Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Peds EOR > GI > Flashcards

GI Flashcards

1
Q

treatment appendicitis

A

appendectomy
-give 3rd gen cephalosporin pre-op (remember ONE/TEN/ME for cephs) and if appendix is perf, continue it post-op

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is colic

A

severe and paroxysmal crying, usually in the evening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when does colic peak

A

2-3 months, ends around 4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

rule of 3’s for colic

A

cry > 3 hrs/day, 3 d/wk, for 3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

childhood constipation is almost always {what type of constipation}

A

functional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what diagnostic criteria is used to dx constipation

what imaging might you get

A

Rome III criteria

may have to get abdominal XR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Rome III criteria for constipation

A

At least two of the following in a child with a developmental age younger than four years

Two or fewer bowel movements per week
At least one episode of incontinence per week after the acquisition of toileting skills
History of excessive stool retention
History of painful or hard bowel movements
The presence of a large fecal mass in the rectum
History of large-diameter stools that may obstruct the toilet
At least two of the following in a child with a developmental age of four years or older with insufficient criteria for irritable bowel syndrome

Two or fewer bowel movements in the toilet per week
At least one episode of fecal incontinence per week
History of retentive posturing or excessive voluntary stool retention
History of painful or hard bowel movements
The presence of a large fecal mass in the rectum
History of large-diameter stools that may obstruct the toilet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MC triggers for constipation

A

transitioning to solid foods from breastmilk and formula, potty training, and starting school

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

tx constipation

A

increase fiber 11-24 g/day
decrease cow’s milk
mineral oil
polyethylene glycol
lactulose
bathroom training

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the most accurate signs in dehydration

A

prolonged capillary refill, poor skin turgor, and abnormal breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is duodenal atresia

A

complete absence or closure of a portion of the duodenum leading to a gastric outlet obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what other issues is duodenal atresia associated with

A

down syndrome
polyhydramnios (be more suspicious of duodenal atresia if polyhydramnios is present)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

sx duodenal atresia

A

bilious emesis within 24 hours after birth
abdominal distention
emesis worse with feeding
failure to pass meconium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

dx duodenal atresia

A

abdominal XR - double bubble sign - distended air-filled stomach + smaller distended duodenum separated by the pyloric valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

tx duodenal atresia

A

non-emergent surgical correction

NG decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

fecal incontinence is also called

A

encopresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how old do you have to be to be dx with encopresis

A

4 or older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

encopresis is almost always associated with

A

severe constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what diagnostic imaging should be obtained for encopresis

A

KUB, rectal exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Traveler’s diarrhea

A

e coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Diarrhea after a picnic and egg salad

A

staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Diarrhea from shellfish

A

vibrio cholera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Diarrhea from poultry or pork

A

salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Diarrhea in a patient post-antibiotics

A

c diff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Diarrhea in poorly canned home foods

A

C. perfringens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Diarrhea breakout in a daycare center

A

Rotavirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Diarrhea on a cruise ship

A

norovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Diarrhea after drinking (not so) fresh mountain stream water

A

Giardia lamblia – incubates for 1-3 weeks, causes foul-smelling bulky stool, and may wax and wane over weeks before resolving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is frequently associated with GERD

A

hiatal hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is a significant risk factor for GERD

A

obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

pathophys of GERD

A

hypotensive LES or transient LES relaxations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

sx GERD

A

heartburn (pyrosis) and regurgitation

heartburn - burning sensation in retrosternal area after eating, worse when supine; relieved with antacids (usually)

regurgitation - sour/acidic taste in mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

criteria standard dx for GERD and what should you do if alarm features

A

pH monitoring - < 4 = diagnostic

upper endoscopy if alarm features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

tx GERD

A

diet modifications
H2RAs (sx < once weekly) - famotidine for example
PPI (2 or more episodes per week) - omeprazole for example

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is the MC cause of cholestasis in newborn

A

neonatal hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Hirschsprung disease is also called

A

congenital aganglionic megacolon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the cause of Hirschsprung disease

A

absence of ganglion cells in the mucosal and muscular layers of the colon leading to a functional obstruction (failure of colonic muscles to relax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what organs are MC affected in Hirschsprung disease

A

rectum and part of the sigmoid colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

who is more likely to get Hirschsprung disease, M or F?

