GI Flashcards
What are the two leading causes of exocrine pancreatic insufficiency?
- CF (positive sweat chloride, resp symptoms)
- Shwachmann-Diamond (bone marrow failure)
Conditions associated with celiac disease
- T1DM
- T21
- Turner
- IgA Deficiency
- William’s syndrome
- Autoimmune
- First-degree relative (1:20)
Extra-intestinal manifestations of celiac disease?
- dermatitis herpetiformis (symmetric to extensor surfaces and ++ itchy)
- dental enamel hypoplasia
- osteopenia
- short stature
- delayed puberty
- IDA
- Hepatitis
- Arthritis
- epilepsy with occipital lobe calcifications
Crohn’s vs. UC
Extra-intestinal manifestations of IBD
What extra-intestinal manifestations correlate with bowel disease?
- erythema nodosum
- anemia
- peripheral arthritis
What can fecal calprotectin NOT distinguish?
IBD vs.
- infection
- malignancy
- NSAID use
What medications are available for IBD?
Induce Remission
- Tube feeds (CD)
- Corticosteroids
- 5-ASA (UC)
- Biologics (if severe)
Maintenance
- 5-ASA (UC)
- Tube feeds (CD)
- Azathioprine
- MTX
- Biologics
**NOT steroids
What organisms cause bloody diarrhea?
- salmonella
- shigella
- yersinia
- campylobacter
- E.coli
Blood is SECSY as per Kenzie ;)
Bugs causing gastroenteritis
- Recent antibiotic exposure: C. difficile
- Traveler’s diarrhea: E. coli
- Common causes of food poisoning: Staphylococcus aureus, Bacillus cereus (reheated rice)
- Similar presentation to appendicitis: Yersinia entero colitica
- Contaminated poultry: Campylobacter
- Seizures: Shigella
- Reptiles, animals, livestock, picnic: Salmonella
- Bloody diarrhea: Salmonella, Shigella, Campylobacter, C. difficile, enterohemorrhagic E. coli (EHEC),
Y. enterocolitica - Communicable diarrhea despite exposure to treated water: Cryptococcus (chlorine-resistant)
- Immunocompromised host: Cytomegalovirus (CMV), herpes simplex virus (HSV), BK (acute), crypto sporidium, Mycobacterium avium complex (MAC)
DDx of Upper GI Bleeding
DDx of Lower GI Bleeding
Etiology of Short Gut
Prenatal
- midgut volvulus
- intestinal atresia
- long-segment Hirschsprung’s
- gastroschisis
Neonatal
- midgut volvulus
- thrombosis
- NEC
Postnatal
- midgut volvulus
- thrombosis
- Crohn’s
- Trauma
- vascular malformation
Treatment of H. pylori
PPI
amoxicillin
clarithromycin/metronidazole
Diagnosis of EoE
> /= 15 eosinophils/hpf on biopsy
Long term complications of TPN
- TPN liver disease (PNALD)
- CKD
- bone disease
- CVC-related clots
- sepsis
Criteria for Functional Constipation
> /= 2 months and >/= 2 of:
- < 3 bowel movements per week
- excessive stool retention
- painful or hard bowel movements
- large fecal mass in the rectum
- episodes of incontinence after toilet training - 3x 1/week
- large diameter stool that blocks the toilet
What maternal condition predisposes to small left colon syndrome/intestinal atresia?
Diabetes!
Functional Abdominal Pain
Functional Constipation
Cyclic Vomiting Syndrome
Functional Nausea and Vomiting
Non-retentive Fecal Incontinence
Functional Dyspepsia
Rumination Syndrome
IBS
Abdominal Migraine
Infant Colic and Functional Diarrhea
Infant Dyschezia
Hepatitis B Serology
Who gets prophylaxis for Hepatitis A?
- unvaccinated close contacts within 2 weeks of exposure - vaccinate!
- immunocompromised, age < 12 months, chronic lier disease
Water Soluble Vitamins
Fat Soluble Vitamins
Approach to conjugated hyperbili
Treatment of C. diff
Caffeine Recommendations
Indications for probiotics
- neonatal sepsis
- NEC
- neonatal feeding and growth
- infantile colic
- antibiotic-associated diarrhea
- prevention of C .diff and associated diarrhea (NOT Tx)
- H. pylori
- Functional abdominal pain, esp. IBS
- prevention of eczema (no other atopic dx)
Optimal fluoride in water?
0.7ppm
