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Peds clerkship > GI > Flashcards

GI Flashcards

1
Q

def. gastroenteritis

A

most common

- rotavirus most common

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2
Q

def. gastroenteritis

A

most common

- rotavirus most common

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3
Q

major cause by age

A
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4
Q

onset times

A

12-24 hours after and last 3-7 day

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5
Q

key part of Phx

A

hydration status

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6
Q

investigations for GE

A

genrally none

- can culture

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7
Q

mgmt of GE

A
  • replace fluid losses
  • mild- ORT
    mod - ORT and ondasetron
    severe- IV NS
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8
Q

foods to avoid for GE

A

high sugar and fat

- fluid with high sugar

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9
Q

def. chronic diarrhea

A

14 days

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10
Q

5 types of diarreha

A
  1. osmotic
  2. secretory
  3. dysmotility
  4. inflammatory
  5. infectious
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11
Q

investigations for chron. dia

A

based on suspect Dx

  • stool culture
  • bloodwork - CBC, lytes, ESR, CRP
  • TSH, sweat chlorise
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12
Q

DDx for diarrhea without fail to thrive

A
  1. infect
  2. carb malabsorption
  3. IBS
  4. meds
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13
Q

DDx for diarrhea with fail to thrive

A
  1. diarrhea of infacny
  2. abnormal immune response
    - celiac
    - IBD
    - enteropathies
  3. immune def.
  4. maldigestion of fat
  5. GI protein losses
  6. bowel obst.
  7. neuroendocrine tumors
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14
Q

DDx for vomiting by age

A

p 117

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15
Q

DDx for abdo masses

A

see chart p 118

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16
Q

3 most common GI causes of abdo pain

A
  1. constipation
  2. IBS
  3. lactose intolerance
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17
Q

other cause of abdo pain

A 
GYN
- dysmennorhea
neuro
- migraine
endocrine
- hyperparathyroid
CVS
- SMA syndrome
heme
- sickle cell
- leukemia/lymphoma
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18
Q

issues leading to constipation problems

A
  • no fiber in child diet
  • often missed for long time
  • not treated well
  • leads to encoporeses
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19
Q

3 Phx for constipation

A
  1. palpate abdo
  2. inspect anal
  3. neuro of lower limbs
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20
Q

mgmt of constipation

A
  • clear explanation
  • long term
  • cleanout essential
  • diet changes for family
  • delay toilet training
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21
Q

meds for constipation

A

PEG-3350

- restoralax, laxaday

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22
Q

main cause of lower bowel pain

A

altered bowel habits

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23
Q

main cause of lower bowel pain

A

altered bowel habits

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24
Q

major cause by age

A
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25
Q

onset times

A

12-24 hours after and last 3-7 day

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26
Q

key part of Phx

A

hydration status

27
Q

investigations for GE

A

genrally none

- can culture

28
Q

mgmt of GE

A
  • replace fluid losses
  • mild- ORT
    mod - ORT and ondasetron
    severe- IV NS
29
Q

foods to avoid for GE

A

high sugar and fat

- fluid with high sugar

30
Q

def. chronic diarrhea

A

14 days

31
Q

5 types of diarreha

A
  1. osmotic
  2. secretory
  3. dysmotility
  4. inflammatory
  5. infectious
32
Q

investigations for chron. dia

A

based on suspect Dx

  • stool culture
  • bloodwork - CBC, lytes, ESR, CRP
  • TSH, sweat chlorise
33
Q

DDx for diarrhea without fail to thrive

A
  1. infect
  2. carb malabsorption
  3. IBS
  4. meds
34
Q

DDx for diarrhea with fail to thrive

A
  1. diarrhea of infacny
  2. abnormal immune response
    - celiac
    - IBD
    - enteropathies
  3. immune def.
  4. maldigestion of fat
  5. GI protein losses
  6. bowel obst.
  7. neuroendocrine tumors
35
Q

DDx for vomiting by age

A

p 117

36
Q

DDx for abdo masses

A

see chart p 118

37
Q

3 most common GI causes of abdo pain

A
  1. constipation
  2. IBS
  3. lactose intolerance
38
Q

other cause of abdo pain

A 
GYN
- dysmennorhea
neuro
- migraine
endocrine
- hyperparathyroid
CVS
- SMA syndrome
heme
- sickle cell
- leukemia/lymphoma
39
Q

issues leading to constipation problems

A
  • no fiber in child diet
  • often missed for long time
  • not treated well
  • leads to encoporeses
40
Q

3 Phx for constipation

A
  1. palpate abdo
  2. inspect anal
  3. neuro of lower limbs
41
Q

mgmt of constipation

A
  • clear explanation
  • long term
  • cleanout essential
  • diet changes for family
  • delay toilet training
42
Q

meds for constipation

A

PEG-3350

- restoralax, laxaday

43
Q

def. of recurrent abdo pain in child

A

> 3 attacks of pain > 3 months in > 3 year old

44
Q

main cause of lower bowel pain

A

altered bowel habits

45
Q

DDX for RAP

A
  1. constipation
  2. abdo migraine
  3. PUD
  4. IBD
  5. bilary colic
  6. UPJ obst.
46
Q

typical present

A
  • variable with gradual start
  • periumbilical
  • typically peptic Sx
  • interferes
  • psych stress and “painful” families
47
Q

red flags that might be something else

A
  • weight loss
  • fever
  • joint pain
  • oral leiokns
  • rectal bleeding
  • pain away from umbilicus
  • rebound tenderness
  • pain wakes from sleep
48
Q

RAP workup

A

do NOT do AXR

  • generally clincial
  • maybe CBC and stool Cx
49
Q

RAP mgmt

A
  • affirm pain
  • ID psych stressors
  • psych and family intervention
50
Q

epi of pyloric stenosis

A

3-6 weeks, rare after 12

- M>F

51
Q

present of pyloric stenosis

A

projectile, non-bilous vomit after eating

  • hungry right away
  • “olive” mass
52
Q

invest of pyloric sten

A
  • may have lyte abnormalities

- US is standard

53
Q

mgmt of pyloric sten

A
  • NPO
  • hydrate
  • surg
54
Q

def. of malrotation

A

gut not rotated in utero

- high risk of volvulus

55
Q

presentation of malrotation

A

midgut volvulus

- blious vomiting, abdo pain, distension, mucus and blood in stool

56
Q

invest. for malrotaion

A
  1. plain film
    - double bubble
    - gasless abdo
  2. upper GI series
    - misplaced ligament of treitz
  3. contrast enema
    - see position of cecum
  4. US
    - SMA/AMV reversed
57
Q

mgmt of malrotatiokn

A

NPO

  • braod spectrum ABx
  • surg
58
Q

def. hirschprungs

A

lack of motor neurons in gut
- delay in meconium passage
- distension/constipation
need tp remove gut part

59
Q

def. intussicception

A

bowel scoping into self

- most common abdo emerg. in

60
Q

Hx of intuss

A
  • sudden onset severe, crampy abdo pain
  • episodes each 15-20 minutes
  • drawing legs to abdo
  • currant jelly stool
61
Q

Phx of intuss

A
  • diffuse tender
  • distension
  • RUQ sausage mass
62
Q

invest. for intuss

A
  • FOBT
  • no air/barium if perf expected
  • US - bulls eyes sign
  • AXR - target sign
63
Q

mgmt

A

can be non-operative or operative

- need to operate if pertonitis or perf

Peds clerkship (22 decks)

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