GI Flashcards
What condition is known as aganglionic megacolon?
Hirschprung’s
What condition is known as bowel telescoping?
intussusception
What condition is characterized by the narrowing of the pyloris?
pyloric stenosis
What GI condition presents with bile-colored emesis?
bowel obstruction
What condition presents with painless rectal bleeding?
Meckel’s Diverticulum
The gold standard diagnostic test for Meckel’s Diverticulum is a?
Meckel’s scan
What acid/base imbalance do children with pyloric stenosis present with?
Metabolic alkalosis
Hirschprungs primarily occurs in ____ _____
male neonates
*may also present later in life
In the neonatal periods, Hirschprungs is characterized by the delayed passage of?
meconium
Physical examination of a child with Hirschprungs includes the palpation of a ____ ____ in the ______
fecal mass in the LLQ
The gold standard diagnostic test for Hirschprungs is a?
rectal biopsy
What is the most frequent cause of intestinal obstruction in the first two years of life?
intussusception
Children with intussusception often present with ____ ____ stools that are ___ ___ in color
currant jelly stools that are dark red in color
Parents may say that their child with intussusception often feeds ___ with in-between ____ and _____
well with in between irritability and emesis
Clinical examination of a child with intussusception includes the palpation of a ____ ____ mass in the _____
sausage-shaped mass in the RUQ
The gold standard diagnostic test for Intussusception is an ____ with b_____ a____ c____ e____
US
barium air contrast enema
*Ensure to have surgery on board
Pyloric stenosis most often occurs within the first ____weeks of life
8 weeks
In what condition are infants eager to eat, eat frequently, but experience no weight gain?
pyloric stenosis
The clinical presentation of an infant with pyloric stenosis includes
____ baby, feeding ____
n_____ p____ v_____
weight ____ and some degree of ____
Happy baby feeding well
non-bilious projectile vomiting
weight loss and some degree of dehydration
Physical examination of an infant with pyloric stenosis includes the palpation of an ___-shaped ____ in the ___ ____ abdominal area
olive-shaped mass
in the mid epigastric
Infants with pyloric stenosis may display gastric ____ ____ upon the visual abdominal assessment
peristaltic waves
What is the gold standard test for pyloric stenosis?
abdominal US
Treatment for an infant with pyloric stenosis includes
stabilizing ______
r______
and scheduling an ____ _____ ____
electrolytes
rehydrating
open laparoscopic surgery
Appendicitis is more common in what age group?
adolescents and teenagers
The clinical presentation of children with appendicitis includes
p____ p____ which migrates to the __
and on/off f_____
periumbilical pain which migrates to the RLQ
and on/off fever
*males may c/o testicular pain
McBurney’s point is characterized by?
RLQ pain
Psoas sign is elicited by?
pain while flexing the right thigh backwards while child is laying on left side
obturator sign is elicited by?
pain on internal rotation of hip when right knee flexed
The gold standard diagnostic test for appendicitis is an?
abdominal CT
Midgut malrotation/volvulus occurs within the first _____ of life
year
*may be congenital
Infants with midgut malrotation/volvulus will have b_____ o_____ and b____ e______
bowel obstruction and bilious emesis
50% of infants with malrotation/volvulus will have ___ of the colon
twisting
The gold standard diagnostic test for an infant with malrotation/volvulus is?
Abdominal CT
What acid/base imbalance is indicative of bowel obstruction?
metabolic acidosis
What surgery corrects malrotation/volvulus?
Ladd procedure
Toxic megacolon occurs most often in kids with i____ b____ d____
inflammatory bowel disease
Children with toxic megacolon will present with
f____
abdominal _______
p_____
increased w_____
decreased p____ and a_____
fever
abdominal distension
pain
increased WBC
decreased potassium and albumin
Toxic megacolon is characterized by ____ of the colon
dilation
Diagnostic studies for toxic megacolon include obtaining an abdominal ____, a ___ and ____
x-ray
CBC
CMP
Toxic megacolon management includes
a____
f____ and as a last resort
c_____
antibiotics
fluids
colectomy
The most common reason for bowel perforation in neonates is?
NEC
NEC is considered a surgical emergency due to b___ w___ r____
bowel wall rupture
Initial NEC diagnostic study includes an?
xray
An x-ray showing NEC will display a___ in the a____ c____
air in the abdominal cavity
The confirmatory diagnostic test for NEC is via?
CT
An infant with NEC will present with
a___
increased w_____
and b____ e_____
acidosis
increased WBC
bilious emesis
NEC treatment includes s____, a____ and f_____
surgery, antibiotics, fluids
NEC complications include b____, i____, and a_____
bleeding, infection, abscess
Meckel’s Diverticulum is most commonly seen in kids betwen ___-____ YOA
2-4
Children with Meckel’s Diverticulum often present with P_____ r____ b_____
painless rectal bleeding
The gold standard diagnostic test for Meckel’s Diverticulum is?
Meckel’s Scan
Meckel’s Diverticulum is treated with?
surgery
In what condition does the large intestine have ulceration and inflammation?
ulcerative colitis
Ulcerative colitis presents most often in what age group?
teens and young adults
S/S of ulcerative colitis includes
R___ u____
b____
t_____
rectal urgency
bleeding
tenesmus (feel the need to pass stools)
Patients with Ulcerative colitis are initially treated with?
steroids
What is the gold standard diagnostic test for Ulcerative Colitis and Crohn’s Disease?
endoscopy
What may be done for a patient with Ulcerative Colitis to allow for bowel rest?
colectomy
In what GI condition is it typical to see rectal fissures or tags?
Crohns disease
Crohn’s disease leads to the malabsorption of
i___, z____, f___ and vitamin __
iron
zinc
folate
vitamin b12
Crohn’s disease may involve any GI segment, s/s may include a__ p___ and r___ b____
abdominal pain and rectal bleeding
Upon diagnosis of Crohn’s disease, what treatment is indicated for a suspected fistula or abscess?
antibiotics
What should children with Crohn’s disease avoid?
NSAIDS
Acute abdominal pain differential diagnosis includes
o____
p_____
c______
and g___-u___ disorders
obstruction
pancreatitis
colilithiasis
genito-urinary disorders
Children with esophageal obstruction present with excessive ____ and _____
secretions and vomiting
Children with stomach obstruction present with?
nonbilious vomiting
Children with obstruction at the duodenum, jejunum, ileum, and colon present with?
bilious emesis
Abdominal compartment syndrome typically occurs s/p ____ or ____ GI processes
infection or inflammatory
Children with pancreatitis will c/o s__ or d___ e___ pain, which radiates to the ____ side of the ____, accompanied by __/___/____
sharp or dull epigastric
Left side of the back
accompanied by N/V/D
What laboratory test is a more specific marker for pancreatitis?
Lipase
what laboratory test will rise first when pancreatitis is present?
amylase
Pancreatitis management includes placing the child ____, ___ control, and ___ nutrition. Children with pancreatitis should maintain a ___ ___ diet
NPO
pain control
IV nutrition
low fat diet
Cholelithiasis is more prevalent amongst?
teens and young adults
Cholelithiasis s/s include abdominal ___ which radiates to the ___ accompanied by __/___ after ____
pain
back
n/v after eating
What is the gold standard diagnostic test for cholelithiasis?
ERCP
*other studies may include a HIDA scan or MRCP
What labs are elevated in cholelithiasis?
w___, g____, a__ p___, ____/____, d___/i____ b____, a_____
WBC
GGT
alkaline phosph
AST/ALT
direct/indirect bilirubin
amylase
Gastroenteritis is typically ___ in nature. Acquired via the f___/o____ route
viral
fecal/oral
Gastroenteritis s/s include f___, v___, d____
fecal
vomiting
diarrhea
If stable, the key to gastroenteritis treatment is?
oral rehydration at home
GI bleeding treatment may include
o_____, v____, and b___ b_____
ocerotide
vasopressin
beta blockers
Neonatal causes of acute GI bleeds include
rectal f____
C____
g____
e____
s/p m_____ v____
and/or due to congenital v___ lesions
rectal fissures
CMPA
gastritis
esophagitis
mechanical ventilation
vascular lesions
Causes of acute GI bleeding in infants- 1YOA includes
G_____
G____
I____
GERD
Gastritis
IBD
Causes of acute GI bleeding in children 1-2 YOA includes
e___ v____
b____ a_____
p____ v____ t____
v____ lesions
i____ d_____
esophageal varices
biliary atresia
portal vein thrombosiss
vascular lesions
infectious diarrhea
Causes of acute GI bleeding in children 2 YOA and older include
p____ h____
e___ v____
I____
i____ d_____
portal HTN
esophageal varices
IBD
infectious diarrhea
In any acute GI bleed monitor c___ and c____ studies
CBC and coagulation
acholic stools are a sign of?
liver failure
When working up a child with hyperbilirubinemia obtain
L___
G____
a___
a____
c___ studies and
g_____
LFT’s
GGT
Albumin
Ammonia
coagulation
glucose
For patients with biliary atresia and/or in preparation for liver transplant treatment may include i____ or p____
IVIG
phenobarb
The gold standard diagnostic test for biliary atresia is?
liver biopsy
The treatment of choice for biliary atresia is the?
kasai procedure
Children with biliary atresia will need f___ s___ v____ supplements and l__ f___ formulas
fat-soluble vitamin supplements
low fat formulas
S/S of kernicterus includes
s____ h___ loss
loss of u____ g____
and l____ which is considered an emergency
sensorinural hearinig loss
loss of upward gaze
lethargy
-due to encephalopathy
Hepatitis B and C is usually transmitted from ____ to ____
mother to infant
The is the diagnostic test for pediatric hepatitis?
A_____ ___ with Doppler
abdominal US with doppler
Children with hepatitis should avoid ____ ____ _____
liver toxic medications
At every encounter children with hepatitis should have their ____ monitored
LFT’s
Children with Hepatitis will experience worsening in ___ ___ every time they are rsick
liver function
Children with liver failure may require the administration of ___ __. Ensure to monitor ___ studies.
vitamin k
coagulation studies
Unconjugated hyperbilirubinemia is most often caused by conditions that?
increase the destruction or RBC’s
Children with conjugated hyperbilirubinemia are at greatest risk for?
gall stones
Examples of conditions leading to unconjugated hyperbilirubinemia include?
i____ p____ jaundice
g____ syndrome
infantile physiologic
gilberts
Examples of conditions leading to conjugated hyperbilirubinemia include?
o____ jaundice
obstructive jaundice
—anything that blocks bile flow such as stones, tumors
Clinical manifestations of conjugated hyperbilirubinemia include
elevated ____
p_____
d___ u____
s_____
and decreased _____ absorption
elevated cholesterol
pruritis
dark urine
steatorrhea (fatty stools)
vitamin
