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paediatrics > GI > Flashcards

GI Flashcards

1
Q

GORD presentation

A 
regurgitation
distress after feeding
apnoea
pneumonia
anaemia
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2
Q

GORD management

A 
reassurance, avoid over feeding
antacid and sodium/magnesium alginate
consider domperidone (increases stomach and bowel contractions) +/- omeprazole
most resolve 6-9months
fundoplication if failure to thrive
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3
Q

pyloric stenosis presentation

A 
projectile vomiting after feeding
vomit contains no bile
no diarrhoea
constipation likely
2-8 weeks of life
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4
Q

pyloric stenosis diagnosis

A

hypochloraemic, hypokalaemic metabolic alkalosis

visable LUQ peristalsis when feeding`

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5
Q

pyloric stenosis management

A

ramstedts pyloromyotomy

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6
Q

intussuception presentation

A 
epsodic (colicky) pain - may present with epsodic crying or drawing of legs up (an interception)
vomiting
PR blood (red current jam)
sausage shape mass in abdomen
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7
Q

intussuception investigations

A

abdominal US with reduction by air enema

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8
Q

ulcerative colitis definition

A

recurrent inflammatory and ulcerating disease involving mucosa of colon and or rectum

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9
Q

ulcerative colitis symptoms

A

colicky pain

diarrhoea +/- blood and mucus

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10
Q

ulcerative colitis diagnosis and features

A

faecal calprotectin and colonoscopy
mucosal / submucosal inflammation
continuous lesions
crypts

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11
Q

ulcerative colitis management

A

mild - mesalazine (5 aminosalicylate)
moderate - add oral prednisolone
severe - IV hydrocortisone

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12
Q

crohns disease definition

A

transmural granulomatous inflammation affecting any part of the gut from mouth to anus. commonly terminal ileum

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13
Q

crohns disease symptoms

A

abdominal pain
diarrhoea
weight loss

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14
Q

crohns disease diagnosis and features

A

faecal calprotectin and endo/colon oscopy
transmural inflammation
granulomas
skip lesions

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15
Q

crohns disease managment

A

mild/moderate - prednisolone

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16
Q

gastroenteritis cause

A

rotavirus commonest in children

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17
Q

gastroenteritis presentation

A

sudden onset diarrhoea +/- vomiting

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18
Q

IBS definition

A

abdominal symptoms with no organic cause

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19
Q

IBS diagnosis

A

recurrent abdominal pain with at least 2 of:
relief by defication
altered stool form
altered bowel frequency

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20
Q

appendicitis presentation

A

periumbical pain that moves to RIF
rovsings sign (pain in RIF when press LIF)
fever and guarding

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21
Q

coeliac disease definition

A

T cell response to gluten in small intestine causes villous atrophy and malabsorption
associated with human leukocytes antigen HLA DQ2

22
Q

coeliac disease presentation

A 
malabsorption after induction of wheat containing foods
stinking stools
diarrhoea
weight loss
anaemia
23
Q

coeliac disease diagnosis

A

raised IgA anti tissue transglutaminase

biopsy - small intestine villous atrophy

24
Q

coeliac disease management

A

gluten free diet

25
Q

failure to thrive causes

A

organic - impaired suck/swallow (cleft palate)
non organic - inadequate food
inadequate absorption - coeliac
excessive calories loss - vomiting (GORD)
excessive calorie requirements - malignancy

26
Q

failure to thrive definition

A

poor weight gain falling across centile lines

head circumference preserved relative to height

27
Q

marasmus definition

A

lack of calories and discrepency between height and weight - HIV associated

28
Q

marasmus signs

A

distended abdomen
diarrhoea / constipation
hypoalbuminaemia

29
Q

kwashiorkor cause

A

due to low intake of protein and essential amino acids

30
Q

kwashiorkor signs

A 
poor growth
diarrhoea
anorexia
odema
distended abdomen
31
Q

lactose intolernace presentation

A

Explosive watery stools, abdominal distension, flatulence, audible bowel sounds

32
Q

hirschprungs disease presentation

A

meconium ileus
vomiting (bilious green)
abdominal distension
constipation

33
Q

hirschprungs disease definition

A

absence of ganglia in segment of colon

34
Q

hirschprungs disease management

A

bowel washouts / irrigation

surgical excision of anganglionic section

35
Q

parasitic cause of acute diarrhoea

A

Giardia

36
Q

toddlers diarrhoea presentation

A

chronic, non specific diarrhoea

well and thriving

37
Q

toddlers diarrhoea management

A

adequate fat and fibre

38
Q

cows milk protein allergy

A 
Associated with atopy
IgA deficiency and IgG subclass abnormalities
39
Q

cows milk protein allergy diagnosis and management

A

Diagnosis – elimination diet

Management – Hydrolysed or AA feeds

40
Q

neonatal jaundice after 24hrs of birth causes

A

caused by hyperbilirubinaemia
breastfeeding
physiological:
increased bilirubin production due to shorter RBC lifespan
decreased bilirubin conjugation due to hepatic immaturity
absence of gut flora impedes elimination of bile pigment

41
Q

neonatal jaundice within 24hrs of birth causes

A

abnormal
sepsis
rheus haemolytic disease
ABO incompatibility

42
Q

prolonged neonatal jaundice >14 days causes

A

sepsis
hypothyroidism
breastfeeding

43
Q

neonatal jaundice complications

A

kernicterus - acute bilirubin encephalopathy (unconjugated bilirubin can be deposited in basal ganglia)

44
Q

neonatal jaundice management

A

phototherapy

45
Q

necrotising enterocolitis definition

A

inflammatory bowel necrosis (Bacterial invasion of ischaemic bowel wall)
major risk factor in prematurity
More common in premature baby’s fed with cow’s milk

46
Q

necrotising enterocolitis signs

A

abdominal distension in premature baby
billious vomiting
Fresh blood in stool

47
Q

necrotising enterocolitis management

A

stop oral feeding

cefotaxime and vancomycin

48
Q

intestinal malrotation what is it

A

Obstruction of small bowel – congenital anomaly of rotation of midgut

49
Q

intestinal malrotation presentation

A

billious vomiting
Abdo pain
Tenderness (peritonitis/ischaemic bowel)

Bile stained vomit in 1st week of life = Malrotation until proven otherwise!

50
Q

intestinal malrotation investigations and management

A

Upper GI Contrast Study (diagnostic)

Surgical correction - Ladd’s procedure

paediatrics (13 decks)

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