GI Infant Disorders Flashcards
When does cleft lip occur?
During embryonic development.
What positive and negative teratogenic factors are associated with cleft lip?
Smoking and viral infections (positive), folic acid deficiency (negative).
What happens to make a cleft lip occur? What weeks during embryonic development does this occur?
Maxillary and nasal structures don’t fuse. Week 5-8.
What does CL often occur with?
Cleft palate
What is cleft palate? What weeks during embryonic development does this occur? What is the treatment for CL and CP?
Incomplete fusion of palatine structures. Weeks 9-12. Surgery.
CP has a strong link to what during pregnancy?
Smoking.
What other structure is malformed with CP?
Nasal structures.
Is pyloric stenosis (PS) a functional or congenital problem? What is it?
Functional. Hypertrophy and constriction at pylorus.
When does pyloric stenosis occur in children? Who is it more common in?
2-8 weeks old. Females.
What is the etiologic factor for PS? 3 possible links?
Idiopathic. Links: hypergastrinemia, PGE (prostaglandin e, local hormone) and erythromycin exposure.
What is the patho for PS? Manifestation? Complications?
Hypertrophy - constriction - inflammation and exudate forms - obstruction - feed can’t pass into duodenum - stomach stretch. Projectile vomit. Dehydration and malnourishment.
How is PS diagnosed? Treatment?
Palpable tiny mass in URQ and US. Surgery to open sphincter.
Gastroesophageal reflux (GER): common in what age? What type of disorder is this?
0-3 months. Neuromuscular etiology, functional issue.
What happens in GER? What is the patho of it?
Reflux occurs at the distal esophageal sphincter. Gastric contents move into esophagus - esophagitis.
What are complications of GER related reflux?
Growth issues (baby not wanting to feed), esophageal erosion.
What are treatment methods of GER? How long does this take to correct itself usually?
Antacid, PPI, H2RA, modify behaviour around feeding (positioning of infant) and modify feed (smaller feeds increased viscosity). Fundoplication to fortify cardiac sphincter?
What is Hirschprung Disease? What causes this disease? Is it common?
Genetic problem. RET gene mutation on chr. 10. Not common.
What is the RET gene? What do the proteins it codes for do?
RET gene codes for protein involved in cell signalling for formation of neural tissue in colon specifically.
What is the patho of Hirschprung disease? Complications?
RET gene mutation - part(s) of colon lack parasympathetic ganglia (neural tissue) - no localized peristalsis - accumulation of contents - colon distention - abdominal distention. Rupture of colon, peritonitis.
What is the treatment for Hirschprung disease?
Aganglionic segment of colon removed.
What is intussusception? Where is the most common part in the GIT for this to occur? Why?
Invagination of intestine into adjoining part. Illeocecal valve because of a smaller diameter moving through to a larger diameter.
What is the patho for intussusception? What are 3 complications? How is this treated?
Invagination - obstruction - inflammation - edema - ischemia due to increase intraluminal pressure. Necrosis perforation, peritonitis. Hydrostatic reduction (using water soluble contrast medium and air pressure). Surgery required sometimes.
