GI Flashcards
malnutrition as a result of near starvation from protein and non preteen deficiency, very thin from loss of muscle and body fat
marasmus
seen in parts of the world where starch is main diet, protein deficient state
kwashiorkor
stool ph below 5.6 suggests?
carbohydrate malabsorption
a positive clinitest reaction shows?
watery and acidic stool resulting detected as reducing substances
what are 2 causes of carbohydrate malabsorption?
isolated congenital enzyme deficiency
mucosal atrophy
what can be used to document enteric protein losses?
fecal a1-antitrypsin levels
decreased _____ activity results in steatorrhea?
lipase actvity
abetalipoproteinemia is suggested by what?
acanthocytosis
macrocytic blood smear suggests what?
folic acid or vitamin b 12 deficiency
what majorly causes protein intolerance?
cows milk protein
what is the management of protein intolerance?
withdrawal and will resolve by 1-2 years of age
celiac disease location?
proximal small intestine
etiology of celiacs?
intolerance to gluten
what is the gold standard for celiac disease?
small bowel biopsy
what will small bowel biopsy show?
short/flat villi, deep crypts and vacuolated epithelium
what are specific in screening in celiac disease?
serum IgA - endomysial and serum tissue transglutaminase antibody testing
this occurs from small bowel resection as a result of volvulus, gastroschises?
short bowel syndrome
whats important in management of short bowel syndrome?
early TPN and parental feedings
this is characteristic torticollis with arching of the back caused by painful esophagitis
sandifer syndrome
this is the gold standard for GERD diagnosis
pH probe measurement
this is a motility agent used to increase LES tone or increase gastric emptying?
metoclopramide
palpable olive mass, projectile vomitting, and peristaltic waves
pyloric stenosis
metabolic profile of pyloric stenosis
hypochloremic, hypokalemic, metabolic alkalosis
what is the diagnostic method of choice for pyloric stenosis
ultrasound
what is the management of pyloric stenosis?
correct electrolyte abnormalities and then correct w/ partial pyloromyotomy
diagnostic tool for volvulus?
upper go contrast imaging
is volvulus a surgical emergency?
yes
what is the most common location of intussusception?
ileocolic
what is generally the etiology of intussception?
lead point
how do an infants legs present w/ intussception?
draw legs towards chest
currant jelly stools, sausage shaped mass and coil spring sign on radiograph?
intussecption
gold standard for intussception
contrast enema w/ air
first line therapy for intussception?
contrast enema w/ air or hydrostatic pressure
if intessucpetion w/ peritonitis or pneumoperitoneum?
operative reduction
bluish discoloration of flanks
gray turner sign
bluish discoloration of periumbilical area
cullen sign
what do gray turner sign and cullen sign indicate?
pancreatitits
what is elevated in acute pancreatitis?
serum amylase and serum lipase
imaging for pancreatitis?
abdominal US
imaging for pseudocyst in pancreatitis?
abdominal CT
acute a calculous cholecystitis is caused by what infections?
salmonella, shigella and e coli
what condition may cause acute chile in infants?
sickle cell disease
what is used to soften the stool in constipation?
mineral oil
painless acute rectal bleeding in a otherwise healthy child?
meckels diverticulum
how does jaundice generally occur?
begins cranially and extends caudally
this syndrome associatiated with hemolysis or with a very large hematoma, first starts as increased indirect to increased direct bill
inspissated bile syndrome
mild unconjugated biliburinemia occurs w/ stress or poor nutrition
UDP-glucuronyl transferase deficiency
autosomal recessive disorder 100% of udp transferase is absent causing kernicterus
criggler najar type i
autosomal dominant 90% udp gluorynl transferase absent
criggler najar type II
most common cause of cholestasis in new born
neonatal hepatitis
management of neonatal hepatitis
supportive
nutritional support
ursodeoxycholic acid
livertransplantation
hepatosplenomegaly, polyspenia syndrome, increased bilirubin levels?
biliary atresia
progressive fibroscleortic disease that affects the extra hepatic biliary tree
biliary atresia
intraop cholangiogram w/ laparotomy to examine biliary tree
dx. of biliary atresia
management of biliary atresia
kasaiportoenterstomy (roux-en-y intestinal loop)
paucity of intrahepatic bile ducts and multi organ involvement?
alagille syndrome
clinical features of alagille syndrome
debilitating pruritus broad forehead saddle nose pulm outflow obstruction renal disease posterior embryotoxon butterfly vertebrae and broad thumbs
management of alagille syndrome
supportive
picornovirus hepatitis caused by fecal oral route
hep A
a DNA virus heptitis?
hepatitis B
transmission of hep B
perinatal vertical exposure, infected blood products, body secretions
HBsAg
active disease ( used in hep B vaccine)
HBsAB
protective results from vaccination or natural infection
HBcAb
natural infection and persists life long
HBeAg
infectious, acute
RNA flavivirus family
hep C infection
those with hepatitis B have an increased risk of what?
hepatocellular carcinoma
this virus requires HBsAg for replication
heptatis D
elevated serum transaminatses, hypergammaglobulinema and circulating autoantibodies + family history of autoimmune disease
autoimmune hepatitis
management for autoimmune hepatitis
corticosteroids and immunosuppresive agents (azathioprine or 6 mercaptopurine)