Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Paediatrics > Gastrointestinal and surgery > Flashcards

Gastrointestinal and surgery Flashcards

1
Q

which type of inflammatory bowel disease is more common in children?

A

Crohns

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

discuss the pathology of crohns disease?

A
  1. transmural inflammation with non-caseating granulomas
  2. most commonly effects the terminal ileum, but may occur anywhere from mouth to anus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

local complications of crowns?

A
  1. strictures
  2. adhesions
  3. fistulas
  4. abscesses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how does crohn disease most commonly present? 3

A
  1. weight loss
  2. diarrhea
  3. abdominal pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

extra-intestinal features of IBD?

A

erythema nodosum
pyoderma gangrenosum
uveitis
arthritis

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

potential systemic features of IBD

A

anemia, tachycardia, fever

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

diagnosis of IBD?

A
  1. gold standard is colonoscopy and biopsy
  2. FBC for anemia, CRP and ESR are also elevated
  3. stool cultures often necessary to exclude infective causes of colitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how is the severity of IBD determined? name of the scale and what does it take into account

A

Paris classification
age at diagnosis
location of involvement
behaviour of disease
Childs growth

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

management of IBD active disease?

A

anti-inflammatories: sulfalazine (DMARD) and Mesalazine

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

management of relapses of IBD

A
  1. steroids
  2. immunosuppressants to maintain remission: azathioprine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when to consider biologics for IBD?

A

treatment resistant cases

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

which biologic is commonly used in treatment resistant IBD

A

infliximab (TNF-alpha inhibitor)

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

define celiac disease?

A

autoimmune disease caused by an abnormal response to the gliadin component of gluten

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

How may celiac disease present in a young child? 2

A

1) failure to thrive
2) abdominal distension

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

how may celiac disease present in a older child?

A

weight loss
buttock wasting

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

what are other features of celiac disease? 3

A

anemia
steatorrhea
micronutrient deficiencies (iron, folate, vitamin D, calcium)

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

what rash is associated with celiac disease?

A

dermatitis herpetiformis

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

what are other conditions associated with celiac disease?

A

other autoimmune conditions (diabetes, hashimotos)

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

what is the gold standard for diagnosis of celiac disease? what does it show?

A

duodenal biopsy which shows villus atrophy and crypt hypertrophy

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

how can celiac disease be diagnosed by serology ?

A

elevated IgA tissue transglutaminase autoantibody. IgG can also be used if the patient has IgA deficiency. IgA anti-endomysial antibody can also be used

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

what blood tests besides autoantibodies do you want in someone with suspected celiac?

A

FBC - for anemia
vitamin D
calcium
iron studies

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

management of Celiac disease?

A

Gluten free diet
supplementation of deficiencies

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

complications of celiac (from non-adherence to gluten free diet)

A
  1. micronutrient deficiencies
  2. osteopenia
  3. bowel lymphoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is a differential diagnosis in someone who presents with a clinical picture suggestive of celiac disease + signs of infection ? what is the management

