GI Flashcards
What is the dose of octreotide for upper GI bleeding?
initial IV loading dose of 1 to 2 µg/kg, followed by a 1 to 2 µg/kg/hr continuous IV infusion
What classes of medications are used to treat ulcerative colitis?
5-ASA (5-acetylsalicylic acid)
prednisone
azathioprine
infliximab (anti-TNF a)
surgical resection
Methods for clearing blocked gtube
*warm water
Pancreatic enzymes + bicarbonate
High pressure saline
Carbonated beverage
Repositioning
Removal + replacement
Risk factors for perforation during reduction of an intussusception
<3 minor >5 yrs
Longer duration of symptoms (esp >48h)
Hematochezia
Significant dehydration
Evidence of small bowel obstruction on X-ray
High fever
Leukocytosis
Systemically toxic
Ddx lower GI bleeding in neonate
swallowed maternal blood
infectious colitis
allergic colitis
hemorrhagic disease (vit K def)
Duplication of bowel
Meckel diverticulum
Volvulus
Hirschprung
NEC
Intussusception
CHF
What is Peutz-jeghers?
polypes hamartomateux intestinaux et freckling des lèvres, bouche, main, pied et OGE
augmentation du risque de néoplasie intestinale, maladie héréditaire (50% de transmission)
Systemic signs/symptoms of Crohn’s
Growth failure/failure to thrive (decrased height velocity)
Primary or secondary amenorrhea
Pubertal delay
Extraintestinal manifestations of Crohn’s
Oral aphthous ulcers
Peripheral arthritis
Erythema nodosum
Digital clubbing
Episcleritis
Uveitis
Iritis
Renal stones
Gallstones
Pancreatitis
Anemia - iron deficiency or chronic disease
Removal or dysfunction of what part of the bowel can cause B12 malabsorption?
Terminal ileum
Which inflammatory bowel disease is most commonly associated with:
1. Erythema nodosum
2. Pyoderma Gangrenosum
- Crohn’s
- UC
Which inflammatory bowel disease is most associated with primary sclerosing cholangitis?
UC
Pre-hepatic
Hepatic
Post-hepatic
Causes of portal hypertension
Pre-hepatic - portal vein thrombosis, splenic vein obstruction
Hepatic- cirrhosis (eg. BA, alpha1 antitrypsin deficiency, cystic fibrosis)
Post-hepatic - Hepatic vein thrombosis or tumour
Most common cause of pre-hepatic portal hypertension in children
portal vein thrombosis from omphalitis
Parasitic disease that can cause portal hypertension
schistosomiasis
Signs + symptoms of portal hypertension
ascites
GI bleeding
Varices
Splenomegaly
Systemic effects of portal hypertension
GI hemorrhage
Congestive or hemorrhagic gastritis
Increased cardiac output
Hypervolemia
decreaed systemic vascular resistance
hypotension
Thrombocytopenia
Leukopenia
Anemia
Hepatopulmonary stndrome
portopulmonary hypertension
hepatorenal syndrome
What is hepatopulmonary syndrome
increase in levels of vasoactive agents - pulmonary vasodilatation - ventilation-perfusion mismatch
Causes of neonatal conjugated hyperbilirubinemia
- Biliary atresia
- TORCH infection
- Alagille syndrome
- Choledochal cyst
- Alpha-1-antitrypsin deficiency
- Metabolic disorder
- HSV
- Neonatal hemochromatosis
- Tyrosinemia
- Urea cycle defect
Features on history/physical that are more specific for hirschprungs than functional constipation
onset at birth
enemas necessary
no abdominal pain
+ abdominal distension
episodes of intestinal obstruction
no encopresis
rectal examination - rectum empty
Risk factors for pyloric stenosis
White
Male
(esp firstborn male)
affected first-degree relative
genetic syndromes - Cornelia de Lange, Smith-Lemli-Opitz, Apert, Zellweger, Trisomy 18
Neonatal exposure to erythromycin (enteral)
What are the possible infectious causes of acute pancreatitis?
mumps
coxsackievirus B infection
hemolytic Streptococcus infection
Salmonella infection
hepatitis Aand B
What drugs can cause pancreatitis?
steroids
chlorothiazides
azathioprine
alcohol
valproic acid
tetracyclines
oral contraceptives
What drugs can cause pancreatitis?
steroids
chlorothiazides
azathioprine
alcohol
valproic acid
tetracyclines
oral contraceptives
What is are the endocrine + metabolic causes of pancreatitis?
Hyper-PTH
Hypercholesterolemia
Cystic fibrosis
Vitamin A + D deficiency
What are possible severe complications of pancreatitis?
pleural effusion
abscess/superinfection
hypocalcemia
ARDS
