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PEDS > GI > Flashcards

GI Flashcards

1
Q

externalized intestines, not in a pouch

A

gastroschesis

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2
Q

Complications of gastrochesis

A

infection
hypothermia
necrosis of the intestines

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3
Q

immediate tx of gastrochesis

A

sterile saline and gauze to wrap intestines

wrap saran warp to keep moisture and heat in

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4
Q

problems that has sx without pathologic correlation. Lab tests/ work up are negative

A

Functional

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5
Q

sx caused by an distinct pathological entity.

A

organic problem

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6
Q

what does a Chem 7 look at?

A

basic electrolytes

kidney function

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7
Q

what can strep throat depend on?

A

Headache and stomachache

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8
Q

Most common sources of acute abdominal pain in young children?

A

Malrotation
intussusception
incarcerated hernia
congential anomalies

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9
Q

Most common source of acute abdominal pain in older children

A

Appendicitis

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10
Q

pouch on the wall of the lower part of the intestine that is present at birth

A

Merckel’s diverticulum

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11
Q

what are 2 function chronic abdominal pains

A

constipation

IBS

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12
Q

common organic problems of abdominal pain

A

gastritis/ ulcer
lactose intolerance
parasites
gallbaldder dz

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13
Q

bloating, transitioning b/w constipation and diarrhea.

A

IBS

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14
Q

tx for functional abdominal pain

A

reassurance and explanation of functional pain (fluids, diet, activity, sleep, emotions)

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15
Q

most common cause of vomiting in childhood?

A

Viral gastroenteritis

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16
Q

what can forceful or projectile vomiting indicate?

A

Pyloric stenosis, obstruction

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17
Q

what causes billious (green/yellow) vomiting?

A

Beyond ampulla of vater (means there is a problem beyond that point)

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18
Q

what can cause bloody vomiting?

A

mallory weis tear
gastric
peptic ulcer

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19
Q

problems associated with projectile vomiting in neonates

A

obstruction
duodenal atresia/ stenosis
malrotation/ volvulus
pyloric stenosis

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20
Q

What is forceful vomiting that is non-billious and forceful and projectile. Will present with FTT

A

Pyloric stenosis

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21
Q

Most common cause of vomiting in older children?

A

Viral illness

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22
Q

Vomiting first thing in the morning associated with headaches. Not associated w/ nausea or abdominal pain.

A

CNS problem

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23
Q

what is the origin of acute diarrhea usually?

A

Infectious

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24
Q

Tx for acute diarrhea

A

Fluids, Na, K

oral rehydration

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25
Q

what part of the GI system does rotavirus affect?

A

Small intestine

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26
Q

what presents with volumous watery diarrhea without leukocytes or blood. Will first have vomiting then followed by a low fever.

A

Rotavirus

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27
Q

what age groups is roatvirus common in?

A

3-15 months, peak in winter

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28
Q

who are enteroviruses more common in

A

Toddlers and school aged

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29
Q

What is a potential cause of traveler’s diarrhea?

A

Norovirus (winter vomiting syndrome)

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30
Q

How do you tx diarrhea?

A

No antidiarrheal medications because they are ineffective and possibly worsen the illness

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31
Q

What should you suspect if there is blood in the stool?

A

Colitis, bacterial cause

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32
Q

Patients with shigella often also have what?

A

a high fever

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33
Q

when can abx be harmful with diarrhea?

A

Shigella, can cause hemolytic uremic syndrome

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34
Q

what are the only indications for abx in bacterial diarrhea

A

C. Diff or

salmonella or campylobacter with risk of further infection

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35
Q

What conditions can cause malabsorption diarrhea?

A

Lactose inteolerance
celiac disease
cystic fibrosis
steatorrhea

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36
Q

Pt. presents with fever, tenesmus, abdominal pain with diarrhea and hx of being on abx.

A

pseudomembranous colitis by C. Diff

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37
Q

what causes toddler’s diarrhea

A

too much fat, not enough protein

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38
Q

most common reason for constipation in children.

A

Functional

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39
Q

Think of with a constipated infant. Stool isn’t moving due to lack of innervation.

A

Hirschsprung disease

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40
Q

causes of organic constipation

A

cystic fibrosis
hypothyroidism
anorectal malformation

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41
Q

Chronic constipation with dilatation of rectal ampulla and fecal soiling

A

Encopresis

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42
Q

Tx for consptiation

A

increase fiber, avoid dairy increased fluids

toilet training exercising after eating

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43
Q

Signs of an organic cause of constpation

A 
No massage of meconium w/i 2 days of birth
hard, infrequent stooling
poor growth/ development
distended abdomen
abnormally placed anus
44
Q

Medical tx for constipation

A

osmotic laxative- polyethylene glycol

45
Q

Causes of signifiant GI bleeding in kids

A

PUD
Meckel’s diverticulum
colitis
intussusception

46
Q

Causes of minor GI bleeding in kids

A

Anal fissure
mallory-Weiss tear
swallowed nasopharyngeal blood

47
Q

outpouching of the small intestines

A

Meckel’s diverticulum

48
Q

most common cause of rectal bleeding in infants

A

colitis from allergies (milk allergy) or anal fissue

49
Q

common causes of GI bleeding in odler children

A

IBS

meckel’s diverticulum

50
Q

tx you can do for Mecke’s diverticulum

A

Meckel scan (nuclear med test)

51
Q

Is a paralytic ileus functional or organic?

