GI

Question 1

Biliary atresia

Answer 1

Tx by 2 months (EARLY) critical
Surgery

fibrosis of biliary ducts
Progressive cirrhosis, death by 10y/o

Question 2

Hypertrophic pyloric stenosis

Answer 2

Constriction of pyloric sphincter
Obstruction of gastric outlet

Develops first few weeks of life

Main symptoms: Non-bilious vomiting after feeding (30-60 mins, projectile)

Needs early dx

Surgery

OLIVE LIKE MASS WHEN PALPATING STOMACH

Question 3

intussusception

Answer 3

telescoping of one part of intestine into another

Common in kids under 2, male

Can be idiopathic

Can cut off blood flow–>ischemia
Venous engorgement–>blood and mucus leaking into intestine–>JELLY STOOLS

SAUSAGE SHAPED MASS URQ
Empty LRQ

Painful episodes, drawing knees to chest

surgery

Question 4

Malrotation

Answer 4

Abnormal rotation around superior mesenteric artery as embryo

Question 5

Volvulus

Answer 5

Twisting of intestine around itself–>ischemia, peritonitis, perforation, necrosis, death

Question 6

Normal newborn urine production

Answer 6

1-2mL/kg/hr

Question 7

Normal urine production rate in children

Answer 7

1mL/kh/hr

Question 8

Vesicoureteral reflux

Answer 8

Backflow of urine from bladder to ureters

becomes reservoir for bacteria growth via stasis of urine

Low dose antibiotics+try to stop urine from going back to kidneys

Most will outgrow it, but if severe surgery may be indicated

Question 9

Acute pyelonephritis

Answer 9

Kidney infection

E coli

Symptoms:
N/V, chills
Frequency/urgency
Back pain
Odor of urine
Costovertebral tenderness

Even if symptoms subside infection is still there

CBC to look at WBC

Relapse common

Question 10

Nephrotic sydrome

Answer 10

Proteinuria
Hypoalbuminemia
Edema
Hyperlipidemia

Most common glomerular injury in children

Question 11

Minimal Change Nephrotic Syndrome

Answer 11

80% of nephrotic cases

2-7 y/o

Generalized Edema
Proteinuria 2+

Reduce fluid retention/infection–>low protein and sodium diet, fluid restriction may be used if severe

Steroids (Predinisone) first line of therapy (6wks)
2mg/kg divided into 2 doses/day

Immunosuppressant therapy may be used

Relapse and immunosuppression huge issues

Question 12

Acute glomerulonephritis

Answer 12

Facial edema in morning
Edema distributed to rest of body through day

Oliguria
HTN
Hematuria (cola piss)
Proteinuria

Question 13

Acute Postrstreptococcal glomerulonephritis

Answer 13

Immune complex disease

Occurs after strep infection

Latent period of 10-21 days between infection and symptoms

Can occur any age but most common in boys 6-7

Monitor for acute HTN (BP q4-6h)

Reduce sodium
Daily weights
I&Os