Gi Bleeding Flashcards
Q: What are the symptoms of upper GI bleeding?
A: Hematemesis (vomiting blood) and melena (black, tar-like stool).
Q: What are the symptoms of lower GI bleeding?
A: Hematochezia (passing bright red blood or blood clots in stool).
What is the most common cause of GI bleeding in neonates for lower GI bleeding?
What condition in neonates is marked by abdominal distension, poor feeding, and bloody stool?
A: Necrotizing enterocolitis (NEC), typically seen in premature infants.
Describe the presentation of malrotation with midgut volvulus in neonates.
A:
Sudden onset of melena, bilious emesis, and abdominal distension.
How can maternal blood ingestion cause GI bleeding in neonates?
A: Swallowed blood during birth or can appear in the stool or vomit.
What is stress gastritis in neonates, and how is it diagnosed?
A: Found in NICU patients, often diagnosed with upper endoscopy.
What deficiency causes hemorrhagic disease in newborns, leading to GI bleeding?
A: Vitamin K deficiency affecting clotting factors II, VII, IX, and X.
What is the common cause of esophagitis in children aged 1 month to 1 year?
A: Gastroesophageal reflux or eosinophilic esophagitis.
What are the primary causes of gastritis in children?
A: Helicobacter pylori infection, NSAID use, and Zollinger-Ellison syndrome.
What is intussusception, and how does it present in infants?
Bowel segment pulled into another; presents with cramping, sausage-shaped abdominal mass, and “currant jelly” stools.
Q: What is the preferred diagnostic tool for detecting intussusception?
A: Ultrasonography, showing target sign or pseudokidney sign.
How is milk protein allergy related to GI bleeding in infants?
A: Causes colitis with symptoms like diarrhea, weight loss, and bleeding.
What causes peptic ulcers in children and their main clinical presentation?
A: Caused by H. pylori infection or stress; presents with hematemesis, melena, and abdominal pain.
What is Zollinger-Ellison syndrome?
A: Rare disorder with excessive gastric acid secretion due to a gastrinoma, leading to refractory peptic ulcers.
What are juvenile polyps and how do they present?
A: Benign growths in the colon causing painless rectal bleeding; diagnosed with colonoscopy.
What is Meckel’s diverticulum?
A: A congenital pouch in the ileum causing painless lower GI bleeding due to ectopic gastric tissue.
Q: What diagnostic test is used for Meckel’s diverticulum?
A: Technetium-99m pertechnetate scan (Meckel’s scan).
What are esophageal varices, and what causes them?
A: Enlarged veins in the esophagus, often due to liver disease or portal vein thrombosis.
What is the initial management approach for GI bleeding in children?
A: Stabilization with oxygen, IV access, fluid resuscitation, and addressing coagulopathies.
Q: What is the clinical significance of the “corkscrew sign”?
A: It’s an imaging finding associated with midgut volvulus, visible on an upper GI contrast study
How does maternal blood ingestion in neonates differ from fetal blood?
A: The Apt test distinguishes between maternal and fetal hemoglobin.
What are the risks of mechanical ventilation in neonates regarding GI bleeding?
A: It increases the risk of stress gastritis, particularly in premature and distressed infants.
How is vitamin K deficiency treated to stop hemorrhagic disease in newborns?
A: Administration of 1 mg vitamin K intravenously, stopping bleeding within 2 hours.
What is eosinophilic esophagitis, and how is it treated?
A: An allergic condition causing esophagitis; treated with allergen elimination and specific medications.
What are common symptoms of gastritis in children?
A: Abdominal pain, nausea, loss of appetite, and weight loss.
How does Helicobacter pylori infection in children often spread?
A: Through horizontal transmission, sometimes through breastfeeding if the mother is infected.
What is the role of proton pump inhibitors (PPIs) in gastritis treatment?
A: They reduce stomach acid, aiding in the treatment and healing of gastritis.
Describe the “currant jelly” stool seen in intussusception.
A: It’s a mixture of blood and mucus in the stool, commonly seen in intussusception.
What is the target sign in intussusception diagnosis?
A: An ultrasound finding indicative of intussusception, showing concentric rings in the bowel.
How are severe cases of intussusception treated if an enema is unsuccessful?
A: Surgical intervention may be necessary to correct the bowel obstruction.
What distinguishes gangrenous bowel from other causes of GI bleeding in children?
A: It results from decreased blood flow, causing symptoms like sudden abdominal pain and urgent bowel movements.
What is the treatment for milk protein allergy in infants with GI symptoms?
A: Removal of cow’s milk protein from the diet or use of hypoallergenic formulas.
What is the role of the C-urea breath test in diagnosing peptic ulcers?
A: It detects H. pylori infection, which is a common cause of peptic ulcers in children.
What are the two main goals of ulcer therapy in children?
A: Ulcer healing and elimination of the primary cause, such as H. pylori.
What type of polyp is most common in children with GI bleeding?
A: Juvenile (hamartomatous) polyps, which are benign but can bleed.
How is Meckel’s diverticulum bleeding typically managed?
A: Surgical resection to prevent further bleeding or complications.
Why are esophageal varices particularly dangerous in children?
A: They can cause significant blood loss and are associated with serious liver disease.
How is infectious diarrhea associated with GI bleeding managed?
A: Initial focus on rehydration, with antibiotics if caused by bacteria like E. coli or Shigella.
What diagnostic method is preferred for visualizing esophageal varices?
A: Upper endoscopy to definitively identify varices and assess for bleeding.
How is active variceal bleeding managed?
A: Through hemodynamic stabilization, vasopressors, antibiotics, and possible endoscopic treatment.
What are vascular lesions, and how do they present in GI bleeding?
A: Malformations like hemangiomas or AV malformations that can cause GI bleeding, especially in the colon.
What are the primary interventions for acute GI bleeding in children?
A: Stabilization, oxygen delivery, IV fluids, and blood resuscitation if needed.
How is gangrenous bowel identified in children?
A: Symptoms include sudden abdominal pain, tenderness, and blood in the stool.