A

M 4:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

sx Hirschsprung disease

A

neonatal large bowel obstruction –> meconium ileus within first 48 hours of life
bilious vomiting
progressive abdominal distention
poor feeding –> failure to thrive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

PE for Hirschsprung disease

A

no stool in rectal value bc of the tight anal sphincter

abdominal distention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

tx Hirschsprung disease

A

surgical resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

how to remember the location of indirect vs direct inguinal hernia

A

MDs LIe

Medial (to the inferior epigastric artery) = direct

Lateral (to the inferior epigastric artery) = indirect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is hesselbach’s triangle composed of (inguinal hernia anatomy)

A

RIP - rectus abdominis (medial border), inferior epigastric vessels (lateral border), poupart’s (inguinal) ligament (inferior border)

45
Q

what is the MC type of hernia in both sexes, young children, and adults

A

indirect hernia

46
Q

indirect hernia is due to

A

persistent patent processes vaginalis

47
Q

sx indirect hernia

A

asx
may develop scrotal swelling
incarcerated - painful, enlargement of irreducible hernia
strangulated - irreducible hernia with compromised blood supply + toxicity

48
Q

sx direct hernia

A

asx, swelling at hernia site
incarcerated - painful, irreducible
strangulated - irreducible + compromised blood supply + toxicity

49
Q

dx inguinal hernia

A

clinical
groin US initial
CT if unsure or possibility of strangulation

50
Q

tx inguinal hernia

A

surgical repair with mesh

strangulated = medical emergency

51
Q

what is intussusception and what place is MC involved?

A

telescoping (invagination of an intestinal segment into the adjoining distal intestinal lumen leading to bowel obstruction

Ileocolic junction MC (ileum + cecum)

52
Q

what is the most common cause of bowel obstruction in infants and young kids

A

intussusception

53
Q

MCC of intussusception

A

idiopathic (75%)

54
Q

sx intussusception

A

triad - vomiting + abdominal pain + passage of blood per rectum – currant jelly stools (stool mixed with blood and mucus)

abdominal pain is usually severe, crampy, and progressive

vomiting may be bilious

55
Q

PE for intussusception

A

sausage-shaped mass may be palpation in mid-right upper abdomen + emptiness in right lower quadrant (Dance’s sign)

may have positive guaiac if currant jelly stool

56
Q

Dx for intussusception

Make sure to remember what type of contrast

A

US - best initial; donut, target, or bull’s eye sign - concentric alternative echogenic and hypo echoic bands

air or contrast enema - diagnostic and therapeutic; air enema MC&raquo_space;

water-soluble contrast&raquo_space; barium

57
Q

Tx intussusception

A

initial - fluid and electrolyte replacement

pneumatic (air) decompression enema

surgery if air enema fails

58
Q

when is hyperbilirubinemia considered pathologic in a newborn

A

within the first 24 hours of life

59
Q

what type of hyperbilirubinemia in dubin-johnson syndrome

A

direct (conjungated) = dubin-johnson

60
Q

sx dubin-johnson syndrome

A

usually asx
generalized constitutional sx
mild icterus

61
Q

dx dubin-johnson syndrome

A

mild, isolated conjugated hyperbilirubinemia - can increase w illness, pregnancy, contraception

bx - grossly black liver and dark granular pigment in hepatocytes

62
Q

tx dubin-johnson syndrome

A

no treatment

63
Q

inheritance for crigler-najjar syndrome

A

autosomal recessive

64
Q

what type of hyperbilirubinemia in crigler-najjar syndrome

A

unconjugated = crigler-najjar

65
Q

what is the cause/pathophysiology of crigler-najjar syndrome

A

decreased glucuronosultransferase (UGT) enzyme which converts indirect bilirubin to direct

66
Q

different types of crigler-najjar syndrome

A

type 1 - no UGT activity
type 2 - markedly reduced UGT activity

67
Q

sx crigler-najjar syndrome

A

type 1 - neonatal jaundice w severe progression –> kernicterus

type 2 - asx

68
Q

dx Crigler-najjar syndrome

A

isolated indirect (unconjugated) hyperbilirubinemia

molecular testing for mutations in the bilirubin-UGT1 A1 gene

normal hepatic bx

69
Q

tx crigler-najjar syndrome

A

type 1 - chronic daily phototherapy

type 2 - no tx usually - can use phenobarbital

70
Q

what type of hyperbilirubinemia of Gilbert’s syndrome

A

mild isolated unconjugated (indirect) = Gilbert’s

71
Q

what is the cause/pathophysiology of Gilbert’s syndrome

A

reduced uridine diphosphoglucuronate-glucuronosyltransferase 1A1 (UGT1A1)

72
Q

sx Gilbert’s syndrome

A

transient episodes of jaundice triggered by stress, fasting, alcohol, illness, dehydration, menstruation, overextension

