GI Flashcards
Diagnostic procedure for EA w/ TEF
NGT/ OGT insertion
Chronic postprandial regurgitation common among 4 month-old infants
GERD
Common lung lobe affected by aspiration pneumonia among infants
RUL
Treatment for intractable GERD
Nissen fundoplication
Only PPI preparation in granules
Esomeprazole
How many hours will you observe a child who ingested a blunt nontoxic object?
24 hours
What types of necrosis is observed on liquid alkali ingestion & acidic caustic agent ingestion?
Liquefaction & coagulation necrosis respectively
What will you do on an asymptomatic patient who ingested caustic agents?
Observe for 24 hours for late signs
Grade of esophageal injury which is circumferential
Grade 3
Grade of esophageal injury that is not circumferential
Grade 2
Contraindicated management for caustic ingestion
Neutralization, induced emesis, gastric lavage
Classic symptoms of intestinal obstruction
N/V, abdominal distention, obstipation
Ground glass appearance on RLQ with trapped air bubbles
Meconium ileus
X-ray sign on abdominal obstruction
Stepladder sign
Most common cause of nonbilous vomiting, presenting with firm, movable, olive-shaped mass
Hypertrophic pyloric stenosis
Shoulder sign & double tract sign in barium studies
Hypertrophic pyloric stenosis
Triad of sudden onset epigastric pain, inability to pass tube into the stomach & retching with emesis
Volvulus
Most common sites of volvulus
Sigmoid & cecum
X-ray findings in volvulus
Bird’s beak sign
Inverted U sign
Coffee bean sign
Recurrence rate of volvulus after decompression
50%
Bilous vomiting without abdominal distention
Duodenal atresia
Incomplete rotation of intestine during fetal development (3 mos.)
Malrotation
X-ray finding on malrotation
Corkscrew sign (distal duodenum & proximal jejunum do not cross midline)
Remnant of omphalomesenteric duct
Meckel diverticulum
Most frequent congenital GI anomaly
Meckel diverticulum
Intermittent painless rectal bleeding & brick-colored stool due to ectopic acid-secreting mucosa
Meckel diverticulum
Most common cause of lower intestinal tract obstruction
Hirschprung disease
Arrest of neuroblast migration to distal bowel resulting to absence of meissner & auerbach plexus
Hirschsprung disease
Currarino triad: anorectal malformation, sacral bone anomalies, presacral masses
Hirschsprung disease
Diarrhea that stops with fasting
Osmotic diarrhea
Diarrhea that continues with fasting
Secretory diarrhea
Lactose intolerance is a type of _________ diarrhea
osmotic
Cholera is a type of _______ diarrhea.
secretory
Based on WHO classification, what degree of dehydration involves 5-10% weight loss?
SOME dehydration
How many cc/kg of ORS should you give in a child with SOME dehydration over 4 hours?
75
How many cc/kg PLRS should you give in an INFANT with SEVERE dehydration over 6 hours?
100
First 30 cc/kg over 1 hour
Next 70 cc/kg over 5 hours
mEq/L Na of WHO ORS-75 (reduced Osm)
75
mEq/L of glucose of ORS-75
75
mEq/L of Cl of ORS-75
65
mEq/L of K of ORS-75
20
Osm of ORS-75
245
Most common etiologic agent of infantile diarrhea
Rotavirus
1st line antibiotic for shigellosis
Ciprofloxacin
Antibiotic of choice for diarrhea caused by E. histolytica & G. lamblia?
Metronidazole
Treatment of choice in a profuse watery diarrhea presenting with fishy odor & washer woman’s hands?
Tetracycline/ azithromycin/ TMP-SMX
Clinical picture: Epigastric pain increasing in intensity after 1 week of systemic viral infection
Acute pancreatitis
Condition involving autodigestion & conversion of lecithin to toxic lysolecithin
Acute pancreatitis
Test more SPECIFIC for acute pancreatitis (rises in 4 hrs, peaks at 24 hours, lasts for >2 weeks)
Lipase
What will increase in lab values in acute pancreatitis?
WBC, glucose, bilirubin, glutamyl transpeptidase
Abdominal x-ray sign in acute pancreatitis?
Cut-off sign (dilated transverse colon)
1st serologic marker to appear in Hepa B infection;
detects acute & chronic infection;
used in Hep B vaccine
HBsAg
Marker in resolved Hep B infection;
detection of immunity after vaccination
Anti-HBs
Marker for highly-infectious Hep B
HbeAg
Interpret:
HBsAg (-)
anti-HBc (-)
anti-HBs (-)
Susceptible
HBsAg (-)
anti-HBc (+)
anti-HBs (+)
Immune due to natural infection
HbsAg (-)
anti-HBc (-)
anti-HBs (+)
Immunized with Hep B vaccine
HbsAg (+)
anti-HBc (+)
IgM anti-HBc (+)
anti-HBs (-)
Acutely infected
HBsAg (+)
anti-HBc (+)
IgM anti-HBc (-)
anti-HBs (-)
Chronically infected
HBsAg (-)
anti-HBc (+)
anti-HBs (-)
Interpretation unclear 4 possibilities: 1) Resolved infection 2) False (+) anti-HBc 3) "Low level" chronic infection 4) Resolving acute infection
Urinalysis result confirmatory of hematuria
> 5 RBC/hpf
Normal specific gravity for urine
1.015-1.025
Most common type of Esophageal Atresia with Tracheoesophageal fistula
Type A: EA w/ distal TEF