A

giardia lamblia
metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is something that is often confused with GERD? how common is it? and when does it usually resolve
simple reflux occurs in 40% of infants after feeds and resolves by 1 year
26
when is GERD considered a disease in children?
if occurring with complications: 1) failure to thrive 2) esophagitis/esophageal stricture 3) aspiration pneumonitis 4) Sandifer syndrome
27
what is Sandifers syndrome?
a manifestation of GERD which imitates seizures. causes a child to adapt an opisthotonic posture with dystonic neck and trunk movements in reaction to acidic reflux
28
what are predisposing factors for GERD in child?
1) cerebral palsy 2) neurodevelopment disorders 3) bronchopulmonary dysplasia 4) post-surgery
29
what is the management of GERD in a infant?
1. simple measures such as smaller feeds, winding, and keeping the baby upright 2. adding thickeners to feeds (carobel) 3. if not improving consider other causes such as cow milk protein allergy 4. last line treatment: Nissen fundoplication surgery
30
how can cows milk protein allergy be divided?
IgE and non-IgE mediated
31
presentation of non-IgE mediated cows milk protein allergy?
1) causes delayed gastrointestinal symptoms 2) over time leads to a failure to thrive
32
presentation of IgE mediated cows milk protein allergy
causes immediate symptoms including 1) wheeze 2) conjunctivitis 3) angioedema 4) also GI symptoms
33
what is the management of cows milk protein allergy?
management is by avoiding cows milk and substitution with a hydrolyzed formula
34
what does trachea-esophageal fistula commonly occur with ?
esophageal atresia
35
presentation of tracheo-esophageal fistula ?
frothy and choking newborn (often with polyhydraminos), nasogastric tube cannot be passed
36
how is tracheo-esophageal fistula diagnosed?
chest x-ray
37
management of trachea-esophageal fistula?
surgical correction
38
what is tracheo-esophageal fistula associated with?
VACTERL syndrome
39
components of VACTERL syndrome
1. vertebral anomalies 2. anorectal anomalies (anal atresia 3. Cardiac anomalies 4. tracheoesophageal fistula 5. renal anomalies 6. limb anomalies
40
what age range does pyloric stenosis usually occur in ?
3-12 weeks
41
presentation of pyloric stenosis ?
1) projectile non-bilious vomiting 2) olive-like mass palpable superficially at the epigastric region (level of the pylorus)
42
what are the metabolic consequences of repetitive vomitting?
hypokalemic hypochloremic, metabolic alkalosis
43
what is the management of pyloric stenosis ? it is an emergency?
yes it is a surgical emergency 1) ABCs + IV fluids + electrolyte correction (remember the role of Cl- in correcting the metabolic alkalosis) 2) surgery
44
name of surgical intervention required to treat pyloric stenosis ?
ramstedt pyloromyotomy
45
presentation of duodenal atresia ?
presents postnatally with bilious vomitting
46
are most cases of duodenal atresia isolated lesions?
yes
47
30% of cases of duodenal atresia occur with??
trisomy 21
48
diagnosis of duodenal atresia ? what does it show
plain film x-ray double bubble sign
49
management of duodenal atresia ?
1. ABCs + IV fluids + electrolyte correction 2. surgery: duodeno-duodenostomy
50
presentation of volvulus?
1. bilious vomitting 2. abdominal distension 3. PR blood 4. often in shock
51
what is mid-gut volvulus associated with?
malrotation of the midgut
52
diagnosis of mid-gut volvulus?
upper GI series
53
management of volvulus? emergency ?
1. ABCs, IV fluids, electrolytes 2. surgical emergency
54
what age range does intussusception usually occur in ?
6 months to 2 years
55
presentation of intussusception?
1. intermittent abdominal pain examination may show sausage like mass in the abdomen 2. screaming with drawn up legs and passing "redcurrant jelly" stool 3. vomitting
56
diagnosis of intussusception?
ultrasound showing "donut sign"
57
management of intussusception ?
1. ABCs 2. air enema or surgery
58
define gastroschisis?
abdominal wall defect occurring to the right of the umbilical cord insertion without a covering of membrane
59
gastroschisis is associated with? 3
1. intrauterine growth restriction 2. prematurity 3. low birth weight
60
gastroschisis is more common in young mothers taking ....?
recreational drugs
61
management of gastroschisis?
surgical repair
62
what is the feared complication of surgical reduction of gastroschisis ?
abdominal comparent syndrome leading to organ ischemia
63
what defines minor vs major omphalocele (exompthalmos)
size: minor < 5cm, major > 5cm
64
omphalocele is associated what genetic syndrome?
Beckwith-Widemann syndrome (organomegaly)
65
minor omphalocele is often mistake for...?
umbilical hernias
66
in a patient with an omphalocele it essential to do a .... and ..... to exclude other disorders??
echocardiogram genetic karyotyping
67
management of omphalocele ?
minor: surgical closure major: staged surgical closure
68
define hirschprung disease?
congenital absence of ganglionic cells in the distal rectum. failure of migration of neural crest cells
69
classic presentation of Hirschprung disease?
distal obstruction causing bilious vomiting and a failure to pass meconium within 48 hours
70
diagnosis of hirschprung's disease ?
1. barium enema (dilation) of proximal segment and distal narrowing 2. rectal biopsy
71
management of Hirschprung's disease?
resection of the affect bowel segment
72
define necrotizing enterocolitis?
acute ischemic necrosis of the intestines occurring mostly in premature infants <32 weeks
73
presentation of NEC?
abdominal distension bilious vomitting blood PR
74
predisposing factors for NEC?
Patent ductus arteriosus cardiac surgery sepsis
75
management of NEC?
1. NPO + TPN + Antibiotics for 10 days 2. Surgery if perforated
76
diagnosis of NEC?
gold standard is abdominal X-ray which may show air in the wall of the bowel wall (pneumatosis intestinal, dilation of the bowel, portal venous gas
77
what is the differential for bilious vomitting in a new born? 3
1. severe gastroenteritis 2. NEC 3. distal obstruction including; duondenal atresia, meconium ileum, Hirschprung disease, volvulus
78
differential for non-bilious vomitting in a newborn? 3
1. mild gastroenteritis 2. GORD 3. pyloric stenosis
79

Paediatrics (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions