Gastrointestinal Disorders Flashcards
2 month old male infant presented with recurrent vomiting, with mass palpated in the epigastric area:
a. Pyloric stenosis
b. Duodenal atresia
c. Hepatoblastoma
a. Pyloric stenosis
Patient with encopresis and on abdominal PE there was palpable hard mass on the left lower quadrant.
a. Chronic constipation
b. Diarrhea
a. Chronic constipation
What is the explanation for a baby with constipation and Abdominal Xray showing (features of Hirschsprung Disease):
a. Aganglionosis
b. Mucosal damage
a. Aganglionosis
What is the mechanism of GERD in causing cough with wheezes?
a. Chemical irritation of airways
b. Chronic damage to the larynx ?
b. Chronic damage to the larynx ?
* Nelson’s 18th: GERD may produce respiratory symptoms by direct contact of the refluxed gastric contents with the respiratory tract (aspiration, laryngeal penetration, or microaspiration)
What is the pathophysiology behind diarrhea caused by lactose intolerance?
a. Fermentation
b. Mucosal damage
c. Secretory
a. Fermentation
Nelson’s 18th: The classic example of osmotic diarrhea is lactose intolerance due to lactose enzyme deficiency. The colonic bacteria ferment the nonabsorbed lactose to short-chain organic acids, generating an osmotic load…
Below -2 for Height for age ad weight-for-length: A. wasted B. underweight C. stunted and wasted D. stunted
C. 43. Nutrition, Food Security and Health weight-for-length in below -2: WASTED DEFINITIONS OF MALNUTRITION Gomez Definition: Weight below % median WFA GRADING Mild (grade 1) 75%-90% WFA Moderate (grade 2) 60%-74% WFA Severe (grade 3) < or = z score < -2 Severe z score < or = z score < -2 Severe z score < 0.31 Moderate < 0.28 Severe < 0.25
COLE
Definition: z score of bmi for age
Grade 1 <-3
PUD is due to increased peptic laden acid in the duodenal mucosa…blah blah. What is the TRUE statement about PUD? A. Patient with severe respiratory condition, enteral feeding compared with parenteral feeding?
B. Enteral feeding stimulates immature gut mucosa
C.
D.
?
Soy-based milk are not being given to premature infants because you would expect the infant to experience: A. hypocalcemia B. hypoglycemia C. D.
A.
NTP19 Ch 48 Rickets and Hypervitaminosis D
Because the majority of children with rickets have a nutritional deficiency, the initial evaluation should focus on a dietary history, emphasizing intake of vitamin D and calcium. Most children in industrialized nations receive vitamin D from formula, fortified milk, or vitamin supplements. Along with the amount, the exact composition of the formula or milk is pertinent, because rickets has occurred in children given products that are called milk (soy milk) but are deficient in vitamin D and/or minerals.
In the rehabilitation of malnourished children
A. Iron should be given in the initial rehabilitation phase
B. Start on high protein and large volume load
C. Hypophosphatemia can result from refeeding syndrome
D.
C
NTP19 Ch 43 Nutrition, Food Security and Health
The usual approach to the treatment of severe acute malnutrition includes 3 phases (Table 43-5 and Fig. 43-7). The initial phase (1-7 days) is a stabilization phase. During this phase, dehydration, if present, is corrected and antibiotic therapy is initiated to control bacterial or parasitic infection. Because of the difficulty of estimating hydration, oral rehydration therapy is preferred (Chapters 55 and 332Chapter 55 Chapter 332). If intravenous therapy is necessary, estimates of dehydration should be reconsidered frequently, particularly during the first 24 hr of therapy. Oral feedings are also started with specialized high-calorie formula (seeFig. 43-7 and Table 43-6), proposed by the World Health Organization, that can be made with simple ingredients. The initial phase of oral treatment is with the F75 diet (75 kcal or 315 kJ/100 mL). The rehabilitation diet is with the F100 diet (100 kcal or 420 kJ/100 mL). Feedings are initiated with higher frequency and smaller volumes; over time, the frequency is reduced from 12 to 8 to 6 feedings per 24 hr. The initial caloric intake is estimated at 80-100 kcal/kg/day. In developed countries, 24-27 calorie/oz infant formulas may be initiated with the same daily caloric goals. If diarrhea starts or fails to resolve and lactose intolerance is suspected, a non–lactose-containing formula should be substituted. If milk protein intolerance is suspected, a soy protein hydrolysate formula may be used.
Wikipedia
Refeeding syndrome is a syndrome consisting of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved or severely malnourished.[1] The syndrome was first described after World War II in Americans who, held by the Japanese as prisoners of war, had become malnourished during captivity and who were then released to the care of United States personnel in the Philippines.[2]
Definition
Any individual who has had negligible nutrient intake for >5 consecutive days is at risk of refeeding syndrome. Refeeding syndrome usually occurs within four days of starting to feed. Patients can develop fluid and electrolyte disorders, especially hypophosphatemia, along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications.
GER resolves by
a. 0-6 mos.
b. 6-12 mos.
c. 12-24 mos
c. 12-24 months. Infant reflux becomes symptomatic during the first few months of life, peaking at about 4 months and resolving in most by 12 months and nearly all by 24 months. P.1222
23.Px just recovered from URTI. Currently, he was noted to be crying every 15 mins. with a mass on the right upper quadrant.What is the most likely diagnosis?
Intussusception p. 1242
Diagnostic imaging for Meckels diverticulum
radionuclide scan (meckel scan)
A 3-year old child was brought in for consult at your clinic. She is lethargic, edematous, with desquamation in the abdomen. What is your diagnosis? a. Kwashiorkor b. Marasmus c. Vitamin A deficiency d. Vitamin D deficiency
A. (p. 172, Nelson’s). Kwashiorkor may present as vague manifestations, such as lethargy, apathy or irritability. Other manifestations may include inadequate growth, lack of stamina, loss of muscle tissue, increased susceptibility to infections, vomiting, diarrhea, anorexia, edema and dermatitis. Marasmus, on the other hand, presents as failure to gain weight and irritability, followed by weight loss, listlessness until emaciation results. The infant’s face may appear shrunken and wizened.
An infant may suffer from this deficiency (kwashiorkor) if the milk that he is drinking is not fortified with: a. minerals b. sodium c. vitamin C d. vitamin D
D. vitamin D
