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PNCB CPNP-PC > GI Issues & Disorders > Flashcards

GI Issues & Disorders Flashcards

1
Q

Gastroenteritis
Definition: a nonspecific term applied to a syndrom of -1- nausea, -2-, and -3- as the result of an acute irritation/inflammation of the gastric mucosa; children attending day care are at increased risk

A
  1. severe, acute
  2. vomiting
  3. diarrhea
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2
Q 
Gastroenteritis Causes/Incidence
-1- cause the majority of cases and are especially active during the winter
> -2-
> -3-
> -4-
A
  1. Viruses
  2. Rota (immunized)
  3. Noro (cruise)
  4. Adeno (autumn)
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3
Q 
Gastroenteritis Causes/Incidence
Bacterial
> -1- (odorous stool)
> -2- (mild loose stools); most -3-
> -4-
> -5- (fever spikes, bloody stools, febrile seizures)
A
  1. campylobacter
  2. E. coli
  3. common bacterial cause of diarrhea
  4. salmonella
  5. shigella
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4
Q 
Gastroenteritis Causes/Incidence
Viral
Bacterial
-1-
-2- contents (-3-)
-4- stress
A
  1. parasites
  2. inorganic food
  3. PICA
  4. emotional
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5
Q

Gastroenteritis S/S
> -1-
> -2-
> -3-/decreased -4-

A
  1. Vomiting
  2. Watery diarrhea
  3. dehydration/decreased
  4. urine output
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6
Q

Gastroenteritis S/S

  • 1- (fever when septic)
  • 2- and/or -3-
A
  1. General “sick” feeling/affect
  2. cramping abdominal pain
  3. abdominal distention
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7
Q 
Ax of Dehydration
> Moderate
>> HR -1-
> Severe
>> HR -2-
>> -3- prolonged (-4-)
A
  1. increased
  2. severe, decreased
  3. cap refill
  4. > 3sec
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8
Q

Ax of Dehydration

Moderate to severe: Urine -1- or -2-

A
  1. <1mL/kg/hour

2. <6 wet diapers/day

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9
Q

Gastroenteritis - Dx Tests/Findings
> None indicated unless symptoms persist for -1- or -2- is present
> -3- may be -4- w/ -5- infections

A
  1. > 72 hours
  2. bloody stool
  3. stool guaiac
  4. positive
  5. bacterial
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10
Q

Gastroenteritis - Dx Tests/Findings
> stool for -1-
> -2-
> stool for -3-

A
  1. WBCs
  2. stool culture
  3. ova & parasites
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11
Q

Gastroenteritis - Mgmt
Daycare exclusion: rotavirus, -1-, and -2-; only -1- & -2- require -3- prior to -4-
> Frequent -5- is often all that is needed

A
  1. e. coli
  2. shigella
  3. two negative stool cultures
  4. return to daycare
  5. supportive therapy
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12
Q

Gastroenteritis - Mgmt
> -1- should continue
> -2- with -3-

A
  1. Breastfeeding/formula
  2. oral rehydration therapy
  3. Pedia-, Infa-, Naturalyte, and Rehydrate
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13
Q

Gastroenteritis - Mgmt

|&raquo_space; -1-, soda, and -2- are -3- due to -4- and -5-

A
  1. apple juice
  2. sports drinks
  3. not appropriate
  4. significant carb concentration
  5. limited E- concentrations
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14
Q

Gastroenteritis - Mgmt

A regular -1- after the patient is rehydrated (or -2-)

A
  1. diet gradually resumes

2. BRAT for diarrhea

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15
Q

Gastroenteritis - Mgmt
-1- should be used -2-
> may -3-
> -4- in patients with fever and/or -5-

A
  1. anti-motility drugs
  2. judiciously
  3. prolong illness –> perforation
  4. Shouldn’t be used
  5. bloody stools
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16
Q

Gastroenteritis - Mgmt
-1- therapy
> since most cases are -2- -1- are generally not indicated
> therapy is -3-
> Long term (for any reason): Include -4-, helps return -5- to -6-

