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Pediatrics Clerkship > GI > Flashcards

GI Flashcards

1
Q

Imperforate anus pathogenesis?

A

No anal opening

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2
Q

Imperforate anus associated with?

A

VACTERL

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3
Q

How to diagnose imperforate anus?

A

Clinical, then upside down babygram to determine whether to fix

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4
Q

How to treat imperforate anus?

A

Upside down babygram to see where rectum is. If far, make colostomy and fix before toilet training. If close, fix today.

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5
Q

Hirschsprung’s Disease Pathogenesis

A

No auerbach’s plexus due to decreased migration of neurons

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6
Q

How does hirschsprung’s patient present?

A

Failure to pass meconium or chronic constipation which is explosive after a DRE.

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7
Q

How to diagnose hirschsprung’s disease?

A

Babygram shows dilated loops of bowel with normal segment.

Full thickness rectal biopsy, can also do barium enema or anal manometry

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8
Q

How to treat hirschsprung disease?

A

Resection of bad colon

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9
Q

Meconium ileus pathogenesis?

A

Cystic fibrosis

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10
Q

How does mec ileus present?

A

FTPM, no prenatal screen.

Bilious emesis

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11
Q

How to diagnose mec ileus?

A

Babygram shows ground glass with dilated loops of bowel

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12
Q

How to treat mec ileus?

A

Gastrographin enema

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13
Q

Voluntary constipation patient presentation?

A

Constipation with intermittant diarrhea and encopresis

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14
Q

How to diagnose voluntary constipation/

A

Xray shows a colon full of stool

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15
Q

How to treat voluntary constipation?

A

Laxatives then disimpaction in OR under anesthesia

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16
Q

Malrotation pathogenesis?

A

Volvulus

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17
Q

Patient presentation with malrotation?

A

Normal uterine course presents with bilious emesis

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18
Q

How to diagnose malrotation?

A

X-ray shows double bubble sign with a normal gas pattern beyond. This is ominous. Barium swallow shows birds beak duodenum

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19
Q

How to treat malrotation?

A

Surgery

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20
Q

Duodenal atresia/annular pancreas pathogenesis?

A

Failure of duodenum to recanalize or failure of pancreas to fuse properly.

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21
Q

How does patient with duodenal atresia or annular pancreas present?

A

With bilious emesis, but polyhydramnios in utero.

Duodenal atresia happens with downs, annular pancreas does not.

22
Q

Pathogenesis of Intestinal Atresia

A

Vascular accident in utero (cocaine)

23
Q

How does patient with intestinal atresia present?

A

+/- polyhydramnios, bilious emesis

24
Q

How to diagnose intestinal atresia?

A

Double bubble sign on x-ray with multiple air fluid levels beyond

25
Q

How to treat intestinal atresia?

A

Resect dead bowel.

26
Q

Pyloric stenosis patient presentation

A

Patient feeds normally for ~3 weeks, then projectile nonbilious vomiting with an olive shaped mass

27
Q

How to diagnose pyloric stenosis

A

CMP shows decreased K, decreased Cl, increased pH and donut sign

28
Q

How to treat pyloric stenosis?

A

Myomectomy

29
Q

Necrotizing enterocolitis pathogenesis?

A

Prematurity

30
Q

Necrotizing enterocolitis patient presentiation

A

Premature baby with bloody BM at first feeding

31
Q

How to diagnose necrotizing enterocolitis

A

Pneumatosis intestinalis on XR

32
Q

How to treat necrotizing enterocolitis?

A

NPO, IVF, TPN, IV antibiotics

33
Q

F/u for NEC?

A

Check for retinopathy, interventricular hemorrhage, respiratory distress syndrome

34
Q

How to treat anal fissures?

A

Reassurance

35
Q

Intussuception pathogenesis

A

Telescoping section of bowel, vascular comprimise

36
Q

Patient presentation of intussuception

A

abrupt onset of colicky pain, knees to chest, sausage mass with currant jelly stool.

37
Q

How to treat intussuception?

A

Air enema is diagnostic and therapeutic

38
Q

Meckel’s Diverticulum pathogenesis

A

Most common cause of lower GI bleed in children. Vitelline duct. True diverticulum

39
Q

How does patient with meckel’s present?

A

Painless lower GI bleed, FOBT+, BRBPR

40
Q

How to diagnose meckel’s?

A

Technicium 99

41
Q

How to treat meckels?

A

Resection

42
Q

Causes of prehepatic jaundice?

A

Hemolysis

43
Q

Causes of posthepatic jaundice?

A

Biliary atresia, sepsis, metabolic syndromes

44
Q

Features of unconjugated bilirubin

A

Fat soluble, can’t get excreted into urine, can cross BBB, can cause Kernicterus

45
Q

Features of conjugated bilirubin

A

Water soluble, can get excreted into urine, so causes darkening, doesn’t cause BBB, cannot cause kernicterus.

46
Q

Physiologic vs pathologic jaundice onset and resolution

A

Phys onsets >72 H, pathologic onsets 1 week if normal or >2 if premie

47
Q

Physiologic vs pathologic jaundice D bili content and rise

A

Physiologic jaundice has D bili 10.

Rise for physiologic jaundice is 5 points/day.

48
Q

Tests to order to work up physiologic jaundice?

A

Coombs (to see if there’s isoimmunization with Rh or ABO incompatibility).

Hgb (to see if there’s a blood transfusion from twin-twin or mom-baby with delayed clamping)

Reticulocyte count (to check for hemorrhage/hemolysis like in G6PD, pyruvate kinase deficiency or hereditary spherocytosis)

If all negative, then breast jaundice.

49
Q

Breast feeding vs breast milk jaundice

A

Breast feeding due to low intake. Gut motility decreases, more reabsorption. tx: feed more

Breast milk jaundice decreases activity of 2,3 UGT. Conjugation decreases. Tx by switching to formula.

50
Q

How to treat physiologic jaundice

A

UV light or exchange transfusion.

Pediatrics Clerkship (7 decks)

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