GI Flashcards
def. gastroenteritis
most common
- rotavirus most common
def. gastroenteritis
most common
- rotavirus most common
major cause by age
onset times
12-24 hours after and last 3-7 day
key part of Phx
hydration status
investigations for GE
genrally none
- can culture
mgmt of GE
- replace fluid losses
- mild- ORT
mod - ORT and ondasetron
severe- IV NS
foods to avoid for GE
high sugar and fat
- fluid with high sugar
def. chronic diarrhea
14 days
5 types of diarreha
- osmotic
- secretory
- dysmotility
- inflammatory
- infectious
investigations for chron. dia
based on suspect Dx
- stool culture
- bloodwork - CBC, lytes, ESR, CRP
- TSH, sweat chlorise
DDx for diarrhea without fail to thrive
- infect
- carb malabsorption
- IBS
- meds
DDx for diarrhea with fail to thrive
- diarrhea of infacny
- abnormal immune response
- celiac
- IBD
- enteropathies - immune def.
- maldigestion of fat
- GI protein losses
- bowel obst.
- neuroendocrine tumors
DDx for vomiting by age
p 117
DDx for abdo masses
see chart p 118
3 most common GI causes of abdo pain
- constipation
- IBS
- lactose intolerance
other cause of abdo pain
GYN - dysmennorhea neuro - migraine endocrine - hyperparathyroid CVS - SMA syndrome heme - sickle cell - leukemia/lymphoma
issues leading to constipation problems
- no fiber in child diet
- often missed for long time
- not treated well
- leads to encoporeses
3 Phx for constipation
- palpate abdo
- inspect anal
- neuro of lower limbs
mgmt of constipation
- clear explanation
- long term
- cleanout essential
- diet changes for family
- delay toilet training
meds for constipation
PEG-3350
- restoralax, laxaday
main cause of lower bowel pain
altered bowel habits
main cause of lower bowel pain
altered bowel habits
major cause by age
onset times
12-24 hours after and last 3-7 day
key part of Phx
hydration status
investigations for GE
genrally none
- can culture
mgmt of GE
- replace fluid losses
- mild- ORT
mod - ORT and ondasetron
severe- IV NS
foods to avoid for GE
high sugar and fat
- fluid with high sugar
def. chronic diarrhea
14 days
5 types of diarreha
- osmotic
- secretory
- dysmotility
- inflammatory
- infectious
investigations for chron. dia
based on suspect Dx
- stool culture
- bloodwork - CBC, lytes, ESR, CRP
- TSH, sweat chlorise
DDx for diarrhea without fail to thrive
- infect
- carb malabsorption
- IBS
- meds
DDx for diarrhea with fail to thrive
- diarrhea of infacny
- abnormal immune response
- celiac
- IBD
- enteropathies - immune def.
- maldigestion of fat
- GI protein losses
- bowel obst.
- neuroendocrine tumors
DDx for vomiting by age
p 117
DDx for abdo masses
see chart p 118
3 most common GI causes of abdo pain
- constipation
- IBS
- lactose intolerance
other cause of abdo pain
GYN - dysmennorhea neuro - migraine endocrine - hyperparathyroid CVS - SMA syndrome heme - sickle cell - leukemia/lymphoma
issues leading to constipation problems
- no fiber in child diet
- often missed for long time
- not treated well
- leads to encoporeses
3 Phx for constipation
- palpate abdo
- inspect anal
- neuro of lower limbs
mgmt of constipation
- clear explanation
- long term
- cleanout essential
- diet changes for family
- delay toilet training
meds for constipation
PEG-3350
- restoralax, laxaday
def. of recurrent abdo pain in child
> 3 attacks of pain > 3 months in > 3 year old
main cause of lower bowel pain
altered bowel habits
DDX for RAP
- constipation
- abdo migraine
- PUD
- IBD
- bilary colic
- UPJ obst.
typical present
- variable with gradual start
- periumbilical
- typically peptic Sx
- interferes
- psych stress and “painful” families
red flags that might be something else
- weight loss
- fever
- joint pain
- oral leiokns
- rectal bleeding
- pain away from umbilicus
- rebound tenderness
- pain wakes from sleep
RAP workup
do NOT do AXR
- generally clincial
- maybe CBC and stool Cx
RAP mgmt
- affirm pain
- ID psych stressors
- psych and family intervention
epi of pyloric stenosis
3-6 weeks, rare after 12
- M>F
present of pyloric stenosis
projectile, non-bilous vomit after eating
- hungry right away
- “olive” mass
invest of pyloric sten
- may have lyte abnormalities
- US is standard
mgmt of pyloric sten
- NPO
- hydrate
- surg
def. of malrotation
gut not rotated in utero
- high risk of volvulus
presentation of malrotation
midgut volvulus
- blious vomiting, abdo pain, distension, mucus and blood in stool
invest. for malrotaion
- plain film
- double bubble
- gasless abdo - upper GI series
- misplaced ligament of treitz - contrast enema
- see position of cecum - US
- SMA/AMV reversed
mgmt of malrotatiokn
NPO
- braod spectrum ABx
- surg
def. hirschprungs
lack of motor neurons in gut
- delay in meconium passage
- distension/constipation
need tp remove gut part
def. intussicception
bowel scoping into self
- most common abdo emerg. in
Hx of intuss
- sudden onset severe, crampy abdo pain
- episodes each 15-20 minutes
- drawing legs to abdo
- currant jelly stool
Phx of intuss
- diffuse tender
- distension
- RUQ sausage mass
invest. for intuss
- FOBT
- no air/barium if perf expected
- US - bulls eyes sign
- AXR - target sign
mgmt
can be non-operative or operative
- need to operate if pertonitis or perf