A
  1. Antibiotic(s)
  2. caused by viruses
  3. based on the offending organism
  4. L. acidophilus
  5. gastric pH down
  6. physiologic/antiseptic levels
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17
Q

GERD

Definition: common condition in which -1- into the -2- from the stomach through the -3-

A
  1. gastric contents pass
  2. esophagus
  3. lower esophageal sphincter
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18
Q

GERD - classes

-1-: -2- episodic vomiting

A
  1. physiologic

2. infrequent

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19
Q

GERD - classes

-1-: painless, -2- with -3-

A
  1. Functional
  2. Effortless vomiting
  3. no physical sequelae
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20
Q

GERD - classes

-1-: -2- with alteration in physical funciotning such as -3- and -4-

A
  1. pathologic
  2. frequent vomiting
  3. FTT
  4. asp. pna
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21
Q 
GERD - S/S
-1-
-2-, wheezing
-3-
Other (less common): -4-, -5-, -6-, pharyngitis
A
  1. weight loss
  2. choking, coughing
  3. heartburn
  4. otitis media
  5. dental erosion
  6. sore throat
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22
Q

GERD - Labs/Dx

Diagnosis is usually made from … findings

A

history and phys exam

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23
Q 
GERD - MGMT - feeding habits
> -1- feedings
> -2- feeding
> continue -3-
> Avoid -4-
A
  1. Small, frequent
  2. burp frequently during
  3. breastfeeding
  4. formula changes
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24
Q

GERD - MGMT

-1- or use -2-: one tablespoon of -3- per ounce of formula

A
  1. weighted formula
  2. anti-reflux formula
  3. rice cereal
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25
Q

GERD - MGMT
Medications
> -1- to inhibit -2- (e.g., -3-); best for mild or intermittent symptoms: may cause gynecomastia

A
  1. Histamine H2-receptor antagonists
  2. histaminic acid secretion
  3. famotidine (pepcid AC)
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26
Q

GERD - MGMT
Medications
> -1- to block -2- caused by histamine, acetylcholine, or gastrin (e.g., -3-): may cause -4-

A
  1. PPIs
  2. gastric acid secretion
  3. lansoparazole (prevacid), pantoprazole (protonix)
  4. permanent gynecomastia
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27
Q 
GERD - MGMT
> Frequent follow-ups to -1-; parent education
> Consider -2- specialist for
>> -3-, -4-, and/or
>> -5-
A
  1. montior growth parameters
  2. referral to GI
  3. FTT
  4. Growth delay
  5. refractory to two meds
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28
Q 
Constipation
Def: a -1- in toddlers, children, and adolescents
S/S
> -2-
> -3-
> -4-
Labs/Dx
> Dx is usually mad efrom -5-, but sometimes -6- findings
A
  1. common problem
  2. decreased appetite
  3. abdominal pain
  4. painful stooling
  5. history & physical
  6. KUB
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29
Q

Constipation - Mgmt
Consider -1- and/or -2-
Refer to a pediatirician or -3-

A
  1. stool softeners
  2. high fiber foods
  3. peds GI
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30
Q

Pyloric Stenosis

Def: obstruction resulting from -1- of the -2-, occurring in 1:500 infants

A
  1. thickening of the circular muscle

2. pylorus (stomach-duodenal sphincter)

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31
Q 
Pyloric Stenosis
General
> -1-; may be -2-
> -3- more often affected
> Most common in -4-
> -5- presentation
A
  1. cause is unknown
  2. familial predisposition
  3. Males
  4. Caucasians
  5. breastfeeding delays
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32
Q 
Pyloric Stenosis
S/S
> Presentaiotn is usually from -1-
> -2- after eating
> -3-
> Eventually -4-
> -5- after vomiting (rare)
A
  1. 3 weeks to 4 months of age
  2. projectile, non-bilious vomiting
  3. hungry after vomiting
  4. becomes dehydrated
  5. palpable mass (grape sign)
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33
Q 
Pyloric Stenosis
Labs/Dx
> abdominal -1-
> -2- if -1- is not diagnostic commonly shows -3-
Mgmt
> -4-; prognosis excellent, (-5-)
A
  1. ultrasound
  2. Upper GI
  3. “string sign” (narrow pyloric canal)
  4. surgical referral
  5. 12-hour recovery
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34
Q

Intussuception

Def: -1- of one part of the -2-

A
  1. Telescoping

2. intestine into another adjacent segment

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35
Q

Intussuception
General
> -1- but may be due to -2-
> Other prposed causes include -3- and -4-

A
  1. cause is unknown
  2. adenovirus
  3. celiac
  4. CF
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36
Q 
Intussuception
General
> Most common cause of bowel obstruction in children -1-
>> Peak incidence: -2-
> more common in -3-
A
  1. 3 mo - 6 years of age
  2. 9 mo - 3 years
  3. males
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37
Q 
Intussuception
S/S
> -1- develops -2-
> High-pitched, -3- caused by abdominal pain
> -4- vomiting
A
  1. previously healthy infant
  2. acute colicky pain
  3. sudden, loud crying
  4. bilious vs non-bilious
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38
Q

Intussuception
S/S
> -1- in -2-
> -3-: late presentation

A
  1. sausage-shaped mass
  2. RUQ
  3. Currant jelly stool
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39
Q 
Intussuception
Labs/Dx Options
> -1-
> -2-
> -3-
> -4-
A
  1. US
  2. X-ray
  3. CT
  4. Enema (contrast or air)
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40
Q 
Intussuception
Mgmt
> Refer to a pediatirican or -1-
> fluid or -2-
> -3-
> may be -4-
A
  1. Peds GI
  2. air enema
  3. surgery
  4. fatal if not treated urgently
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41
Q 
Hirschprung's Disease
Def: birth defect in which -1- at the end of the child's bowel, causing -2-
> Causes/Incidence
>> May present in -3- or in -4-
>> More common in -5-
A
  1. nerves fail to grow/cells are missing
  2. blockages in the bowel
  3. infancy
  4. older children
  5. males than females
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42
Q 
Hirschprung's Disease
S/S
> -1-
> progressive -2-
> failure -3-
> -4- & -5-
A
  1. bilious vomiting
  2. abdominal distension
  3. to pass meconium
  4. empty rectum
  5. tight anal sphincter
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43
Q

Hirschprung’s Disease
S/S
> -1-
> -2-

A
  1. FTT

2. malnutrition

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44
Q 
Hirschprung's Disease
Labs/Dx
> abdominal -1-
> -2-
> -3-: -4-
A
  1. X-ray
  2. barium enema
  3. rectal/colon biopsy
  4. gold standard
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45
Q

Hirschprung’s Disease
Mgmt
> Referral;…

A

…requires surgery

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46
Q

Volvulus
Def: -1- of the GI tract, leading to bowel obstruction
> Causes/Incidence
» May be first -2- disease in children

A
  1. torsion

2. sign of hirschprung

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47
Q 
Volvulus
S/S
> Insidious, -1-
> -2-
> -3-
> -4-
A
  1. progressive abdominal pain
  2. constipation
  3. abdominal distension
  4. N/V
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48
Q

Volvulus
Labs/Dx
-1-
Plain abdominal -2-, CT scan and/or Upper GI series

A
  1. CBC & BMP

2. radiography

49
Q 
Volvulus
Tx/Mgmt
> referral to pediatrician and/or -1-
> -2- may be used
> -3- is the definitive -4-
A
  1. peds GI
  2. endoscopic detorsion
  3. Surgery
  4. intervention
50
Q

Celiac Disease

Def: -1- to -2-, a protein found in wheat, barley, and rye; results in an inflammatory response & GI S/S

A
  1. Immune reaction

2. gluten consumption

51
Q

Celiac Disease Causes/Incidence
> -1-
> -2- are more affected than -3-
> May first appear in -4-

A
  1. genetic disorder
  2. females
  3. males
  4. infants
52
Q

Celiac Disease S/S
GI (findings often -1-)
> -2- (primary finding; stools may be -3-, light tan, -4-)

A
  1. suggestive of malabsorption
  2. diarrhea
  3. greasy
  4. foul smelling
53
Q 
Celiac Disease S/S
GI
> -1-
> -2-
> -3-
A
  1. flatus
  2. weight loss
  3. stomach pain
54
Q 
Celiac Disease S/S
Extraintestinal
> -1-
> -2- 
> -3- (e.g., -4-, paresthesias, ataxia)
> -5-
A
  1. anemia
  2. bleeding diathesis
  3. neuro findings
  4. Sz, motor weakness
  5. amenorrhea
55
Q 
Celiac Disease
Labs/Dx
> Referral to pediatrician (-1- via GI endoscopy)
> -2-
> BMP & CBC for -3-
A
  1. gold standard: intestinal biopsy
  2. Ab testing: tTG-IgA (eat gluten 2 weeks before)
  3. malabsorption & anemia
56
Q 
Celiac Disease
Mgmt
> Per pediatrician & -1-
> -2-
> Daily -3- for newly diagnosed patients
> -4- used for refractory patients
> Comorbid with -5-, immediate -6-
A
  1. peds GI
  2. gluten-free (trigger-free) diet
  3. multivitamin
  4. corticosteroids
  5. T1D or hypothyroidism
  6. GI referral
57
Q 
Ulcerative Colitis
Def: -1- condition that affects the GI tract; most commonly affects the -2-
> Incidence
>> First pediatric peak onset in -3- 
>> More common in -4- in pediatric cases
A
  1. Idiopathic, inflammatory
  2. small bowel & colon
  3. adolescence
  4. males than females
58
Q

UC S/S

  • 1- in children and adolescents
  • 2-
  • 3- or periumbilical -4- by -5-
A
  1. Possible growth delay
  2. prolonged diarrhea
  3. RLQ
  4. pain relieved
  5. defecation
59
Q

UC S/S

  • 1-
  • 2-
  • 3- (colon involvement)
A
  1. low-grade fever
  2. weight loss
  3. bloody stool
60
Q

UC Labs/Dx
> -1- establishes -2-
> -3- can differentiate between -4-

A
  1. Colonoscopy
  2. diagnosis
  3. serologic testing
  4. Crohn’s & UC
61
Q

UC Tx/Mgmt

  • 1- disease: -2- therapy
  • 3- disease: -4-
A
  1. Mild
  2. mesalamine, abx, nutritional (fiber)
  3. Severe
  4. corticosteroids, methotrexate
62
Q

UC Tx/Mgmt

If all other therapies fail, -1- or -2- may be needed

A
  1. biologics (e.g., infliximab)

2. surgery

63
Q 
IBS
Def: -1- that include -2-
> Causes/General
>> -3-
>> Greater incidence among -4-
A
  1. Group of symptoms
  2. ABD pain, diarrhea, constipation, or a combo of the three
  3. Stress theory
  4. females
64
Q 
IBS S/S
> -1-
> -2-
> -3-
> -1- may be relieved by defecation
> *-4-*
A
  1. Abdominal pain/cramping
  2. diarrhea
  3. constipation
  4. rectal tenesmus common (specific to IBS)
65
Q

IBS Dx

  • 1-
  • 2-
  • 3-
A
  1. CBC
  2. UA & culture
  3. Stool sample
66
Q

IBS Dx
-1- test
abdominal -2-
-3-

A
  1. lactose breath hydrogen (lactose intolerance)
  2. x-ray & US
  3. endoscopy/colonoscopy
67
Q

IBS Mgmt
-1-
-2-
Stool -3-

A
  1. symptomatic treatment
  2. dietary fiber supplementaion
  3. softeners for constipation
68
Q 
Malabsorption Syndrome
Def: Refers to a(n) -1- in which the small intestine is unable to -2-
> Causes
>> -3- disease
>> -4- disease
>> -5-
A
  1. group of disorders
  2. absorb adequate nutrients
  3. Celiac’s
  4. Crohn’s
  5. CF
69
Q

Malabsorption Syndrome - S/S
-1-
-2-
Bulky, foul stool (-3-)

A
  1. FTT
  2. severe, chronic diarrhea
  3. steatorrhea
70
Q

Malabsorption Syndrome - S/S

  • 1-
  • 2-
  • 3- abdomen
A
  1. Vomiting
  2. ABD pain
  3. protuberant
71
Q 
Malabsorption Syndrome - S/S
Assoc. w/ Vitamin deficiency/malabsorption
> -1-
> -2-
> -3- abnormalities
> -4-
> -5-
A
  1. pallor
  2. fatigue
  3. hair and dermatological
  4. cheilosis
  5. peripheral neuropathy
72
Q 
Malabsorption Syndrome
> Labs/Dx
>> StooL: -1-, hemocult, and ova/parasite exam
>> -2-
> DDx
>> -3-
>> -4- disease
>> -5- disease
A
  1. culture
  2. bone age
  3. CF
  4. Hepatic
  5. Inflammatory bowel
73
Q 
Malabsorption Syndrome - Mgmt
> Dietary modificaionts:
>> -1- wheat, oats, rye, barley
>> CF: -2-; fat soluble vitamins (-3-)
>> Treat -4-
A
  1. celiac disease: no
  2. pancreatic enzyme replacement
  3. A, D, E, K
  4. persistent enteric infections
74
Q

Neuroblastoma
Def: -1- type of -2- of the -3-; most commonly found in the -4-, but can spread to other parts of the body
> Causes/Incidence
» Most common before th age -5-

A
  1. rare
  2. cancerous tumor
  3. neuroblasts
  4. adrenal gland
  5. of 5 years
75
Q

Neuroblastoma S/S

-1- where -2-

A
  1. Lump, pain

2. tumor is growing (e.g., neck, chest, abdomen, pelvis)

76
Q 
Neuroblastoma Labs/Dx
> CT/-1-
> -2-
> -3- or biopsy
> -4-
> -5- (VMA, HVA test)
A
  1. MRI
  2. PET
  3. bone marrow aspirate
  4. Tissue biopsy
  5. urine catecholamines
77
Q 
Neuroblastoma Mgmt
> Referral to pediatric -1-
> -2-
> -3-
> Prognosis: -4-
A
  1. oncologist & surgeon
  2. Surgery
  3. Chemotherapy
  4. starkly dependent on timing of Dx
78
Q

Hepatitis
Def: a(n) -1- of the -2- with -3-
> General Comments
» Most common types in pediatrics: -4-

A
  1. inflammation
  2. liver
  3. resultant liver dysfunction
  4. A, B, & C
79
Q

Hep A
An enteral virus, transmitted via the -1-
> contaminated -2-
> -3- manifest -4- infection

A
  1. oral-fecal route
  2. food, especially shellfish (e.g., raw oysters, clams, and mussels)
  3. S/S
  4. 2-6 weeks after
80
Q

Hep B
A blood-borne virus present in -1- secretions, and -2-
> May be transmitted via blood & blood products, sexual activity, and -3-
> Incubation: -4-

A
  1. saliva, semen, vaginal
  2. all bodily fluids
  3. mother to fetus (vertically)
  4. 6 weeks to 6 months
81
Q

Hep C
> Traditionally associated with -1-
> Today, most cases are related to -2-
> Incubation: -3-

A
  1. blood transfusion
  2. IV drug use
  3. 4-12 weeks
82
Q 
Hepatitis S/S
> -1-: -2-
> -3-
> HA
> aversion to -3- and -4-
A
  1. Pre-icteric
  2. fatigue, malaise
  3. anorexia, N/V
  4. second-hand smoke
  5. alcohol odors
83
Q

Hepatitis S/S
> -1-, -2-, clay colored stool, -3-
> Young children with hepatitis (esp. A) tend to be -4- or have only -5- including -6-.

A
  1. Icteric (yellow sclera): weight loss
  2. jaundice (rarely < 6 yo), pruritis (from elevated LFTs), RUQ pain
  3. dark urine
  4. asymptomatic
  5. mild flu-like symptoms
  6. fever, nausea, and anorexia
84
Q

Hepatitis S/S
> -1-
> -2-
> -3- over -4- area

A
  1. hepatosplenomegaly
  2. diffuse abdominal pain
  3. tenderness
  4. the liver
85
Q

Hepatitis Labs/Dx
> -1-
> -2-
> -3-

A
  1. US
  2. CBC
  3. UA: proteinuria, bilirubinemia
86
Q

Hepatitis Labs/Dx
> Elevated -1- and -2-
> Lactate dehydrogenase, -3-, alk phos, & PT may be normal or slightly elevated

A
  1. AST
  2. ALT (500 - 2,000 IU/L)
  3. bilirubin
87
Q 
Hepatitis Labs/Dx
Serology tests
> Active Hep A: Anti-HAV, -1-
> Recovered Hep A: Anti-HAV, -2-
> Active & Chronic Hep B: HBsAg, Anti-HBc, -1-
> Recovered Hep B: Anti-HBc, -3-
> Acute Hep C: -4-
> Chronic Hep C: Anti-HCV, HCV RNA
A
  1. IgM (IMmediate, active)
  2. IgG (Gone, recovered)
  3. Anti-HBsAg
  4. same as chronic (Anti-HCV, HCV RNA)
88
Q

Hepatitis Mgmt
> Referral to a peds -1-
> -2-

A
  1. GI

2. supportive care (no specific therapy is available)

89
Q

Appendicitis S/S
> Begins with -1- pain
> After several hours, the -2- RLQ of the abdomen

A
  1. vague, colicky umbilical

2. pain shifts to

90
Q

Appendicitis S/S
> McBurney’s -1-: 1/3 the distance from the anterior -2- to the -3-
> Rovsing’s sign: -4- when pressure is applied to the -5-

A
  1. point tenderness (palpate, along with Rovsing’s)
  2. superior iliac spine
  3. umbilicus
  4. RLQ pain
  5. LLQ
91
Q

Appendicitis S/S
> Psoas sign: pain w/ -1-
> Obturator sign: pain with internal rotation of the -2-

A
  1. Rt thigh extension (manipulate, along with obturator)

2. flexed right thigh

92
Q

Appendicitis S/S
> Pain -1- and localizes -2-
> Nausea with -3- episodes of -4-
> -5-

A
  1. worsens
  2. with cough
  3. one to two
  4. vomiting (more than this: other diagnosis)
  5. Fever (low grade)
93
Q

Appendicitis Labs/Dx
> Elevated -1-: 10k - 20k/mcg
> -2-
> -3- or -4-

A
  1. WBCs
  2. Elevated ESR
  3. US
  4. CT is diagnostic
94
Q

Appendicitis Mgmt
> -1- tx w/ wound healing; prognosis is -2-
> -3-

A
  1. surgical
  2. typically very good (full recovery in 24 hours)
  3. pain mgmt
95
Q

Foreign body ingestions -1- in children between the ages of -2- as well as in older children with -3-. -4- ingestions are more frequent in adolescents, adults, and in those with underlying -5-.

A
  1. occur most commonly
  2. 0.5-3 years
  3. developmental delays
  4. Intentional
  5. behavioral/mental health diagnoses
96
Q

Interventions for ingestions are based on the -1- ingested, time since ingestion, -2- of the object, and -3-. Any foreign body lodged -4- is considered an emergency due to the risk of -5-.

A
  1. object or objects
  2. anatomic location
  3. presenting symptoms
  4. in the esophagus
  5. perforation and sepsis
97
Q

Button battery ingestions have the -1- for serious injury. Lodged -2-, a button battery can result in burns and -3- to tissues within two to three hours of ingestion. An ingested button battery lodged -2- is therefore the -4- for endoscopic removal.