A

Functional

52
Q

Is disordered peristalsis functional or organic?

A

Functional

53
Q

Is a septic ileus functional or organic?

A

Functional

54
Q

For an ______ you have pain that is out of proportion to the physical exam. will hear hypertympanic bowel sounds.

A

obstruction

55
Q

sill be sitting still

A

peritonitis

56
Q

if pain is increasing in frequency or severity what does it suggest

A

Ischemia

57
Q

what is the major cause of small bowel obstruction

A

surgery (due to surgery)

58
Q

what can show an obstruction

A

x-ray (KUB) do supine and upright to look for air/fluid levels

59
Q

A Blueish hue in infants can indiacte what?

A

Perforation

60
Q

what does increased bowel sounds indicate (high pitched)?

A

obstruction

gastroenteritis

61
Q

what usually cause decreased bowel sounds?

A

paralytic ileus
obstruction
ischemia

62
Q

exposure of the esophagus to gastric contents. It is a physiologic problem

A

GE reflux

63
Q

Casues of reflux

A

Increased frequency of sphincter relaxation
Decreased lower esophageal sphincter resting tone
Poor esophageal clearance of refluxed material
Slow gastric emptying

64
Q

when is spitting up a problem

A

Pain
FTT
aversion to eating

65
Q

Pulmonary complications of reflux

A

Aspiration pneumonia
Broncho-pulmonary disease
Asthma/reactive airway disease
Apnea and bradycardia

66
Q

irritation of the esophagus

A

Esophagitis

67
Q

meds for GERD in kids

A 
H2 antagonists (zantac, pepcid) 
PPIs (prilosec, prevacid, nexium)
68
Q

what is a surgery that tightens the esophagus and is for severe reflux.

A

Nissen fundoplication

69
Q

will present with copious oral secretions,choking aspiration,

A

tracheoesophageal fistula

70
Q

What is tracheoesophageal fistula associated with?

A 
VACTREL 
Vertebral
Anaal atresia
Cardiac
TE_F
renal
Limb abnormalities
71
Q

Hernia presents at birth, repair if present after first few years of life.

A

Umbilical hernia

72
Q

Hernia more common in males, rarely incarcerated. corrected by surgeon

A

Inguinal hernia

73
Q

big concern with pyloric stenosis

A

FTT

74
Q

what abx given in neonatal period has been associated w/ higher incidence of pyloric stenosis in infants (<30 days)

A

erythromycin

75
Q

In childhood most are secondary to underlying illness, toxins, or drugs causing a breakdown in mucosal defenses.

A

PUD

76
Q

Most accurate study for PUD

A

endoscopy

77
Q

best test for H. Pylori

A

Usually the stool, because serum testing is for the antibody

78
Q

End result is obstruction with dilated bowel proximally, small disused bowel distally

A

Intestinal atresia

79
Q

double bubble sign refers to what type of obstruction

A

small intestine

80
Q

tx for duodenal atresia

A

surgery – duodenoduodenoscopy (bipass stenosis)

81
Q

Due to abnormal movement of intestine around the superior mesenteric artery as intestine reenters abdominal cavity at ~10 weeks

A

Malrotation

82
Q

where does midgut malrotation appear

A

duodenojejunal junction-

83
Q

presents with pain, bilious vomiting, distention.

A

Malrotation

84
Q

Tx for malrotation

A

Surgical emergency

85
Q

Herniation through cord

Associated with anomalies

A

omphacele

86
Q

what is gastroschisis associated w/?

A

spina bifida

87
Q

Tx for congenital diaphragmatic hernia

A

NPO, NG for gastric decompression, Surgery

88
Q

Can present in toddlerhood with worsening respiratory distress and failure to thrive.

A

Congential diaphragmatic hernia

89
Q

Outpouching of ileum in mid to distal ileum

A

Meckel diverticulum

90
Q

tx for meckel diverticulum

A

surgery

91
Q

Telescoping of bowel that causes progressive edema and ischemia

A

Intussusception

92
Q

Present with ~20 minute cycles of intermittent pain,
vomiting
Heme positive stools (95% of the time.)

A

Intussusception

93
Q

Is Meckel diverticulum painful?

A

No usually painless

94
Q

what does meckel diverticulum usually present with?

A

bloody stools

95
Q

what condition with have ribbon like stools?

A

Hirschsprung dz

96
Q

Major compilation from hirschsprung dz

A

toxic megacolon

97
Q

usually around 18 months-3 years old, intermittent episodes. Will bring knees to chest. Currant jelly stools.

A

Intussusception

98
Q

tx for intussusception

A

contrast enema

99
Q

most common cause of obstruction in first couple years of life

A

intussusception

100
Q

most common cause of acute abdomen in older children

A

acute appendicitis

101
Q 
Abdominal pain
Diarrhea, constipation
Gassiness, distention, bloating
Anorexia
Poor weight gain, FTT (but can be obese)
Irritability, lethargy
A

Celiac dz

102
Q

will see distended belly and then wasting.

A

Celiac’s dz

103
Q

tx for celiacs

A

avoid gluten

104
Q

Gold standard for celiac dx

A

small bowel biopsy

105
Q

bile ducts aren’t complete. Will have bile reflux back to liver. can cause jaundice after first few years of life.

A

biliary atresia

PEDS (11 decks)

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