GI

Question 1

Focus after delivery for these two structural disorders is airway and sucking.

Answer 1

Cleft lip and cleft palate

CL can be repaired by 3 mos
CP can be repaired around 6 mos

Question 2

Protrusion of part of the gut or bowel through the inguinal ring into the scrotal or labial area

Treatment: Outpatient Surgery

Answer 2

Inguinal hernia

Question 3

Common in infants

Umbilical rings does not close at the end of the first trimester

Treatment: None unless persists after 5yrs

Answer 3

Umbilical hernia

Question 4

Complete closure of the anal passage
Immediate surgical intervention

Answer 4

rectal atresia

Question 5

Narrowing/constriction of the rectal passage
Can have ribbon-like stools

Answer 5

rectal stenosis

Question 6

No rectal opening
Child may have a fistula going to the GU system

Answer 6

imperforate anus

Question 7

Thickened muscle (pylorus) causing a blockage causing projectile vomiting and olive shaped mass.

Answer 7

Pyloric stenosis

Question 8

How is pyloric stenosis treated?

Answer 8

rehydration, surgery, & early feeds after surgery

D/C home is typically within 24 hrs

Question 9

What is it?
Telescoping of a portion of the intestine, commonly at the ileocecal valve

How is it diagnosed?
Barium or Air Enema and imaging

How is it treated?
Enema or surgery if not corrected

Answer 9

Intussusception

Question 10

Intussusception manifestations

Answer 10

jelly stools, sausage shaped mass, intermittent colicky cry, & fever

Question 11

Abnormal rotation of the intestine around the superior mesenteric artery during fetal development

Answer 11

may lead to malrotation of the intestine. Life threatening if twisting of the intestine around itself, or volvulus, occurs.

Question 12

S/sx of malrotation/volvulus

Answer 12

Intermittent bilious vomit/dehydration
Abdominal distention/pain
Lower GI bleeding
A palpable epigastric mass
Shock (if untreated)

Question 13

Chronic inflammatory disease characterized by periods of exacerbations and remissions. Can affect any portion of the GI tract.

In children, acute or slow onsetabd pain, diarrhea, blood/mucous in stool, urgency/tenesmus, weight loss, RLQ cramping, fatigue

Answer 13

Crohn’s disease

Question 14

An acute or chronic inflammation of the colon, which is characterized by recurring bloody diarrhea.

Symptoms include abd pain, bloody diarrhea, tenesmus, LLQ cramping, weight loss.

Answer 14

Ulcerative colitis

Question 15

How is Crohn’s disease and Ulcerative colitis diagnosed? Treated?

Answer 15

By EGD and w/ surgery

Question 16

Diet for Crohn’s

Answer 16

High fat, high carb, low residue, smaller/frequent meals, supplements

Question 17

Diet for UC

Answer 17

High in protein, high carb, normal fat, decreased roughage, supplements

Question 18

Inflammation of the appendix (end of cecum)

Answer 18

appendicitis

Question 19

A positive Rovsing’s sign is indicative of acute appendicitis, characterized by inflammation, infection, or swelling of the appendix. What is Rovsing’s sign?

Answer 19

refers to pain felt in the right lower abdomen upon palpation

Question 20

What manifestation would indicate the appendix is perforated?

Answer 20

sudden decrease in abdominal pain

Question 21

Clinical manifestations of appendicitis

Answer 21

-Umbilical pain –> RLQ
-Vomiting
-Fever
-Perforation

Question 22

Increased frequency and fluid content of the stools with or without associated symptoms.

Important to assess the presence of other signs and symptoms such as vomiting, fever, and pain.

Answer 22

diarrhea

Question 23

Explosive, watery, pale, & odor

Answer 23

rotavirus

Question 24

Green and watery stool

Answer 24

E. coli

Question 25

Stool +blood

Answer 25

Salmonella

Question 26

Delay or difficulty passing stool for 2 or more weeks

Answer 26

Constipation

Question 27

Clinical manifestations of constipation

Answer 27

Hardened stool Straining Rectal Pain Encopresis Withholding behaviors

Question 28

Return of gastric contents from the stomach through the lower esophageal sphincter back up into the esophagus Functional reflux Causes infrequent, episodic nonbilious, undigested formula

Answer 28

GER

Question 29

Pathological reflux (choking, apnea, frequent OM/URIs, poor weight gain) Common in premature infants and those with neurological issues

Answer 29

GERD

Question 30

No intervention/tests needed for GER & GERD if weight gain is adequate True or False

Answer 30

True

Question 31

Invervention for GER & GERD

Answer 31

May consider thickened formula or breast milk Need cross-cut nipple! May need lactose-free formula Smaller frequent feedings Feed slowly Do not vigorously play after feeding Feed in upright position 30° for after feeds

Question 32

A syndrome in which infants or young children fail to eat enough food to be adequately nourished and achieve age-appropriate weight gain as a result of: Inadequate caloric intake, Inadequate caloric absorption, & Excessive caloric expenditures. Organic vs inorganic etiology Treatment based on cause

Answer 32

Failure to thrive

Question 33

The absence of ganglion cells results in lack of motility in the affected portion of the bowel. AKA aganglionic megacolon.

Answer 33

Hirschprung's disease

Question 34

Clinical manifestations of Hirschprung's disease

Answer 34

Failure to pass meconium Chronic constipation Abdominal obstruction Explosive BMs Vomiting Older children: foul smelling, ribbon-like stools

Question 35

Decreased mucosal surface area. Usually from surgical resection of small bowel (due to NEC, volvulus, Crohn’s)

Answer 35

Short bowel syndrome

Question 36

Treatment for short bowel syndrome

Answer 36

-Administration and monitoring of TPN -Enteral feeding -Emotional and developmental needs

Question 37

Idiopathic, progressive, inflammatory process (postnatal or fetal) that causes an absence of some or all major intrahepatic and extrahepatic biliary ducts resulting in fibrosis and obstruction

Answer 37

Biliary atresia

Question 38

Clinical manifestations of biliary atresia

Answer 38

Jaundice Urine is dark-stains the infant’s diaper Enlarged liver and spleen Itchy

Question 39

Sx of Cannabinoid Hyperemesis Syndrome (CHS)

Answer 39

nausea, stomach pain, tendency to take hot baths and showers for relief, difficulty eating/keeping food down, weight loss, severe vomiting and or diarrhea sometimes lasting days/weeks