gene linked to coeliacs disease

A

HLA- DQ2

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14
Q

what condition is strongly linked to coeliacs disease

A

type 1 diabetes

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15
Q

findings on endoscopy coeliac disease

A

villous atrophy

crypt hyperplasia

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16
Q

management of coeliac disease

A

life long gluten free diet

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17
Q

presentation of IBD in children

A

abdominal pain
diarrhoea (bloody in UC/allergic colitis)
failure to thrive – weight loss

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18
Q

screening test for IBD

A

faecal calprotectin - raised due to inflammation in intestines
- 90% specific to IBD

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19
Q

what should you suspect in baby with delayed passage of meconium, dilated bowel loops + absence of rectal air on XR

A

Hirshsprungs disease

20
Q

what is Hirshsprungs disease

A

aganglionic segment of bowel (loss of parasympathetic)

  • causes delayed passage of meconium in infants
  • differential of constipation + abdo pain in young children
21
Q

what is meconium ileus

A

delayed passage of meconium + abdo distention

22
Q

what condition do the majority of babies with meconium ileus have?

A

cystic fibrosis

23
Q

what should you suspect in a baby with persistent jaundice (past 14 days), pale stools + dark urine, splenomegaly ?

A

biliary atresia

24
Q

what is biliary atresia

A

section of bile duct is either narrowed or absent

  • results in cholestasis
  • high conjugated bilirubin levels
25
Q

red current jelly stools + sausage shaped abdo mass

A

intussusception

26
Q

what is intussuception

A

telescoping of the bowel

27
Q

investigation of intussusception

A

USS

28
Q

bile stained vomit

A

malrotation

29
Q

Ix + management of malrotation

A

upper GI contrast + USS

surgery

30
Q

what is Meckels Diverticulum

A

congenital diverticulum of small intestine

  • occurs in 2% of population
  • 2 feet from ileocaecal valve
  • 2 inches long
31
Q

most common cause of painless massive GI bleeding in children 1-2

A

Meckels Diverticulum

32
Q

laxative choice in children with constipation

A

movicol paediatric plan (osmotic)

+ Senna if ineffective

33
Q

colicky abdominal pain where child draws knees up to chest

A

intussusception

34
Q

double bubble sign

A

duodenal atresia

35
Q

what is gastroschisis?

how is this managed?

A

abdominal contents on outside of body with NO peritoneal covering
surgery as soon as possible i.e. within 4 hours

36
Q

what is exomphalos?

how is this managed?

A

abdo contents on outside of body WITH a peritoneal covering

staged closure by 6 - 12 months

37
Q

what is the initial management of Hirshsprungs?

what is the definitive management?

A

initial – bowel irrigation / rectal washout

definitive – anorectal pull through

38
Q

what is Toddlers diarrhoea

A

benign condition due to fast transit through digestive system
watery stools that often contain undigested food
child otherwise thriving
will resolve

39
Q

what is a common complication of gastroenteritis in children

A

lactose intolerance

40
Q

Target sign

A

intusseseption

41
Q

management of intusseseption

A

reduction under fluoroscopic guidance

42
Q

features of necrotising enterocolitis

A

common in premature infants

- abdo distention, bloody stools, dilated bowel loops, bowel wall oedema, intramural gas

43
Q

imaging used in suspected necrotising enterocolitis

A

XRAY

44
Q

management of necrotising enterocolitis

A

gut rest, TPN feeding, antibiotics

- required laparotomy if perforation

45
Q

management of an umbilical hernia

A

majority spontaneously resolve

elective repair if persists past 4/5 years or causing significant symptoms

46
Q

what is mesenteric adenitis

A

abdominal pain caused by inflamed lymph node in the mesentery

  • will typically follow viral infection
  • resolves spontaneously
47
Q

how is the diagnosis of hirschsprungs made

A

rectal biopsy showing absence of ganglionic cells

Year 4: Paediatrics (16 decks)

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