gastrointestinal diseases

Question 1

what is gastroenteritis?

Answer 1

inflammation from stomach to intestines

Question 2

what are the common causes of gastroenteritis?

Answer 2

viral - rotavirus, norovirus

Question 3

how does gastroenteritis clinically present?

Answer 3

nausea
vomiting
diarrhoea

Question 4

how is gastroenteritis managed?

Answer 4

hydration while waiting on diarrhoea and vomiting to settle
may need IV fluids

Question 5

what is congenital pyloric stenosis?

Answer 5

narrowing of the opening from stomach to first part of small intestine (pylorus)

Question 6

what are the symptoms of congenital pyloric stenosis?

Answer 6

projectile vomiting without the presence of bile (vomiting milk) 30 mins after feed
weight loss
still hungry after feed

Question 7

what are the signs of congenital pyloric stenosis?

Answer 7

signs of dehydration
peristalsis across the abdomen
may feel abdominal mass

Question 8

what investigation is used in congenital pyloric stenosis?

Answer 8

US scan upper abdomen
pyloric hypertrophy
olive shaped RUW mass

Question 9

what is seen on investigation of congenital pyloric stenosis?

Answer 9

hypokalaemic hypochloraemic metabolic alkalosis

Question 10

what is the management of congenital pyloric stenosis?

Answer 10

surgery - ramstedt pyloromyotomy (open or lap)

Question 11

what is a volvulus?

Answer 11

loop of intestine twists around itself and the mesentery that supports it

Question 12

what does volvulus result in?

Answer 12

bowel obstruction

Question 13

what predisposes a child to midgut volvulus?

Answer 13

congenital intestinal malrotation

Question 14

what predisposes a child to segmental volvulus?

Answer 14

abnormal intestinal contents e.g. meconium ileus

Question 15

how does volvulus clinically present?

Answer 15

abdo pain/bloating
vomiting bile - green
constipation
blood stool

Question 16

what investigations are used for volvulus?

Answer 16

1st line - abdo x-ray
2nd lin e- upper GI contrast

Question 17

what is the management of volvulus?

Answer 17

surgery emergency

Question 18

what is intussusception?

Answer 18

when bowel telescopes into itself, narrowing lumen = palpable mass in abdo obstructing passage of faeces

Question 19

what are the symptoms of intussusception?

Answer 19

severe colicky abdo pain
pale, lethargic and unwell child
vomiting

Question 20

what are the signs of intussusception?

Answer 20

redcurrant jelly stool
signs of dehydration
RUQ mass
can be assoc with concurrent viral illness

Question 21

what investigation is used in intussusception?

Answer 21

ultrasound

Question 22

what is seen on ultrasound in a child with intussusception?

Answer 22

target sign

Question 23

what is the management of intussusception?

Answer 23

air reduction (air enema) - don’t need surgery
laparoscopic surgery if air reduction fails

Question 24

what is the main differential for acute abdominal presentation in a child?

Answer 24

appendicitis

Question 25

what are the symptoms of appendicitis?

Answer 25

abdo pain - starts central and moves down to RIF (eventually becomes localised in RIF) anorexia N + V temperature

Question 26

what are the signs of appendicitis?

Answer 26

tenderness in McBurney's point rosvings sign guarding tenderness painful movements

Question 27

what is rosving's sign?

Answer 27

palpation of LIF causes pain in RIF

Question 28

if a child can't jump, feels every bump on way to hospital - what does that suggest?

Answer 28

peritonitis

Question 29

how is appendicitis diagnosed?

Answer 29

clinically based on presentation and raised inflammatory markers US if diagnosis uncertain

Question 30

what is the management of appendicitis?

Answer 30

appendicectomy

Question 31

how would a child with GORD present?

Answer 31

regurgitation

Question 32

how is GORD in a child diagnosed?

Answer 32

clinically

Question 33

what is the management for GORD in a child?

Answer 33

usually self resolves within 1 year