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Pediatrics Exam 2 > GI > Flashcards

GI Flashcards

1
Q

Babies that are fed what do not spit up as much?

A

Breast fed babies do not spit up as much

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2
Q

When does infantile GERD end and adult begin?

A

18 months - infancy should result

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3
Q

What is normal regurgitation for a baby <3 months, 4 months, and 12 months?

A

<3: 1 time day in 1/2
2/3 by 4 months
5% by 12 months

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4
Q

A child over 8 YO will start complaining of ___ with GERD

A

Heartburn

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5
Q

Most common factor in GERD:

A

Transient release LES sphincter

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6
Q

Infants take in ___ the amount of older children in terms of stomach size

A

x2

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7
Q

Labs are ___ indicated for GERD but could be used if the patient is vomiting a lot

A

RARELY

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8
Q

How can you manage GERD (3):

A
  • Decrease amount of feeding and increase frequency
  • Add 1 tbs of oat cereal to the bottle
  • Avoid tobacco
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9
Q

GERD should resolve in:

A

1 year

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10
Q

What is the easiest formula on the stomach?

A

Hydrolyzed milk - consider a 2-4 week trial

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11
Q

What are two drugs you can use for GERD?

A
  • PPI (approved down to 1 month)

- H2 blockers

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12
Q

Refer to GI if an infant has (3) associated with its GERD:

A
  • Poor weight gain
  • Hematemesis
  • Respiratory disease
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13
Q

You loose more fluid from __ than ___

A

Diarrhea > Vomiting

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14
Q

What are three other causes of vomiting in infants?

A
  • Shaken baby
  • Cow’s milk allergy
  • Metabolic disease
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15
Q

What medication can cause vomiting?

A

Erythromyocin

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16
Q

What is cyclic vomiting?

A

Related to migrants - attacks of 1 hour - 10 days of vomiting - Average dx. 9.6 YO

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17
Q

When is diarrhea acute, persistent or chronic?

A

Acute: Under 14 d
Persistent: Over 14 d
Chronic: Over 14 d with another cause

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18
Q

What is Osmotic diarrhea?

A

Small volume, stops when you stop eating food

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19
Q

What is Osmotic diarrhea caused from?

A

Decreased absorption due to infection, lack of enzymes, or excessive intake

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20
Q

What is secretory diarrhea?

A

Watery; continues despite stopping to eat, bacteria, viral or parasite

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21
Q

What is the most common complication of viral gastroenteritis?

A

Dehydration

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22
Q

Progression of viral gastroenteritis (most common in winter):

A

URI –> Fever –> 3-8 d of vomiting and diarrhea

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23
Q

When is enterovirus must common?

A

Summer

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24
Q

You should not use a pool with diarrhea for how long?

A

Up to two weeks

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25
Q

Infectious agents that cause bloody diarrhea (3):

A
  • Campy
  • Shigella
  • E. coli with shiga
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26
Q

You will experience tenesmus with what infectious diarrheal agent?

A

Shigella

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27
Q

You can treat Shigella with:

A

Azithromycin or 3rd generation cephalosporin

28
Q

Antimicrobial therapy is not needed for:

A

Salmonella

29
Q

What diarrheal disease can progress to HUS?

A

Shiga toxin-producing E.coli

30
Q

What are the three symptoms of Hemolytic Uremic Syndrome?

A
  • Hemolytic anemia
  • Thrombocytopenia
  • AKI
31
Q

When does HUS present after the onset of the diarrheal illness?

A

5-10 d after

32
Q

How do you treat Giardia?

A

Metronidazole, (5-7d) <1
Nitazoxanide (3d) 1-3
Tinidazole >3

33
Q

What two races experience the highest amount of food intolerance to lactose?

A

Asians, Native americans

34
Q

What is Toddler’s diarrhea?

A

Drinking too much juice - osmotic

35
Q

Urinary symptoms and ___ symptoms always go together

A

POOPING ISSUES

36
Q

What is Hirshsprung’s disease?

