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Pediatric studying torture > GI > Flashcards

GI Flashcards

1
Q

a separation of abdominal muscles from the xiphoid bone to the symphysis pubis

A

normal unless it is with hernia

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2
Q

Pyloric stenosis risk factors

A

males 5:1 and familial

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3
Q

Non bilious vomiting

A

pyloric stenosis

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4
Q

Most common ages for pyloric stenosis

A

3 week to 6 week old

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5
Q

Non bilious vomiting with plyloric olive
RUQ hard/non tender with mobile mass
Hungry 30 to 60 mins later

A

pyloric stenosis

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6
Q

Consequence of pyloric stenosis

A

hyopchloremic metabolic alkalosis

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7
Q

Pyloric stenosis diagnostic

A

ultrasound

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8
Q

What to do about an umbilical hernia

A

Most resolve by 1 year
Refer to surgery if >5 years of age, nonreducible, dramatically enlarges, fascia defects
>1.5 cm refer esp if hard to close

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9
Q

age ranges for appendicitis

A

10-19 years

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10
Q

Psoas sign

A

Sign for appendicitis
have kid lay supine, place hand above rght knee, direct kid to raise leg against pressure or have kid drop right leg over exam table. kid will have pain

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11
Q

obturator sign

A

Sign for appendicitis
pain in internal and external rotation of the flexed thigh
flex child’s right thigh at the hip and knee bend
rotate leg internally at the hip

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12
Q

tests for appendicitis

A 
Psoas sign
Obturator sign
Heel strike
Rovsing sign
Rebound tenderness
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13
Q

intussusception patho

A

telescoping or invaginating of one portion of the bowel into itself. this produces obstruction and vascular compromise

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14
Q

What is the most common cause of mechanical obstruction in infants and toddlers

A

intussusception

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15
Q

intussusception etiology

A

50% younger than 1 year and 2:1 male to female ratio.

Peaks at 5-10 months

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16
Q

Classic signs of intussusception

A

current jelly stool
vomiting
intermittent abd pain with palpable sausage shaped mass

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17
Q

current jelly stool
vomiting
intermittent abd pain with palpable sausage shaped mass

A

intussusception

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18
Q

colicky abd pain, infant pulls knees to chest, altered mental status, sausage shaped mass during crying

A

intussusception

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19
Q

Dance’s sign

A

used to check for intussusception. It is concavity in the right lower quadrant due to absence of underlying bowel

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20
Q

physical finding of intussusception

A

palpable mass in right upper quadrant

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21
Q

Diagnosis of intussusception

A

barium enema 100% diagnostic

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22
Q

intussusception treatment

A

pneumatic reduction. operation of it doesnt work

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23
Q

no stool within first 48 hours of life

A

hirshsprung’s

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24
Q

history of passing stool occasionally and massive or more frequent and pellet like. stools have pungent odor, abd distension, vomiting with lethargy

A

hirshsprung’s

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25
Q

newborn that is constipated and distended with soft abd and normal hyperactive bowel sounds

A

hirshsprung’s

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26
Q

Rectal exam reveals slight pressure on opening and ampulla is empty, on remove explosive evacuation of stool or gas

A

hirshsprung’s

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27
Q

Most common source of significant lower GI bleeding in children

A

Meckel diverticulum

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28
Q

Meckel diverticulum age

A

preschooler

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29
Q

Meckel diverticulum patho

A

Bleeding from peptic ulceration of the ileal mucosa from HCL. secreted from ectopic gastric mucosa within the diverticulum

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30
Q

Meckel diverticulum diagnostic

A

Technetium-99m pertechnate

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31
Q

meckel treatment

A

surgery if intestinal obstruction, diverticulitis, and umbilicoileal fistulas and hemorrhage

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32
Q

Inguinal hernia etiology

A

highest in first year of life, boys affected six times more than girls

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33
Q

abd distention, bilious emesis, edema, erythema over mass, crying with distention of inguinal ring, scrotum may be swollen, irritability

A

inguinal hernia

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34
Q

inguinal hernia tx

A

surgery within 2 weeks

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35
Q

gold standard for swallowing issues

A

videofluoroscopy

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36
Q

regurgitation

A

not forceful and effortless passage of formula into the pharynx or mouth

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37
Q

vomiting

A

forceful expulsion of gastric contents through the mouth and maybe nose

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38
Q

GERD

A

may not be visible as the gastric contents may only go into the esophagus that results in uncomfortable symptoms or complications

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39
Q

Sandifer syndrome

A

arching done to prevent refluxant from going into the pharynx or mouth

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40
Q

best indication of dehydration

A

cap refill best indication of hydration status. CRT of 2 to 2.9 indicates a 50-90 m;/kg loss of fluids

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41
Q

Vomiting treatment

A

Ondansetron 2mg for kids 8-15kg, 4mg for kids 15-30 kg, 8mg if >30mg.
A period of gut resting is not recommended
Breast feeding infants should cont breastfeeding if possible
Formula fed infants should resume formula asap

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42
Q

Patho of normal GER

A

Decreased lower esophageal pressure
Increased abdominal pressure
Alterations in gastric motility

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43
Q

GERD in infancy

A 
Recurrent regurg
Weight loss or poor weight gain
Irritable
Ruminative bx
Wheezing or coughing
44
Q

GERD in kids

A 
heartburn/chest pain
Hematemesis
Dysphagia
Cough
Hoarse voice
Asthma trigger
45
Q

Gerd signs and symptoms

A 
Esophagitis
Esophageal stricture
Barrett esophagus
Laryngeal inflammation
Recurrent pnx
Anemia
Dental erosion
Sandifer syndrome posturing
46
Q 
Esophagitis
Esophageal stricture
Barrett esophagus
Laryngeal inflammation
Recurrent pnx
Anemia
Dental erosion
Sandifer syndrome posturing
A

GERD

47
Q

Gold standard for GERD dx

A

pH probe but most feel it is unnecessary. Dx with history and physical

48
Q

GERD infancy non medication tx

A 
prone positioning at 30 degree angle after feeding
Thicken formula
Less volume more frequently
Hypoallergenic formula
Gentleease
49
Q

Formula’s for cow’s milk protein allergy

A

Alimentum and nutramigen

50
Q

Formula’s for kids with allergies

A

Elecare, Alfamino, Neocate

51
Q

GERD tx in older kids

A

PPI
Histamine 2 receptor antagonists (approved in infants)
Metoclopramide can stimulate stomach movement

52
Q

abd cramps, flatulence, bloating, anorexia and weight loss, bouts of watery diarrhea. day care kid or trip to a lake or something

A

giardia

53
Q

giardia lab

A

enzyme immunoassay or stool specimen for trophozoites

54
Q

giardia treatment

A

Metronidazole/flagyl 15 mg/kg per day in 3 divided doses for 5 days

55
Q

perirectal itch, nervous, irritable, hyperactive, insomina

A

enterobius vermicularis (pinworms)

56
Q

pinworm diagnostic

A

1cm long worms at night and microscopic exam of worms at night
stool exam not productive

57
Q

pinworm tx

A

Mebendazole 100mg tab
Pyrantel pamote 11mg/kg
Albendazole
Tx family members

58
Q

Worms in stool or vomit

Bowel or biliary obstruction

A

Ascaris lumbricoides (round worm)

59
Q

Ascaris lumbricoides (round worm) diagnostic

A

Seen on microscopy and see marked eosinophilia

60
Q

Ascaris lumbricoides (round worm) tx

A

Albendazole 400 mg
Mebendazole 100 mg bid for 3 days or 500mg once
Ivermectin

61
Q

worms in stool, abd pain, nausea, diarrhea, excessive appetite

A

Taenia (tapeworm)

62
Q

Taenia (tapeworm) diagnostic

A

stool microscopy. ova and parasites

63
Q

Taenia (tapeworm) tx

A

Praziquantel 5-10 mg/kg

Niclosamide 50mg/kg

64
Q

stool incontinence after an age when kids should be able to control bowel movements, usu at 4 years

A

encopresis

65
Q

stained underwear, report of fewer than 3 bm’s per week. difficult or painful defecation. kid become still suddenly during play (to hide urge to poo). Bloating feeling and pain.

