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GEN MED GI > Gen Med Pediatric > Flashcards

Gen Med Pediatric Flashcards

1
Q

Bilious Vomit (yellow Green) is:

A

Obstruction until otherwise proven

Refer for endoscopy ASAP

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2
Q

Projectile Vomit (consistent, not ill)

A

Pyloric Stenosis

Fine/Not Fussy always projectile vomits after eating & wants to eat again

Not sick but likely not gaining well

Image of Choice is Sonogram, looking for target sign if no hemetemesis

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3
Q

Pyloric Olive

A

Hypertrophied Pyloric Sphincter

Cause of Pyloric Stenosis

May be palpable in epigastric

Surgury required

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4
Q

Rx Pyloric Stenosis

A

Surgery

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5
Q

Infantile/childhood Hematemesis

A

911

Refer for endoscopy asap

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6
Q

Common GERD causes in nursing baby

A

Dairy & Beef & Smoking in the house

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7
Q

Uncomplicated GERD fixes

A
  • Sit baby up after eating for 1/2 hr
  • Try soy, Try non-soy
  • -thicken formula w/oat cereal, not rice
  • If nothing works, try 2wk PPI trial use Nexium
  • If that doesn’t work, refer for endoscopy
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8
Q

Target Sign on Sonogram

A

Pyloric Stenosis
or
Intussception “target, bulls eye or coiled sprain”

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9
Q

Hemetemesis

A

Complicated GERD
or
Volvulus

Refer for endoscopy ASAP

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10
Q

Sm bowel invagination, usually near ileocoecal valve

A

Intussusception

  • Under 3
  • Sudden Onset
  • Current Jelly Stool
  • Happy Between Episodes
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11
Q

Rx for Projectile Vomit/Pyloric Stenosis

A

Pyloromyotomy

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12
Q

Intussusception Rx

A

Pneumatic Air Enema Thru Rectum

Surgery if that doesn’t work

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13
Q

Knees Up & Screaming
Belly Distended
Fine between episodes

A

Intussusception

invagination of sm bowel into cecum

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14
Q

Intussusception Triad

A
  • Sausage Shaped Mass in Belly palpable
  • Pain
  • Current Jelly Stool
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15
Q

Happy Pukers

A

Pyloric Stenosis

Check for Olive

Refer for sonogram / target sign

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16
Q

Suspect Volvulus

A

X Ray asap, don’t stop to sonogram w/barium

17
Q

Rule of 2

A 
Meckel's Diverticulum:
2 yrs or younger
2% of the population
2 feet from the ileocoecal valve
2 inches long
18
Q

Most common cause of Obstruction up to age 2-3

A

Intussusception - 911!!!

- Endoscopy    - NG Tube    - IV Fluids    - Pneumatic Air Enema or Barium from Rectum

You CAN have intussusception with no obstruction

19
Q

Meckel’s Diverticulum Image of choice

A

Nuclear Scan, 80% diagnostic

If negative and you have painless lower GI bleed that may look like Appendicitis but Appendix is fine on the nuclear scan
Go to Arteriography

20
Q

Meckel’s Rx

A

Decompress Bowel if obstructed

Augmentin/Flagyl & PPI

Divertiulectomy or Resection/Anastamosis

21
Q

Bowel winds 270 degrees around Ligament of Treitz

A

Intestinal Malrotation

Volvulus -911

22
Q

Malrotation Study of Choice

Volvulus Study of Choice

A

Upper GI w/Barium for Malrotation

Stat X-Ray for Volvulus, no time!! then to OR
LADD procedure untwists & appendectomy

23
Q 
Vomiting bile (green digestive fluid)
Drawing up the legs.
Abdominal pain.
Swollen abdomen.
Diarrhea.
Constipation.
Rectal bleeding.
Failure to thrive.
A

Volvulus

X-Ray

LADD Procedure

24
Q

Painless lower GI Bleed in kids

Appedicitis-y but CT of appendix is good Think:

A

Merkel’s Diverticulum

Rule of 2’s

25
Q

Happy Spitter

A

Uncomplicated Infant GERD

Happy Projectile Vomiter is Pyloric Stenosis

26
Q

Corkscrew on Upper GI w/Barium

A

Intestinal Malrotation

you probably did an X-Ray if you had biliary vomit or hematemesis and suspected Volvulus.

27
Q

Neonate

A

1-28 days

28
Q

Neonate doesn’t pass Meconium in first 2 days of life and Belly Distended & Bilious Vomit

“Squirt Sign” or “Blast Sign” on pinky DRE

A

Hirchsprung Disease

Congenital loss of Myenteric Nerve Bed in distal Sigmoid, loss of peristalsis

Get X-Ray, look for air above the Sigmoid

Refer for REctal Biopsy to DX

Colonectomy is RX

29
Q

painless bleeding from the rectum

A

Meckel’s Divertiuculum

  • One of the Most common congenital abnormalities.
  • Usually Asymptomatic found on scan for something else or looks like appendicitis
  • Arises from incomplete separation of fetal bowel from the placenta
  • Rule of 2’s
  • Nuclear Scan to image or arteriography. Capsule endography not so great as diverticula can be large and capsule can get stuck there.
  • Bowel Abx regimen but substitute Augmentin for Cipro in kids, give Abx prophylactically and in actual diverticulitis.

GEN MED GI (4 decks)

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