Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PNCB2 > Gastrointestinal Issues and Disorders > Flashcards

Gastrointestinal Issues and Disorders Flashcards

1
Q

What causes gastroenteritis?

A 
viruses are the majority--especially during the winter:
    rotavirus (50% of viral cases)
    adenovirus
Bacterial:
    salmonella
    camylobacter (odorous stool)
    shigella 
    e. coli (mild loose stools)
    giardia (from swimming pools)
parasitic 
Inorganic food contents
emotional stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What symptoms are indicative of shigella?

A

fever spikes, bloody stools, febrile seizures

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

Signs/symptoms of gastroenteritis?

A 
N/V/D (watery)
hyperactive bowel sounds
general sick feeling--fever when septic
anorexia
cramping abdominal pain
distention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Explain mild dehydration

A

3-5%

everything is normal, except urine output is slightly decreased

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

Explain moderation dehydration

A 
6-9%
abnormals are:
increased pulse/hr
decreased skin turgor
fontanel slightly sunken
urine output decreased (
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Explain severe dehydration

A 
>/= 10%
bp: normal or decreased
pulse/hr: severe, decreased
prolonged cap refill
decreased skin turgor
sunken fontanel
urine output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Explain daycare exclusion with gastroenteritis

A

if you have rotavirus, e. coli or shigella, need to stay home–if have e. coli and shigella, need 2 negative stool cultures to return to daycare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is moderate and severe oral rehydration therapy?

A

moderate: 50 ml/hr
severe: 100 ml/hr

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

What is the first antibiotic of choice if gastroenteritis is needed to be treated with meds?

A

bactrim (trimethroprim/sulfamethoxazole)
antibiotics considered with pt has more than 8-10 stools daily and indicated when an organism is isolated or symptoms are not resolved

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

What organism that causes gastroenteritis is not very responsive to antibiotics?

A

salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name the 3 classes of GERD

A
  1. physiological: infrequent, episodic vomiting (specific cause and effect)
  2. functional: painless effortless vomiting with no physical sequelae (wet burps, happy spitter)
  3. pathological: frequent vomiting with alteration in physical functioning such as failure to thrive and aspiration pneumonia (irritable)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How common is GERD and when does it typically resolve?

A

85% of premature infants and infants with low birth weight

Typically resolves by 18 months

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

Signs and symptoms of GERD

A 
choking, coughing, wheezing and weight loss (need work up for these symptoms)
irritability
recurrent vomiting
heartburn
painful belching/ab pain
stool changes
sore throat
pharyngitis
otitis media
dental erosions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What medications can be used to treat GERD?

A

Histamine H2-recpetor anatgonist (H2RA) to inhibit gastric acid secretion caused by histamine–ex) ranitidine, famotidine

Proton Pump Inhibitors (PPIs) to block gastric acid secretion caused by histamine, acetylcholine or gastrin–ex) omeprazole

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

What is pyloric stenosis?

A

obstruction resulting from thickening of the circular muscle of the pylorus

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

How common is pyloric stenosis?

A

1:500, more common in males and caucasians

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

What delays presentation of pyloric stenosis?

A

breast feeding

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

What are the signs and symptoms of pyloric stenosis?

A

projectile non-bilious vomiting after eating
hungry after vomiting
poor weight gain or weight loss
eventually becomes dehydrated
visible peristaltic waves
palpable mass (pyloric olive) after vomiting

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

When does pyloric stenosis typically present?

A

from 3 weeks to 4 months

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

What are diagnostic tests of pyloric stenosis?

A 
abdominal US (more accurate)
If US is not diagnostic, GI imaging--commonly shows a string sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is intussusception?

A

acute prolapse of one part of the intestine into another adjacent segment of the intestine

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

What virus is suspected to link to intussusception?

A

adenovirus

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

What are other suspected causes of intussusception?

A

CF, celiac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Who does intussusception typically occur in?

A

males, before the age of 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are signs and symptoms of intussusception?

A

previously healthy infant develops acute colicky pain
bilious vomiting
progressive lethargy
currant jelly stool (dark red seedy) **LATE SIGN
sausage shaped mass in the right upper quadrant
progressive distention, tenderness
if not reduced, perforation and shock may occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does bilious vomiting indicate?

A

an obstruction below the ampulla of water (union of pancreatic duct and common bile duct)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How common is Hirschsprungs Disease (ganglionic megacolon)?

A

1:5000 births, more common in boys in girls

may present in infancy or older children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the signs and symptoms of hirschsprung’s disease?

A 
failure to pass meconium
bilious vomiting
jaundice
infrequent explosive bowel mmt
progressive ab distension
**tight anal sphincter with an empty rectum
failure to thrive
malnutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What would an abdominal X-ray likely show in someone with hirschsprungs?

A

large colon

30
Q

If an appendicitis in untreated what can it lead to?

A

gangrene in perforation may develop within 36 hours

31
Q

Who are appendicitis most common in?

A

males ages 10-30 years old

32
Q

What are the most common signs of appendicitis?

A

colicky umbilical pain
after several hours–pain shifts to RLQ
rebound tenderness
pain worsens and localizes with cough
Nausea with 1-2 episodes of vomiting (more indicates another condition)
sense of constipation (infrequently diarrhea)
fever (low grade)

33
Q

If you have an appendicitis you can’t go to the _______.

A

PROM
P: psoas sign: pain with R thigh extension
R: rebound tenderness
O: obturator sign–pain with internal rotation of the thigh
M: McBurney’s point tenderness

34
Q

What labs/tests would indicate an appendicitis?

A

WBC: 10000 to 20000, ESR elevated

US or CT is diagnostic

35
Q

What are signs and symptoms of malabsorption?

A 
FTT
severe, chronic diarrhea
bulky, foul stool (steatorrhea)
vomiting
ab pain
protuberant abdomen
Also--associated with vitamin deficiency or malabsorption:
   pallor, fatigue, hair/derm abnormalities, cheilosis,                     
   peripheral neuropathy
36
Q

What tests would you do for someone with suspected malabsorption?

A

stool: culture, hemoccult, and ova/parasite exam
serum calcium, phosphorous, alkaline phosphatase, total protein, ferritin, folate, and liver function test
bone age
lactose/sucrose breath hydrogen testing
sweat chloride cystic fibrosis test

37
Q

What vitamins for cystic fibrosis pt?

A

fat soluble vitamins (A, D, E, K)

38
Q

What is a neuroblastoma?

A

tumor arising from neural tissue, frequently from adrenal gland (on top of kidney) and can spread to bone marrow, liver, lymph nodes, skin, and orbits of eyes

39
Q

When does neuroblastoma most commonly occur?

A

before the age of 5

40
Q

What are the signs/symptoms of neuroblastoma?

A

FTT
enlarged abdominal mass
profuse sweating
tachycardia

41
Q

What tests should you do for suspected neuroblastoma?

A

urine catecholamines,

abdominal US or CT

42
Q

What are the most common types of hepatitis in pediatrics?

A

A, B, C

43
Q

Hepatitis A

A

an enteral virus, transmitted via the oral-fecal route

44
Q

What are Hep A outbreaks typically caused by?

A

contaminated food/water–lots of flooding in areas can lead to outbreaks

do not give sushi to children

45
Q

When do symptoms of Hep A typically manifest?

A

2-6 weeks after infection
blood/stools are infectious during the 2-26 week incubation period
HEP A HAS THE SHORTEST INCUBATION PERIOD

46
Q

Do children with Hep A have jaundice?

A

most children are not anicteric (jaundiced) with Hep A so infections frequently go unnoticed

47
Q

What is the serology of active hep A?

A

Anti-HAV, IgM (IgM=active disease)

48
Q

What is the serology of recovered hep A?

A

Anti-HAV, IgG (disease is gone)

49
Q

Does chronic carrier state exist for hep A?

A

NO–and mortality rate is low and fulminant hepatitis A (occurs suddenly/quickly) is rare

50
Q

Hepatitis B

A

a blood-borne virus present in saliva, semen, vaginal secretions and all body fluids which is transmitted via blood, blood products, sexual activity, and mother to fetus

51
Q

What is the incubation period of Hep B?

A

6 weeks- 6 months longest incubation period

52
Q

What makes Hep B and Hep A different?

A

Hep B has a more insidious or gradual onset

53
Q

Is there a risk for fulminant hep B?

A

Yes, but

54
Q

What is the serology for active hep B?

A

HbsAg, HBeAg, Anti-HBc, IgM

55
Q

What is the serology for chronic hep B?

A

HBsAg, Anti-HBc, Anti-Hbe, IgM, IgG

56
Q

What is recovered hepatitis B?

A

Anti-HBc, anti-HBsAg, IgG

57
Q

With Hep B vaccine–serologically converted, what will the serology most look like?

A

recovered hep B

58
Q

Hepatitis C

A

traditionally associated with blood transfusion
50% of cases are related to IV drug use
Risk of sexual transmission is small, and maternal transmission to newborn is rare

59
Q

What is the incubation period of hep C?

A

4-12 weeks

60
Q

What is the serology of acute hep C?

A

Anti-HCV, HCV RNA

61
Q

What is the serology of chronic hep C?

A

Anti-HCV, HCV RNA

62
Q

Is there a cure for hep C?

A

NO so acute and chronic hep c serology look exact same

63
Q

What are pre-icteric signs and symptoms of hepatitis?

A

Before jaundiced: fatigue, malaise, anorexia, N/V, headache and aversion ot second-hand smoke and alcohol odors

64
Q

What are icteric signs and symptoms of hepatitis?

A

weight loss, jaundice, pruritus, RUQ ab pain

65
Q

What are other symptoms of hepatitis?

A 
clay, colored stools
dark urine
low grade fever 
hepatosplenomegaly
diffuse abdominal pain
tenderness over liver
dark urine and light colored stool
66
Q

What are lab tests you would want in someone with suspected hepatitis?

A

CBC
UA: proteinuria, bilirubinuria
AST, ALT (elevated 500-2000)
LDH, bilirubin, alkaline phosphate, and PT are normal or slightly elevated

67
Q

What happens to AST and ALT tests in someone with hepatitis?

A

AST and ALT rise prior to onset of jaundice and will fall after jaundice presents

68
Q

What is the management of hepatitis?

A

generally supportive–rest during active phase
increase fluids
vitamin K for prolonged PT >15 sec
avoid alcohol and meds detoxified by the liver
little to no protein diet

69
Q

What should you increase fluids to in someone with hepatitis?

A

3,000 to 4,000 ML/day

70
Q

What may be prescribed for hep C?

A

rebetron (interferon and ribavirin)

PNCB2 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions