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paediatrics > gastrointestinal disorders > Flashcards

gastrointestinal disorders Flashcards

1
Q

does pyloric stenosis affect more boys or girls?

A

boys (M>F)

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2
Q

a) key signs in pyloric stenosis?

b) at what age?

A

a) projectile vomiting, olive mass in RUQ

b) 4-6 weeks old

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3
Q

how is pyloric stenosis diagnosed? 2 ways

A
  • test feed

- USS

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4
Q

management of pyloric stenosis?

A

Ramstedt pyloromyotomy

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5
Q

presentation of mesenteric adenitis?

A
  • central abdo pain

- URTI

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6
Q

management of mesenteric adenitis?

A

conservative

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7
Q

where does intussusception occur?

A

at the level of the ileocaecal valve

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8
Q

age demographic for intussusception?

A

6-9 months

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9
Q

signs of intussusception?

A
  • colicky pain
  • diarrhoea
  • vomiting
  • sausage-shaped mass
  • red currant jelly stool
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10
Q

management of intususception?

A

air insufflation

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11
Q

which other conditions is malrotation commonly associated with?

A
  • exomphalos
  • diaphragmatic hernia
  • duodenal atresia
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12
Q

how can you tell that malrotation has been complicated by a volvulus?

A

the vomit will be bile-stained

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13
Q

how is malrotation diagnosed?

A
  • UGI contrast study

- USS

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14
Q

management of malrotation?

A
  • laparotomy

- Ladd’s procedure if volvulus is present

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15
Q

what causes Hirschsprung’s disease?

A

absence of ganglion cells from myenteric + submucosal plexuses

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16
Q

how is Hirschsprung’s disease diagnosed?

A

full-thickness rectal biopsy

17
Q

signs of Hirschsprung’s disease in neonate?

A
  • distended abdomen

- failure to pass meconium

18
Q

management of Hirschsprung’s disease?

A
  • rectal washouts

- anorectal pull through procedure

19
Q

presentation of oesophageal atresia?

A
  • choking

- cyanotic spells (following aspiration)

20
Q

presentation of meconium ileus?

A
  • delayed passage of meconium

- distended abdomen

21
Q

what is meconium ileus strongly associated with?

A

cystic fibrosis

22
Q

management of meconium ileus?

A
  • PR contrast can dislodge the meconium plug
  • NG N-acetyl cysteine
  • surgery to remove plug
23
Q

presentation of biliary atresia?

A
  • jaundice > 14 days
  • dark yellow / brown urine
  • pale stools
  • hepatosplenomegaly
  • failure to thrive
24
Q

management of biliary atresia?

A

Kasai procedure (urgent!)

25
Q

main risk factor for necrotising enterocolitis?

A

prematurity

26
Q

presentation of necrotising enterocolitis?

A
  • abdo distension
  • poor feeding
  • passage of (fresh) bloody stools
27
Q

X-ray findings in necrotising enterocolitis?

A
  • dilated bowel loops
  • pneumatosis intestinalis
  • air on both sides of bowel wall
28
Q

management of necrotising enterocolitis?

A
  • broad spectrum ABx
  • total gut rest
  • TPN
  • laparotomy if there is any perforation
29
Q

complications of GOR?

A
  • failure to thrive from severe vomiting
  • oesophagitis
  • iron deficiency anaemia
  • recurrent pulmonary aspiration
  • dystonic neck
  • ALTE
30
Q

how can GOR be investigated in an atypical history?

A
  • 24h oesophageal pH test
  • endoscopy with oesophageal biopsy
  • contrast study of UGI tract
31
Q

management of GOR?

A
  • reassurance
  • thickening agents in milk
  • position 30 deg head-up prone after feed
  • surgery where unresponsive to domperidone
32
Q

at-risk group for severe GOR?

A
  • cerebral palsy

- any other neurodevelopmental disorder

33
Q

risk factors for hirschsprung’s disease?

A
  • male (3x more)

- Down’s syndrome

34
Q

presentation of hirschsprung’s disease in neonates?

A

failure / delay in passing meconium

35
Q

presentation of hirschsprung’s disease in older children?

A
  • constipation

- abdominal distension

paediatrics (10 decks)

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