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Peds Rotation > GI part 2 > Flashcards

GI part 2 Flashcards

1
Q

Sx of GI foreign body

A 
Choking
Gagging
Drooling
Coughing
Wheezing
Dysphagia
Dyspnea
Dysphonia
Fever
Hematochezia
Neck, chest or abdominal pain
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2
Q

Sx of button battery ingestion

A 
Refusal to take fluids
Drooling with black flecks in the saliva
Dysphagia
Vomiting
Hematemesis
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3
Q

Indications for endoscopic or surgical exploration and removal of ingested foreign bodies

A

Retention in the same location of esophagus for more than 12 hrs
Signs of airway compromise
Complete esophageal obstruction
A diseased esophagus obstructed by food boluses
Sharp or pointed objects >4 cm in length, 2 cm in diameter, or with no movement at 3 days after ingestion
Button batteries
Symptomatic pt at any time
Objects causing acute abdominal findings

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4
Q

The majority of foreign bodies that pass the level of ________ proceed through the remainder of the gut without complication

A

Lower esophageal sphincter

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5
Q

Imaging studies for GI foreign body

A

Plain radiography
Flat plate radiography of the abdomen/pelvis in older child or teenager
Barium swallow or upper GI contrast study if FB is radiolucent

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6
Q

What foreign bodies should be able to be passed through without incident?

A

Coins
Small toys
Buttons
Marbles

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7
Q

Tx of GI foreign body

A

Flexible endoscopy
Rigid endoscopy
Foley catheter removal
Surgery

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8
Q

S/sx of encopresis

A

Hx of constipation (sometimes very remote) or painful defecation
Inability to differentiate passing gas and passing feces
Soiling episodes usually occurring during the daytime
With retentive encopresis, intermittent passage of extremely large bowel movements

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9
Q

PE of encopresis

A

Palpable stool throughout the distribution of the colon, esp in the LLQ
Stool smeared around the anus
Lax and patulous anal sphincter
Rectum enlarged and filled with soft stool that yields negative results on fecal occult blood testing

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10
Q

Workup for encopresis

A

Plain abdominal radiography
Anorectal manometry
Biopsy

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11
Q

Tx of encopresis

A 
Demystification and education
Colonic disimpaction followed by routine laxative therapy
Toilet training
Meds:
Polyethylene glycol
Sodium phosphate
Magnesium citrate
Enemas
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12
Q

What is the most common hepatitis in children?

A

A

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13
Q

Major risk factors for hep B and C

A

Injectable drug use
Frequent exposure to blood products
Prenatal transmission from maternal infection

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14
Q

Preicteric phase of hepatitis

A 
Lasts approximately 1 wk
HA
Anorexia
Malaise
Abdominal discomfort
N/V
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15
Q

Extra presentation of preicteric phase in infants of hepatitis B

A

Immune complexes accompanied by urticaria nd arthritis

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16
Q

Icteric phase of hepatitis

A

Jaundice

Tender hepatomegaly

17
Q

What can be common be common with hep A, B, and C, esp in young children?

A

Asymptomatic or mild, nonspecific illness without icterus

18
Q

Labs of hepatitis

A

Elevated alanine aminotransferase and aspartate aminotransferase
PT
Serologic testing
Maternal HBsAg status in children <1 yo

19
Q

Tx of hepatitis

A

Largely supportive:
-Rest
-Hydration
-Adequate nutrition
Hospitalization
Chronic HBV: interferon alfa-2b or lmivudine
HCV: interferon alpha alone or in combination with ribavirin

20
Q

When should hospitalization occur for hepatitis?

A

Severe vomiting and dehydration
Prolonged PT
Signs of hepatic encephalopathy

21
Q

Presenting s/sx of duodenal atresia

A

Onset of vomiting within hrs of birth
Most often bilious, but may be nonbilious
Dehydration
Weight loss
Electrolyte imbalance
Hypochloremic/hypokalemic metabolic alkalosis

22
Q

Labs for duodenal atresia

A

Serum electrolytes
UA
Chromosome analysis

23
Q

Imaging for duodenal atresia

A

Prenatal u/s in polyhydramnios
Erect and recumbent plain radiography of the abdomen
Cardiac and/or renal u/s

24
Q

Tx of duodenal atresia

A 
Pre-surgical
-IV hydration
-TPN
-Gastric decompression
Surgery
25
Q

Hx of niacin deficiency

A 
Tends to be seasonal and occurs during spring and early summer
Poor appetite
Nausea
Epigastric discomfort
Increased salivation
Gastritis
Glossitis
Diarrhea
Dermatitis
Lethargy
Apathy
Depression
Anxiety
Irritability
Poor concentration
Delirium
26
Q

Tx of niacin deficiency

A

Nicotinamide or PO niacin
Diet high in protein and adequate in calories
-Addition of meats, milk, peanuts, leafy green vegetables, whole or enriched grains, and brewers’ dry yeast

27
Q

PE of vitamin A deficiency

A 
Bitot spots- areas of abnormal squamous cell proliferation and keratinization
Blindness
Poor adaptation to darkness
Dry skin and hair
Pruritis
Broken fingernails
Keratomalacia
Xerophthalmia
Corneal perforation
Follicular hyperkeratosis
28
Q

Labs for vitamin A deficiency

A 
Serum retinol study
Serum RBP study
Iron panel
Albumin levels
CBC with diff if anemia, infection or sepsis is a possibility
Electrolytes
Liver function studies
29
Q

Imaging for vitamin A deficiency

A

Radiographic films of long bones

30
Q

Tx of vitamin A deficiency

A 
Consume more:
-Liver
-Beef
-Chicken
-Eggs
-Fortified milk
-Carrots
-Mangoes
-Sweet potatoes
-Leafy green vegetables
Daily oral supplements
31
Q

What are the 4 Hs of vitamin C deficiency?

A

Hemorrhage
Hyperkeratosis
Hypochondriasis
Hematologic abnormalities

32
Q

Sx of vitamin C deficiency

A 
Initial:
Malaise
Lethargy
Loss of appetite
Ill-tempered
Poor wt gain
Diarrhea
Tachypnea
Fever
Later:
Irritability
Pain and tenderness of the legs
Pseudoparalysis
Swelling over the long bones
Hemorrhage
33
Q

Early clinical manifestations of infantile vitamin C deficiency

A

Pallor
Irritability
Poor wt gain

34
Q

Advanced infantile vitamin C deficiency

A

Major manifestation is extreme pain and tenderness of the arms and legs
Frog leg posture
Wasted and edematous body
Petechiae and ecchymoses

35
Q

What circulatory features are observed late in vitamin C deficiency?

A

Hypotension
Cardiac enlargement
EKG changes
Anemia

Peds Rotation (12 decks)

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