A
  1. greatest potential
  2. in the esophagus
  3. liquefaction necrosis
  4. most emergent indication
98
Q

A single -1- which reaches the stomach carries a lower risk, but -2- is an extremely important factor as there may have been adequate exposure within the esophagus to cause -3-. An algorithm for management of a -1- has been published at www.poison.org.

A
  1. ingested button battery/button battery ingestion
  2. time since ingestion
  3. severe tissue injury
99
Q

Cylindrical batteries have been associated with less -1- complications than -2-, if ingested. There is limited -3- ingestion of cylindrical batteries and no -4- of this ingestion.

A
  1. serious and fewer
  2. button batteries
  3. literature regarding
  4. algorithm for management
100
Q

Removal of single cylindrical batteries from the esophagus is typically done -1-. Once these batteries reach the stomach, -2- is appropriate. If multiple cylindrical batteries are ingested, -3- is typically recommended.

A
  1. within 24 hours
  2. observation for stooling
  3. endoscopic removal
101
Q

Injury from ingestion of -1- has been the topic of increased literature within the past decade; including -2- primarily based on expert opinion in 2012 provided by the -3-.

A
  1. high-powered magnets
  2. management guidelines
  3. NASPGHAN (North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition) Endoscopy Committee
102
Q

Ingestion of multiple -1- simultaneously, can result in -2- of the bowel wall and ischemia or -3- if the -1- attract -4-.

A
  1. high-powered magnets/metallic objects
  2. pressure necrosis
  3. fistula
  4. across tissues
103
Q

Due to the possible severe GI injury, multiple magnet ingestion should be -1-, usually inpatient, with -2-. Consult with a -3- and pediatric surgeon is warranted. Ingestion of a single magnet is -4- it arrives in the stomach, with the majority passing -5-.

A
  1. closely monitored
  2. x-rays
  3. pediatric gastroenterologist
  4. usually benign after
  5. without incident
104
Q

A single magnet lodged -1- is treated as any blunt object and -2- within 24 hours if it does not pass into the -3-.

Ingesting -4- is primarily done for purposes of -5- without detection.

A
  1. in the esophagus
  2. removed endoscopically
  3. stomach
  4. packets containing drugs
  5. transporting illegal substances
105
Q

Endoscopic removal of packets containing drugs -1- and is avoided due to -2- the package and causing exposure to -3- of drug. If bowel obstruction or -4-, immediate -5- is indicated.

A
  1. is not indicated
  2. risk of rupturing
  3. potentially fatal amounts
  4. perforation is suspected
  5. surgical intervention
106
Q

In -1- patients who have ingested packets containing drugs, use of -2- irrigation has been described. -3-, if present, are -4- until the packet is passed or surgically removed.

A
  1. asymptomatic
  2. laxatives and bowel
  3. Toxidrome symptoms
  4. treated
107
Q

Giardia duodenalis (formerly Giardia lamblia and Giardia intestinalis) is a -1- found in -2-. It is the most -3- in the United States and is commonly -4-.

A
  1. flagellate protozoan
  2. contaminated water sources/food
  3. common parasitic infection
  4. transmitted in daycares
108
Q

Symptoms of Giardia duodenalis infection typically range from -1- in children and can include abdominal cramps, flatulence, bloating, and -2-. The incubation period is -3-, and the duration of illness is typically -4-.

A
  1. mild to moderate
  2. watery/greasy foul-smelling stools (NO FEVER, NO N/V)
  3. 1-3 weeks
  4. prolonged
109
Q

Some Giardia duodenalis infections are -1- while others may require -2-.

Rotavirus presents with acute -3-. Watery diarrhea occurs -4- in children less than 5 years of age. The duration of illness is -5- with a short incubation period of 48 hours.

A
  1. self-limited
  2. antimicrobial treatment
  3. fever and vomiting
  4. 2-4 days later
  5. 3-8 days
110
Q

Rotavirus is a -1- that occurs more commonly in cooler months. Treatment is -2- with replacement of fluids and electrolytes. The advent of the -3- in 2006 has -4- of the disease dramatically.