73
Q

dx Gilbert’s syndrome

A

slight increase in indirect (unconjugated) bilirubin

74
Q

tx Gilbert’s

A

no tx

75
Q

lactose intolerance is due to

A

low levels of lactase enzyme in SMALL INTESTINE

76
Q

test of choice for lactose intolerance

A

mainly a clinical dx

hydrogen breath test -hydrogen produced when colonic bacteria ferment undigested lactose

77
Q

B3 is also called

A

niacin

78
Q

niacin is also called

A

B3

79
Q

what is the MCC of B3 deficiency

A

alcohol use

80
Q

what is the clinical name for B3/niacin deficiency

A

pellagra

81
Q

sx of pellagra

A

dermatitis - photosensitive hyper pigmented dermatitis (pigmentation and scaling similar to sunburn, esp on sun-exposed areas
diarrhea - due to malabsorption and proctitis
dementia - irritability, anxiety, insomnia, disorientation, delusions, dementia, encephalopathy

82
Q

what is another dermatologic manifestation of pellagra

A

casal’s necklace - ring dermatitis around the neck

83
Q

tx pellagra

A

oral supplementation w 100-200 mg of nicotinamide or nicotinic acid 3x daily for 5 days

84
Q

what is pyloric stenosis

A

hypertrophy and hyperplasia of the pyloric muscles causing a functional gastric outlet obstruction leading to non bilious vomiting, dehydration, and ALKALOSIS in infants < 12 weeks

85
Q

when is pyloric stenosis MC

A

3-12 weeks of life

86
Q

what sex is more likely to get pyloric stenosis

A

M : F
4 : 1

87
Q

what abx are a huge risk factor for pyloric stenosis

A

macrolides - esp erythromycin and azithromycin when given < 2 weeks of age

88
Q

sx pyloric stenosis

A

non bilious, forceful vomiting esp AFTER feeding

strong!!! appetite — “hungry vomiter”

89
Q

what is the nickname for an infant who has pyloric stenosis

A

“hungry vomiter”

90
Q

PE for pyloric stenosis

A

olive sign - palpable pylorus; olive-shaped NONTENDER, mobile hard 1-2 cm mass RUQ esp after emesis

have have dehydration

91
Q

Dx for pyloric stenosis

A

US - elongated, thickened pylorus - also called a target sign on transverse view

upper GI series - string sign - narrowed elongated pyloric channel

92
Q

lab studies for pyloric stenosis

A

hypochloremic hypokalemic metabolic alkalosis from vomiting

93
Q

tx pyloric stenosis

A

surgical pylorotomy after fluid and electrolyte correction

94
Q

when does umbilical hernia usually resolve

A

by 2 years

95
Q

when should surgery be performed for umbilical hernia

A

5 years or older or incarcerated/strangulated

96
Q

sx vitamin A deficiency

A

night blindness
xerophthalmia (dry eyes)
bitot’s spots - white spots on conjunctiva due to squamous metaplasia of the corneal epithelium

97
Q

dx vitamin A deficiency

A

clinical; decreased serum retinol levels

98
Q

what is the syndrome of vitamin C deficiency called

A

Scurvy

99
Q

sx scurvy

A

hyperkeratosis - hyperkeratotic follicular papules (keratosis pilaris?) surrounded by hemorrhage

hemorrhage - vascular fragility w recurrent hemorrhages into the gums, skin, joints; impaired wound healing

hematologic - anemia, glossitis, malaise, weakness, increased bleeding time

100
Q

dx scurvy

A

clinical
serum ascorbic acid levels
leukocyte ascorbic levels more accurate

101
Q

vitamin C is also called

A

ascorbic acid

102
Q

ascorbic acid is also called

A

vitamin C

103
Q

vitamin D deficiency can cause what 2 clinical syndromes

A

osteomalacia (adults MC but also kids)
rickets (kids)

104
Q

sx osteomalacia

A

diffuse bone pain + tenderness
proximal muscular weakness
bowing of long bones (waddling)

105
Q

dx osteomalacia

A

decreased calcium
decreased phosphate
decreased 25-hydroxyvitamin D
increased PTH

radiographs - looser lines (femoral neck, shaft, and trochanter)

106
Q

definition of osteomalacia

A

decreased bone mineralization

107
Q

definition of rickets

A

decreased cartilage at the growth plates

108
Q

sx rickets

A

delayed fontanel closure
craniotabes (soft skull bones)
growth dleays
genu varum (lateral bowing of the femur and tibia)

109
Q

dx rickets

A

same levels as for osteomalacia

radiographs - widening of epiphyseal plate, costochondral junction enlargement (rachitic rosary), & long bones have a fuzzy appearance

Peds EOR (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions