GI Flashcards
Criteria for Pediatric Recurrent Abdominal Pain (RAP) (2)
1) 3 episodes over 3 months
2) Affect typical function
* Rule out other causes first. ~80% of kids have anxiety d/o
First step in diagnosis of suspected Hirschsprung’s or meconium ileus?
Contrast enema (rectal suction biopsy only if not obstructed)
Gold standard for H.pylori dx?
Upper GI endoscopy w/biopsy. Serologies have poor sensitivity and specificity
Malignant potential of pts w/juvenile polyposis syndrome vs FAP?
9-50% vs 100%
Screening recs in juvenile polyposis syndrome:
Annual colonoscopy. Pts at risk for other GI CAs including pancreatic CA
Criteria for juvenile polyposis syndrome (3):
1) >5 colonic polyps + 2) polyps anywhere in the GI tract
OR
Any # of polyps with +FHx
DDx for SBO in infants (3):
1) Duodenal atresia
2) jejunoileal atresia
3) malrotation w/midgut volvulus
Classic imaging finding in duodenal atresia?
Double bubble sign (1 bubble = duodenum; 2nd bubble = stomach)
Classic presentation for midgut volvulus
Bilious emesis and abdominal distention when gut becomes ischemic 2/2 SMA constriction
Next step in evaluating SBO in infants after XR?
UGI series
Prenatal clues to fetal SBO (2):
1) Polyhydramnios, 2) bilious amniotic fluid
Ddx of distal bowel obstruction in infants (6):
1) Distal ileal atresia
2) Colonic atresia
3) Meconium inspissation
4) Meconium plug syndrome
5) Hirschsprung’s
6) Imperforate anus
Next step in dx of imperforate anus after XR shows no gas in rectum?
Lateral and XR w/baby in prone position for assessment of distal progression of gas
Direct vs Indirect hyperbilirubinemia:
1) Gilbert
2) Rotor
3) Criggler-Najjar
4) Dubin-Johnson
1) Indirect - Benign
2) Direct - Rare 2/2 extracellular excretion of conjugated bilirubin
3) Indirect - Rare, severe
4) Direct - Same as Rotor
