GI Flashcards
___ most common chronic childhood dz
dental caries
ex of complications of poor oral health
FTT
impaired speech development
impaired concentration
absence from school
___when primary teeth erupt
6mo
by age ___ children have all 20 primary teeth
2-3 yo
at age 5-6 ___ happens to teeth
start to loosen
permanent molars erupt around age..
6yo
every __months a child should get oral health risk assessments
every 6mo
4 main questions for infant oral health
- bottle in bed?
- water contain fluoride?
- pacifier or suck thumb?
- brushing infans teeth?
oral screening assess what 3 things
tooth decay
malocclusion
oral injury
malocclusion means..
abnormal alighment of upper and lower teeth
when should first dentist visit be?
w/in first 6 mo of eruption of first primary tooth
NO LATER than 12 mo
after that.. q6mo for life
when can infants have teeth brushed?
after teeth erupt use gentle brush to lift up
children under 3yo should brush with ___
a smear of fluoridated toothpaste
brush 2X per day
children 3-6yo should brush with
pea sized amount of fluoridated toothpaste BID
continue supervision until kids is…
8-10yo
__ is the best way to reduce risk for tooth decay
frequent exposure to small amounts of fluoride each day
3 benefits of fluoride
increased resistance to demineralization
enhanved reminerlatizion of early caries
reduced cariogenic activity of plaque
__ is most important source of prvt tooth decay
topical fluoride - via toothpaste or dental tx
___ enhances resistance to later acid dmineralization
Systemic ingestion of fluoride between 6mo and 19 yo
source: fluoridated water or fluoride supplements
__ % of esophageal oreign body are kids ages ____
80%
kids 6mo to 3yo
___% of foreign body ingestion in kids may be totally asymptomatic..
30% take hx carefully!
esophageal foreign bodies are more common in kids with ___
dev delays and psychiatric disorders
most common items ingested…
coins and small toys
choking, gagging, coughing
followed by
increased salivation, dysphagia, food refusal, emesis or pain
esophageal foreign bodies
respiratory sx esophageal foreign body
stridor, wheezing, cyanosis, dyspnea
what films order for esophageal foreign bodies
Plain:
AP and lateral of neck and chest
AP of abdomen
key: coins are ___ on AP view and ___ on lateral films in the esophagus ..
BUT ___ on AP and __ on lateral if in trachea.
Coins flat on AP, edge lateral film for esophagus
BUT..
edge on AP and flat on lateral films in trachea
__hrs for battery induced mucosal injury
1hr
__hrs for battery induced all layer esophageal injury
4hr
Meckel diverticulum is a remnant of …
omphalomesenteric duct
or the vitelline duct
___is most common congential GI anomaly
Meckel diverticulum
def Meckel diverticulum
3-6 cm out pouching of ileum along the
Ant mesenteric border 50-75 cm from ileocecal valve
when do sx of Meckel diverticulum appear?
in 1 or 2nd yo
painless rectal bleeding
brick or currant jelly stool
Meckel diverticulum
sx secondary to ectopic mucosa in diverticulum that ulcerates adjacent ileal mucosa
__ can act as lead pt for intussuception
Meckel diverticulum
dx meckels
Meckel radionuclide scan
mucus secreting cells take up the radionuclide = visualize
tx Meckel diverticulum
surgical excision
incomplete rotation of intestine during fetal dev
malrotation
1/6000 live births
__ present in 1st yr of life and over 50% in 1st mo
malrotation pts
most common sx of malrotation
vomiting
more than bilious emesis and bowel obstruction
presentation of malrotation in older infants
recurrent abdominal pain that mimics colic ..intermittent volvulus
adolescent with malrotation can present with..
acute intestinal obstruction or hx of recurrent abd pain
def malrotation volvulus
acute presentation of small bowel obstruction in a patient without previous hx of bowel surgery
what causes malrotation volvulus
small bowel twists around superior mesenteric artery leading to compromise of blood flow to bowel!
how to confirm malrotation volvulus?
contrast radiographic studies (UGI)
treat malrotation with
surgical bands / adhesions lysed
congenital aganglionic megacolon aka
hirschprung dz
def hirschprung dz
dev. disorder of enteric nervous system
absent ganglion cells in submucosal and myenteric plexus
gender disparity for hirschprung dz
4 males : 1 remales for short segment dz
as length increases gap narrows to 1:1
t/f 80% of hirschprung pts have dz limited to rectosigmoid region
true
neonate distended abdomen, failure to pass meconium, +/- bilious emesis
chronic constipation
enterocolitis: secondary to dilatation of the bowel … bacterial proliveration
hirschprung dz
gold standard for hirschprung dz diagonosis
rectal suction biopsy
look for presence of ganglion cells
additional diagnostics for hirschprung dz
contrast enema in kids over 1 mo
look for abrupt transition zone between dilated proximal colon and obstructed distal aganglionic segment
tx hirshprung dz
Pull through procedure: bring normal innervated colon down to rectum
prognosis hirshprung dz
get stool continence but still have constipation, recurrent entercolitis, stricture, prolapse and fecal spoiling
milk and soy protein intolerance usually from..
cell mediated hypersensitivitieis
IGE testing usually not helpful
shows up in infancy
food protein indced enteriocolitis shows up..
1st several mo of life
sx food protein induced enteriocolitis
irritability, protracted vomiting, diarrhea
vomiting occurs 1-3 hrs after eating
if continued exposure –> abdominal distention, bloody diarrhea, anemia and failure to thrive
blood streaked stool in otherwise healthy infants
food protein induced proctocolitis
in first few mo life
__% breast fed infant with have food protein induced proctocolitis
60
proctocolitis def
inflammation of rectum and colon
food protein induced enteropathy shows up in frist few mo with what sx
diarrhea, steatorrhea, poor weight gain
protracted diarrhea, vomiting, FTT, distension, early satiety and malabsorption
ex of food protein induced enteropathy
cows milk sensitivity and celiac
