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child health > GI disorders part 2 > Flashcards

GI disorders part 2 Flashcards

1
Q

what is the criteria required to diagnose childhood FAP ?

A
  1. must have episodic or continuous abdominal pain
  2. insufficient criteria for other FGID
  3. no evidence of any anatomical, inflammatory or neoplastic cause
    must be fulfilled once per week for more than 2 months
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2
Q

what is the criteria for the diagnosis of FAP syndrome ?

A

some loss of daily functioning

additional somatic symptoms

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3
Q

what is the most common clinical presentation of FAP ?

A 
more in girls 
8-9 years 
gradual onset 
not related to eating, activity or bowel opening 
headache is common
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4
Q

once FAP is diagnosed what are the alarming features that could suggest an organic cause ?

A 
less than 5 years 
pain away from the umbilicus 
nocturnal pain waking the child up 
fever, weight loss , hematemesis 
urinary symptoms 
blood in stool 
FH of IB , peptic ulcer
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5
Q

what is the management in FAP ?

A

symptomatic attempt to alleviate the pain
antispasmodic
antidepressant - amitriptyline
anti seizure drugs - gabapentin

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6
Q

what does infantile colic look like ?

A

paroxysmal , inconsolable crying or screaming several times a day often accompanied by:
drawing up to the knees
passage of excessive flatus

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7
Q

what is the management for infantile colic ?

A

reassurance
if it persists consider CMPA or GER
give trial of hydrolyzed formula followed by antireflux regimen

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8
Q

what is the distribution of affection in Crohn’s disease vs ulcerative colitis ?

A

Crohns: panenteric, perianal disease

UC : colon only

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9
Q

what is the pathology associated with Crohns vs UC ?

A

Crohns : skip lesions, transmural , granuloma

UC : diffuse , mucosal, crypt abscesses

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10
Q

what are the clinical manifestations of Crohn’s disease ?

A

lethargy and generally ill without GIT symptoms
triad of : abdominal pain, diarrhea and weight loss
along with extraintestinal manifestations : joints, eyes and oral and skin lesions ( uveitis, erythema nodosum, perianal skin tags )

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11
Q

what specific physical findings may be found in Crohn’s disease ?

A

orofacial granulomatosis
aphthous ulcers
pyostomatitis vegetans
angular chelitis

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12
Q

what are the phenotypes in distribution of Crohn’s disease ?

A 
L1: distal ileum 
L2 : colonic
L3: illio-colonic 
L4 : upper disease 
L4 a: proximal to treitz 
L4 b: distal to treitz
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13
Q

what is the first line management to induce remission in Crohn’s disease ?

A

enteral nutrition
prednisolone
5 ASA

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14
Q

what is the second line treatment for early relapse or treatment resistant cases in Crohn’s disease ?

A

Azathioprine

Methotrexate

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15
Q

what is the third line treatment for treatment resistant cases in Crohn’s disease ?

A

infliximab

surgery

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16
Q

what are the specific colonic symptoms in UC ?

A

diarrhea
blood PR
abdominal pain

17
Q

what are the extraintestinal manifestations associated with UC ?

A

arthritis

erythema nodosum

18
Q

what is the method of induction inn UC ?

A

prednisolone

sulphasalazine / 5 ASA

19
Q

what is the method of maintenance in nall UC patients ?

A

sulphasalazine/ 5 ASA

20
Q

what is the second line of treatment in UC ?

A

systemic steroids for exacerbations

Azathioprine

21
Q

what is the management for fulminant disease or in steroid dependency ?

A

surgery and cyclosporine

22
Q

what is the practical management of acute toxic colitis ?

A 
fluid resuscitation 
blood transfusion 
IV fluids 
IV hydrocortisone 
Broad spectrum IV antibiotics
23
Q

what is the gold standard definition of constipation ?

A 
less than 3 spontaneous bowel movements 
straining 
lumpy or hard stools 
sensation of anorectal blockage 
sensation of incomplete defecation 
patient should not meet the criteria for IBS
24
Q

what are the types of constipation ?

A

primary and secondary

25
Q

what are the common stages in children that are associated with constipation ?

A

weaning
toilet training
school age

26
Q

what are the red flags associated with constipation ?

A 
delayed passage of meconium 
neonatal onset 
failure to thrive 
abdominal distention 
vomiting 
fever 
neurology
27
Q

what is a diagnostic sign of hirschsprung disease ?

A

failure to pass meconium within the first 24 hours of life

absence of ganglion cells in bowel on biopsy

28
Q

what are the physical findings associated with spina bifida occulta ?

A

sacral dimple above natal cleft , with a hairy patch

29
Q

what are the conditions associated with cystic fibrosis ?

A

meconium ileus equivalent

distal obstruction syndrome

30
Q

what is encopresis ?

A

fecal incontinence

child health (40 decks)

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