A

No ganglion cells in the distal rectum - cannot relax = functional obstruction

37
Q

If a baby has Hirshsprungs, 50-90% will:

A

NOT HAVE passed a stool in the first 48 hours of life

38
Q

When is Hishsprung’s diagnosed?

A

Later in life 5-6

39
Q

You can see what type of emesis in Hirschsprung’s?

A

Bilious

40
Q

What are two risk factors of Hirschsprung’s?

A
  • Down’s

- FH

41
Q

What is a complication of Hirschsprung’s?

A

Toxic megacolon - explosive bloody diarrhea, fever, vomiting

42
Q

What are two other things on the DDX for constipation?

A

Hypothyroidism and Imperforate anus

43
Q

What does not cause constipation?

A

Iron

44
Q

How do you treat constipation in a child (3)?

A
  • 1-2 ox of fruit juice
  • Glycerin suppositories
  • Polyethylene glycol (for 6 mon - 1 yr)
45
Q

Functional abdominal pain is related to what?

A

Functional visceral hypersensitivity and anxiety

46
Q

What is the dx criteria for Functional abdominal pain?

A

Chronic recurrent abdominal pain on 3 or more occasions in a 3 month period of time

47
Q

Irritable Bowel syndrome is diagnosed with:

A

Abdominal pain + (2):
Improvement after BM, 4+ BM/day, 2/fewer a week, hard or loose, urgency, feeling of incomplete evacuation, mucus, bloating

48
Q

What is functional dyspepsia?

A

Epigastric pain not relieved with a BM - can follow a viral illness

49
Q

What is an abdominal migraine?

A

Paroxysmal episodes of peri-umbilical pain that lasts several hours with migraines, vomiting and pallor

50
Q

What is treatment for an abdominal migraine?

A

Reassurance

51
Q

When you are vomiting blood, where is it coming from?

A

Proximal to the ligament of Treitz

52
Q

When you are pooping blood, where it is coming form?

A

Left colon - distal

53
Q

When is Necrotizing Entercolitis seen and what is the risk highest in?

A

Seen in the first month of life - highest in premies and those with low birth weight

54
Q

How do you diagnose Necrotizing Enterocolitis?

A

Abdominal x-ray - pneumatosis intestinalis (gas wall seen)

55
Q

What is the treatment for those with Necrotizing Entercolitis?

A

Supporting, ABX and surgery

*Mortality is inversely related to weight and age

56
Q

Most common cause of anorectal bleeding in kids:

A

Anal fissures

57
Q

What is Meckel’s diverticulum?

A

Remnant of an embryonic vitellointestinal duct that should be gone by 5-6 weeks of gestation - ulcerates and bleeds

58
Q

What are symptoms of Meckel’s diverticulum?

A

Painless rectal bleeding, recurrent intussusception, abdominal pain

*Incidental finding

59
Q

Meckel’s is the disease of 2’s:

A
  • 2%
  • 2x common in males
  • 2 ft from ileocecal valve
  • 2 inches in length
  • 2-4 % complications
  • 2 yrs old at dx (or before)
60
Q

What scan do you do for Meckel’s?

A

A Meckel’s scan with radiopaque dye

61
Q

What are the three treatments for anal fissures?

A
  • Fiber
  • Sitz baths
  • Lidocaine topical gel
62
Q

What drug can turn your puke red?

A

Amoxicillin

63
Q

What drug can turn your poop red?

A

Cefdinir - Omnicef

64
Q

When are pinworms diagnosed?

A

5-10 years of age

65
Q

Anal strep compared to pin worms visually:

A

Anal strep is very well defined margins

66
Q

How do you treat pin worms (2)?

A
  • Albendazole 400 mg
  • Pyrantal pamoate
  • Both are single dose treatments
67
Q

What is the biological name for pinworms?

A

E. vermicularis

Pediatrics Exam 2 (7 decks)

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