GI DIsorders

Question 1

Colic

Answer 1

crying for no apparent reason that lasts for 3 hours or more a day. Must occur 3 days or more a week. Must be younger than 3 months old

Question 2

Colic Medications

Answer 2

probiotics have been used to treat and show mixed results.

Question 3

Foreign Body Ingestion

Answer 3

most are not serious and will pass through the gut without problems. Most common among 6month olds-3 years old.

Question 4

S/sx of Foreign body ingestion

Answer 4

Initial episode of choking, gagging and coughing.
Escessive salivation
Dysphagia
Food refusal
Emesis
Hematemesis
Pain in neck, throat or sternal notch
Stridor
Whezzing
Cyanosis
Dyspnea

Question 4

Lithium battery ingestion

Answer 4

If greater than or equal to 20mm diameter then at great risk due to severe erosion or ulceration in as little as 2 hours. Emergency removal is needed

Question 4

S/Sx of foreign body lodging in the stomach/intestine

Answer 4

Abdominal pain, bloating, vomiting, hematochezia, fever unexplained

Question 5

Imaging for ingestion of foreign body

Answer 5

Most FB are radiopaque and a single frontal X-ray to include the neck, chest and entire abdomen is usually all that is needed to locate the object

Question 6

Appendicitis

Answer 6

Inflammation of the appendix that leads to distention and ischemia that can results in necrosis, perforation and peritonitis/abcess formation

Question 7

Most common cause of Appendicitis

Answer 7

Obstruction- which causes fluid and mucus to build up in the appendix. This pushes on nerve fibers nearby causing pain. If builds up to much it will become ischemic/necrotic/perforation

Question 8

S/Sx of Appendicitis

Answer 8

Pain in RLQ
Elevated WBC
Mcburney’s Point
N/V
Abdominal guarding
inability to stand straight up
positive psoas/obturator

Question 9

Treatment of Appendicitis

Answer 9

Appendectomy and antibiotics. if abscess is present it will need drained

Question 10

Perforation of the appendix

Answer 10

may offer relief in symptoms and less vomiting. Fever greater than 101F, but most comfortable position will be laying on side with legs flexed

Question 11

Intussusception

Answer 11

involves a section of intestine folds inwards, telescopes, on itself. Causes narrowing of the lumen,

Question 12

Dx of appendicitis

Answer 12

CT scan

Question 13

S/Sx of intussusception

Answer 13

Redconcurrant Jelly stools
Sausage shaped mass in RUQ
Distended abdomen
N/V
colicky/crampy abdomen
Screaming with drawing up legs
Hx of an URI is common
Lethargy
Fever- esp if gangrenous

Question 14

Dx of intussusception

Answer 14

Ultrasound is dx of choice and a target sign or pseudo kidney sign present

Air contrast enema is also dx and tx

Question 15

Tx of intussusception

Answer 15

Emergent consult with pediatric radiologist/surgeon
Air contrast enema under fluoroscopy
Observe for 12-18 hours after procedure

Question 16

Failure to Thrive

Answer 16

lack of weight gain that is proportional to age determined by standard growth charts

Question 17

FTT causes

Answer 17

inadequate intake
inadequate absorption
excessive caloric expenditure