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ENPC > GI Emergencies Ch. 18 > Flashcards

GI Emergencies Ch. 18 Flashcards

1
Q

Factors that contribute to reflux in peds

A
  1. shorter esophagus
  2. stomach is more horizontal
  3. sphincter is underdeveloped
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2
Q

Describe gastric motility in the ped

A

it is irregular due to immature nervous system development

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3
Q

What risk do flexible ribs pose?

A

Increase injury to underlying organs like liver an spleen

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4
Q

The abdominal wall in a toddler

A
  1. has less musculature that provides less protection to underlying organs
  2. Incomplete intestinal attachment increases injuries from deceleration, shearing, and compression
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5
Q

Most common type of pathogen causes NVD

A

viral

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6
Q

Tongue finding for DHN Scale

A

0- moist
1- sticky
2- dry

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7
Q

Clinical DHN scale

A

scored 0-8 with 0 being no DHN and progressing to

1-4 moderate and 5-8 moderate to severe

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8
Q

General appearance for DHN

A

0- normal
1-thirsty, restless, irritable, sleepy
2- drowsy, limp, cold, coma

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9
Q

Eyes for DHN scaale

A

0- normal
1-slighty sunken
2- deeply sunken

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10
Q

Tears for DHN scale

A

0- present
1- decreased
2- absent

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11
Q

Factors measured for clinical DHN scale

A

general appearance, eyes, tongue and tears

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12
Q

Rate for oral DHN

A

2-5ml every 2-5 min.

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13
Q

What is the leading emergent surgical issue in children

A

appendicitis

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14
Q

At what age does appendicitis most commonly occur?

A

the second decade of life, between 10-20

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15
Q

Rosvings sign

A

LLQ palpation causes RLQ pain 2* to stretching perotoneal fibers

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16
Q

Psoas sign

A

lifting right leg and flexing thigh against resistance elicits pain

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17
Q

Causes of cholecystitis on kids (6)

A
  1. obesity
  2. sickle cell
  3. infection
  4. hemolytic anemia
  5. cysytic fibrosis
  6. diabetes
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18
Q

CHoley S/SX

A
  1. pain onset after ingestion of a fatty meal
  2. RUQ pain
  3. Murphys sign pain to R subcostal region on inspiration
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19
Q

Pancreatitis causes

A
  1. injury
  2. infection
  3. drugs toxins
  4. systemic disease
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20
Q

Pancreatitis S/Sx

A
  1. pain mid epigastric
  2. distention
  3. pain radiating to the back
  4. vomiting
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21
Q

Another name for Hirshprungs diesease

A

A ganglionic megacolon

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22
Q

Hirshsprungs S/Sx (7)

A
  1. no meconium passed in 1st 2 days
  2. distention
  3. feeding intolerance
  4. bilious emesis
  5. chronic constipation
  6. empty rectum
  7. tight internal sphincter
23
Q

Pyloric stenosis S/Sx and age of occurrence

A
  1. occurs more in males and 1st born
  2. presents around 2-6 weeks
  3. non-blious vomiting that becomes PROJECTILE
  4. Olive shaped mass in RUQ
24
Q

Intucessception S/SX

A
  1. venoous and lymphatic obstruction
  2. bowel obstruction
  3. bowel ischemia and necrosis
  4. occurs b/t 5-12 mo
25
Q

Intucessception S/SX

A
  1. venoous and lymphatic obstruction
  2. bowel obstruction
  3. bowel ischemia and necrosis
  4. occurs b/t 5-12 mo
  5. SUDDEN colicky pain
  6. Sausage shaped masss
  7. CURRANT JELLY stool
26
Q

Other concurrent medical problems seen with Intucesseption (4)

A
  1. cystic fibrosis
  2. lymphoma
  3. meckels divertiuculum
  4. Henoch-Scheindlin Purpura
27
Q

Intucessception treatment

A
  1. air or contrast enema

2. surgery

28
Q

Volvus/Malrotation ages affected

A
  1. usually occurs before 5 years old
  2. 50% by age 1
  3. causes ischemia and necrosis
29
Q

Bilious emesis sign

A

” is critical in any child and warrants rapid evaluation to rule out obstruction”

30
Q

What is Meckels diverticulum

A

“when the vitalline duct in the distal ileum fails to close” during embryo development. Causes an outpouching of the small intestine,

31
Q

Meckels diverticulum S/SX (3)

A
  1. bleeding, painless, rectal
  2. bowel obstruction
  3. perforation
32
Q

Congenital Diaphragmatic hernia

A
  1. abdominal contents end up in the chest cavity
  2. causes pulmonary hypoplasia and hypertension
  3. S/SX- scaphiod (concave) abdomen
  4. requires surgery
33
Q

How soon should a FB battery be removed from esophagus

A

2 hours

34
Q

Esopgageal atresia

A

when esophagus does not connect with stomach

35
Q

Tracheoesophageal fistula

A

traches connects to stomach via an abnormal route or fistula

36
Q

How soon should feeding tubes be replaced if dislodged

A

4-6 hours

37
Q

Leading cause of death in children over 1 yr

A

abdominal trauma (p. 205, pp. 2)

38
Q

Injuries that lap belts can cause

A
  1. small bowel rupture

2. Chance FX, (flexion injury of spine)

39
Q

Facts about Liver injuries

A
  1. most commonly injured organ

2. Right shoulder pain (Kehrs sign)

40
Q

Spleen injuries sign

A
  1. left shoulder pain
41
Q

Pancreatic injury signs (3)

A

LUQ pain
Grey- Turners sign- bruising to flank
Cullens sign - umbilical bruising

42
Q

Hollow viscus injuries

A
  1. may be hard to diagnose on imaging, may require serial images and evalution.
  2. Include; “hematomas, perforations, contusions, transections, tears, and avulsions from the mesentary”
43
Q

Abdominal compartment syndrome (ACS), cause of

A

sustained abdominal hypertension

44
Q

Outcomes of ACS

A

organ failure

45
Q

Two types of Abdominal Compartment Syndrome

A

primary or secondary issues that result in increased fluid in the abdominal cavity

46
Q

Causes of Primary ACS (6)

A
  1. bowel obstruction or lileus

2. infection- abcess, perforation, pancreatitis

47
Q

Causes of Secondary ACS (4)

A
  1. sepsis
    2, burns
  2. trauma
  3. fluid rescecitation

indirect causes

48
Q

Signs of ACS (4)

A
  1. difficulty bagging
  2. abdominal distenstion
  3. decreased UO
  4. pressure measurement via manometry of urinary catheter
49
Q

Treatment for ACS

A

ex lap to decompress abdomen

50
Q

What percent of children are overweight or obese?

A

1/3 (p,207, pp.5)

51
Q

What is the mortality rate for pedi ACS?

A

25-85%

52
Q

Most common causes of Hollow organ injury? (4)

A

seatbelts, bicycle handlebars, falls, recreational sports

53
Q

What percentage of children are overweight or obese?

A

1/3 or 33%

54
Q

At what ages does intussusception tend to occur?

A

5-12 mos.

ENPC (35 decks)

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