A
  1. self-limiting virus
  2. supportive
  3. rotavirus vaccine
  4. decreased the burden
111
Q

Infection with Shigella begins with -1-, abdominal cramping, and -2-. It is most common in children 6 months to 3 years of age, with an incubation period of 24-48 hours and a duration of illness of -3-.

The majority of cases are -4- antimicrobial therapy with the mainstay of treatment being supportive correction of -5- imbalances.

A
  1. fever
  2. diarrhea
  3. 4-7 days
  4. self-limiting/do not require
  5. fluid and electrolyte
112
Q

Abrupt onset of watery diarrhea, -1-, and abdominal cramping are the symptoms of Norovirus; the incubation period is -2-, and the duration can be 24-60 hours. Transmission of this virus is most common in -3-.

A
  1. N/V
  2. 12-48 hours
  3. the cooler months
113
Q

Treatment of Norovirus is -1- to maintain -2- balance.

A
  1. supportive

2. fluid and electrolyte

114
Q

Diseases causing fever, diarrhea, and abdominal pain in children can range from a -1- to more -2-. The initial presentation of a -3- also be considered. Most children with Crohn disease present with diarrhea, abdominal pain, and -4-.

-5- including skin tags, fissures, fistulae, and abscesses may be present.

A
  1. short-lived viral illness
  2. urgent surgical conditions
  3. chronic illness should
  4. weight loss
  5. Chronic perianal disease
115
Q

Recurrent -1- is also suggestive of Crohn disease. Poor appetite, fever, and -2- are also commonly noted at initial presentation.

A child with -3- often presents with vomiting, diarrhea, decreased appetite, and occasionally low-grade fever. Enterocolitis is inflammation of the small and large intestines typically presenting with fever, -4-, and -5-.

A
  1. aphthous stomatitis (differentiating sign, but not necessarily present)
  2. iron deficiency anemia
  3. acute gastroenteritis
  4. abdominal distention
  5. bloody stools
116
Q

Symptoms of pseudomembranous colitis can start -1- days of -2- and include -3- in diarrheal stools, along with abdominal pain and fever.

A
  1. after a couple
  2. taking an antibiotic
  3. blood or pus
117
Q

An -1- is the diagnostic study of choice for pyloric stenosis; it usually reveals an elongated thickened pylorus and a fluid-filled stomach. Although an -2- can be used to diagnose the cause of an infant’s vomiting, this test involves an -3- that do not help diagnose pyloric stenosis.

A -4- is conducted after an infant presents with certain gastrointestinal findings similar to pyloric stenosis, but this test is typically used to confirm gastroesophageal reflux disease.

A -5- may be helpful in determining the nature and degree of symptoms, but are insufficient for definitively confirming pyloric stenosis.

A
  1. abdominal ultrasound
  2. upper gastrointestinal series
  3. x-ray examination series
  4. pH probe study
  5. history and physical
118
Q

Vomiting and choking are signs and symptoms of -1-. -2- usually presents with vomiting but not choking. There would also be a palpable mass visible after vomiting if the child had -2-.

Vomiting is also a symptom of -3-, but, if the patient had this condition, he would have fever and other signs of illness. -4- presents with vomiting, but there would also be -5- in the vomit, as well as signs of jaundice and explosive bowel movements, among others.

A
  1. GERD
  2. Pyloric stenosis
  3. meningitis
  4. Hirschsprung’s disease
  5. bile
119
Q

Findings of paleness, jelly-like stools, vomiting, inconsolable crying, abdominal distention, a sausage-shaped mass in the right upper quadrant, and blood in the baby’s rectum are indicative of -1-, and -2- are the most definitive tools for confirming this diagnosis.

-3- are most useful in diagnosing problems with the solid organs of the abdomen, such as the pancreas and liver. -4- and -5- are more advanced diagnostic tools and are not necessary for diagnosing -1-.

A
  1. intussusception
  2. barium enema radiography
  3. Abdominal ultrasounds
  4. Magnetic resonance imaging
  5. computed tomography scans

PNCB CPNP-PC (19 decks)

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