Gastrointestinal Flashcards
Where do neuroblastomas originate from?
The adrenal glands on the kidney
What are two bacteria that cause gastroenteritis?
Salmonella, campylobacter, shigella, E coli
Which signs or symptoms are associated with vitamin deficiency or malabsorption?
palor, fatigue, hair changes, cheilosis, peripheral neuropathy
What is the first line medical management of GERD?
Histamine H2 receptor antagonists to inhibit gastric acid secretion such as pepcid or zantac
What causes 50% of all viral cases of gastroenteritis?
Rotavirus
what type of GERD is frequent with alteration and physical functioning such as failure to thrive and aspiration pneumonia?
Pathological
Is there a chronic carrier state with hepatitis A?
No No
What are the three C’s of gastroesophageal reflux disease?
Cough, choke, cyanosis
What age does intusseseption typically occur before?
Before 2 years of age
What is prescribed for hepatitis c?
Interferon and ribavirin
What type of GERD is infrequent, episodic, and explainable?
Physiological
What is done before medication use in referral in GERD?
Small frequent feelings, burp frequently, avoid formula changes, switch to a weighted formula or an AR formula, and elevate the head after feeding
How is hepatitis b typically transmitted?
Saliva, semen, vaginal secretions, other body fluids, and blood
Do children with hepatitis A turn yellow?
No, it is an anicteric disease
What are some signs or symptoms of hershprung’s disease?
Failure to pass meconium, infrequent or explosive bowel movements, progressive abdominal distention, tight anal sphincter
When is the olive-like mass palpable?
After vomiting
What is diagnostic of appendicitis?
Ultrasound
What laboratory finding is elevated in neuroblastoma?
Urine catecholamines
What does HBsAg, Anti-HBc, Anti-Hbe, IgM, IgE represent?
Chronic hepatitis B
If needing to treat gastroenteritis with an antibiotic what is the first drug of choice?
Trimethoprim/sulfamethoxazole
What percentage of dehydration is classified as severe dehydration?
Greater than 10%
Signs or symptoms of intussusception?
Acute and colicky pain, vomiting, sausage-shaped mass in the upper right quadrant
What is the serology for active verse recovered hepatitis A?
Anti-HAV IgM vs IgG
What type of GERD is painless, effortless, with no physical sequelae?
Functional
Fatigue, malaise, anarchy, headach e, aversion to secondhand smoke and alcohol odors are signs of what stage of hepatitis?
Pre-icteric stage
What is the second line medication management of GERD?
Proton pump inhibitors to block gastric acid secretion such as omeprazole
How is neuroblastoma typically found?
Large abdominal mass
What diagnostic study can also reduce the intussusception?
Barium enema
Weight loss, jaundice, purrritis, right upper quadrant pain, clay colored stool, and dark urine are in what category of hepatitis signs or symptoms?
Icteric
What severity of dehydration is characterized by a almost decreased heart rate or extremely high heart rate, prolonged cap refill, sunken fontanelle, and very very low urine output?
Severe dehydration
What age group does pyloric stenosis typically present?
3 weeks to 4 months of age
What is an acute prolapse of one part of the intestine into another segment of the intestine?
Intussusception
What is the other term for hirschsprung’s disease?
Aganglionic megacolon
Describe the emesis characteristic of pyloric stenosis?
Projectile, non-billious vomiting
For E coli, and shigella when can the child return to daycare?
After two negative stool cultures and the resolution of the diarrhea
List four lab changes with hepatitis
Elevated AST and ALT, elevated LDH, elevated bilirubin, and elevated prothrombin time
What does HBsAg, HBeAg, Anti-HBc, IgM represent?
Active hepatitis B infection
How is pyloric stenosis diagnosed?
Abdominal ultrasound or string sign on an x-ray
What are the three classes of gastro esophageal reflux disease?
Physiological, functional, pathological
What age does GERD typically resolve by?
18 months
What is the incubation period of hepatitis b?
6 weeks to 6 months
What does Anti-HCV, HCV RNA represent?
acute and chronic hepatitis C
What percentage of dehydration is mild dehydration?
3 to 5%
How is hepatitis c transmitted?
IV drug use
Is pyloric stenosis more common in males or females?
Males
What causes current jelly stools?
Ischemic tissue sloughing into the lumen of the bowel
What percentage of dehydration is moderate dehydration?
6 to 9%
When are stool cultures indicated?
Diarrhea is persistent for more than 72 hours or if bloody stool is present
What does Anti-HBc, Anti-HBsAG represent?
Recovered hepatitis B
How is hirschsprung’s disease diagnosed?
A rectal or colon biopsy
What is the route of transmission of hepatitis A?
Oral to fecal
Is hirschsprung’s disease more common in boys or girls?
Boys
What percentage of dehydration is characterized by a slightly increased heart rate, decreased skin trigger, and decreased urine output?
Moderate dehydration
What are the four key signs or symptoms of appendicitis?
P: psoas signs, pain with right thigh extension R: rebound tenderness O: obturator sign, pain with internal rotation of the right thigh M: McBurney’s point tenderness, RLQ pain
What are four parameters to assess for dehydration?
General appearance, eyes, moisturise of mucous membranes, presence of tears
What are red flags for cyclic vomiting?
She mad at emesis, triggering events, abnormal neural exam, progressively worsening
In peptic ulcer disease where are primary ulcers where our secondary ulcers, and which is chronic or acute? Gastric or duodenal
Duodenal is chronic in primary, gastric is acute and secondary
What does the c-uria breath test test for? What are other ways to test for this disease?
H pylori also can test stool and for IGG titers
What is the treatment for h pylori?
Combination treatment of amoxicillin, cleverthromycin, and omeprazole
What defines colic?
Crying three or more hours per day, three or more days per week, and three or more weeks
How is colic managed?
Breastfeeding elimination diet, hydrolyzed formulas
What foreign body aspiration requires immediate removal?
Disk batteries and sharp objects lodged in the esophagus
What is the most accurate diagnostic process for appendicitis?
A CT scan
P what is the IBS criteria?
Abdominal pain once a week for 2 months, with pain that improves with stool or change in the frequency or character of stool
What does the IGA tissue transglutamarace antibody and the IGA endometrial antibody test for?
celiac disease
What does a positive alpha 1 antitrypsin test show?
Crescent City protein losing enteropathy
When is celiac testing done?
After eating gluten in at least one meal per day for 6 weeks prior to testing and then repeated 6 months after a gluten-free diet
Which disease affects the whole bowel, is segmented in distribution, cobbles to an appearance of bowel wall, with extra intestinal symptoms?
Crohn’s disease
Which disease only affects the colon and rectum it’s continuous and is typically associated with blood diarrhea?
Ulcerative colitis
What are perennial skin tags, deep anal fissures, perianal fistulas, and oral optus ulcers suggestive of?
Crohn’s disease