A

encopresis

66
Q

Mass felt at midline in suprapubic area, anal fissures, abd distention and abd tenderness. Impactions on rectal exam

A

encopresis

67
Q

encopresis treatment

A

bowel cleanse (bisacodyl suppository) then miralax

68
Q

delay of defecation for 2 or more weeks

A

constipation

69
Q

constipation w/o objective evidence of pathological condition. caused by painful bowel movements w resultant voluntary withholding of feces by a kid who wants to avoid unpleasant defecation

A

functional constipation

70
Q

Pain or bleeding when passing stools, abd pain, waxing and waning symptoms, nausea/vomiting, abd distention

A

constipation

71
Q

how many stools do infants have infants have per day during first week of life

A

4

72
Q

stools gradually decline to __ per day at 2 years of age

A

1.7

73
Q

__ stools per day at age 4 years of age

A

1.2

74
Q

some breast feed babies do not have stools for several days or longer

A

true

75
Q

constipation diagnosis

A

history and physical is sufficient
stool test for occult blood is recommended in all infants and kids w abd pain. ftt. diarrhea, or fam hx of polyps/colon cancer

76
Q

6month to 5 year old with diarrhea. 3 weeks of frequent loose stools, and no other GI illness

A

FTT

77
Q

Toddler’s diarrhea tx

A

most symptoms resolve in 90% of kids by age 3.

78
Q

Toddler’s diarrhea patho

A

excessive fluid intake that overwhelms gi tract

79
Q

happy kid that is active w normal growth, 5-10 large loose stools a day, frequent stooling in the morning, no illness vomiting or abd pain

A

Toddler’s diarrhea

80
Q

diarrhea diagnostic

A

stool speicmen

81
Q

1st line test for chron’s

A

ESR

82
Q

Test for celica disease

A

anti gliadin antibodies

83
Q

anal skin tag

A

indicative of chron’s

84
Q

triad of gerd in older kid

A

heartburn, epigastric pain, regurgitation

85
Q

pathological gerd

A

ftt, frequent vomiting, sandifer syndrome

86
Q

Cows milk protein intolerance patho

A

non ige mediated, milk protein isnt broken down

87
Q

Cows milk protein intolerance tx

A

resolves by 1-3 years

88
Q

cows milk protein allergy patho

A

IgE mediated

89
Q

cows milk protein allergy symptoms

A

bloody stool, diarrhea, vomiting, food refusal, hives, or anaphylaxis

90
Q

cows milk protein allergy tx

A

dx with food challenge and keep on dairy free diet

91
Q

diagnostic test for appendicitis

A

CT scan gold standard. may have inc wbc count

92
Q

initial signs of appendicitis

A

vague periumbilical pain that moves to RLQ

93
Q

Impaired growth, diarrhea, steatorrhea, abd distention, wasting, fatigue, delayed puberty, dermatis herpecticum. triggered after eating gluten

A

celiac disease

94
Q

diagnostic of celiac

A

endoscopy/biopsy is definitive

95
Q

Colic treatment

A

supportive, will resolve over time. Dry diet alterations and limiting over stimulation.

96
Q

What is infantile colic

A

persistent crying in infant less than 3 mos of age, for 3 hrs a day 3 days a week

97
Q

bloody diarrhea, weight loss, delayed growth, anorexia, arthritis, abd pain, oral ulcers, skin lesions usu in teenager

A

ulcerative colitis

98
Q

ulcerative colitis dx

A

esr, crp, cbc, stool culture, colonoscopy. Endoscopy=definitive dx

99
Q

abd pain and recurrent vomiting=major criteria

hematemesis, heart burn, anorexia, n, belching, anemia=minor

A

peptic ulcer disease

100
Q

peptic ulcer diagnostic

A

endoscopy + biopsy

101
Q

peptic ulcer tx

A

antacid and amoxicillin

102
Q

String sign on upper GI

A

pyloric stenosis

103
Q

pyloric stenosis tx

A

surgical

104
Q

weight loss, delayed growth, large joint pain, abd pain, bloating and abd pain after meals, jaundice, perinal skin tags and annal fissures

A

chron’s disease

105
Q

chrons diagnostic

A

esr and crp

endoscopy=definitive diagnosis

106
Q

chron’s tx

A

antidiarrheals, corticosteroids, aminosalicylates, immune modulators

107
Q

acute abdominal LUQ pain assc with back pain, fever and vomiting

A

pancreatitis

Pediatric studying torture (23 decks)

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