GI Pt2

Question 1

GERD

Answer 1

Passive transfer of gastric contents into esophagus

Question 2

What causes infants to get GERD?

Answer 2

Lower esophageal sphincter is more relaxed in infants

CNS probs

Developmental exaggerated reflux-spitting up

Question 3

Risk factors increasing risk of GERD

Answer 3

Premature
Bronchopulmonary dysplasia
Esophageal scar tissue
Neuro disorders
Scoliosis
Asthma
Cystic fibrosis

Question 4

infant sx GERD

Answer 4

spitting up
Hematemesis
Melena
Intermittent vomiting
Back arching
ALTE/apnea
Aspiration, pneumonia

Question 5

children sx GERD

Answer 5

heartburn, chest pain
Anemia
Aspiration, pneumonia
Chronic cough
Difficulty swallowing

Question 6

Tx GERD

Answer 6

UGI, 24 hour
PH probe
Endoscopy, labs

Antacids
PPI
Prokinetic meds

surgery – nissen fundoplication

Question 7

Hypertrophic pyloric stenosis

Answer 7

Circular muscle of pylorus becomes thick, causing obstruction of gastric outlet

Question 8

Is the cause of HPS known?

Answer 8

no, genetic component

Question 9

Who is HPS more likely in?

Answer 9

males

Question 10

what is the hallmark sign for HPS?

Answer 10

Projectile vomiting
Olive shaped mass

Question 11

tx HPS

Answer 11

pyloromyotomy
Hydration

Question 12

intussusception

Answer 12

Invagination/telescoping of one portion of intestine to another

Question 13

Who is most common to get intussusception?

Answer 13

6 to 9 months
Male
Cystic fibrosis patients

Question 14

What is most likely the cause of intussusception?

Answer 14

90% idiopathic

Question 15

s/sx intussusception

Answer 15

spasm pain
Paroxysmal abdomen
draws knee to chest
Sausage shaped mass URQ
currant, jelly stools
Tender Abd

Question 16

dx intussusception

Answer 16

Free air enema
X-ray

Question 17

tx intussusception

Answer 17

Nonsurgical hydrostatic reduction
Surgical reduction and resection
Air/barium enema
NG tube
Antibiotics
Hydration

Question 18

celiac disease

Answer 18

Gluten sensitivity, inability to digest
Chronic inflammation of small intestine Mucosa
Atrophy to intestinal villi
Malabsorption

Accumulation of toxic substances that damage mucosal surface and interfere with absorption of nutrients

Question 19

sx celiac disease

Answer 19

secondary deficiency – anemia, rickets
Watery, pale, foul smell stool
Anorexia, muscle wasting

Question 20

dx celiac disease

Answer 20

jujunal biopsy
Elevated endomysial, and anti-tissue transglutaminase antibodies

Question 21

tx celiac disease

Answer 21

eliminate barley, wheat, Rye, oats
Increase calories and protein
Decrease fat
Supplemental Iron and vitamins

Question 22

short bowel syndrome

Answer 22

Malabsorption disorder
Result of decreased mucosal surface area
Increase transit time for intestinal continents

Question 23

causes of short bowel syndrome

Answer 23

Congenital abnormalities
Ischemia, trauma
Large segment resection

Question 24

tx short bowel syndrome

Answer 24

TPN
Lipids
IVF

Question 25

acute appendicitis

Answer 25

Inflammation of veriform appendix Obstruction of lumen of appendix

Question 26

is appendicitis common less than two years old

Answer 26

No

Question 27

s/sx appendicitis

Answer 27

colic pain – RLQ McBurney’s point Rebound tenderness Sudden release of pain – rupture

Question 28

What would a fever indicate with appendicitis?

Answer 28

perforation >102

Question 29

tx appendicitis

Answer 29

Appendectomy

Question 30

T/F enemas and heating pads should be used with appendicitis patients

Answer 30

False

Question 31

T/F the patient should wait for the surgeon to release them for sports

Answer 31

True, about 4 to 6 weeks

Question 32

Meckel diverticulum

Answer 32

Fibrous band, connecting small intestine to umbilicus

Question 33

Who is this more common in?

Answer 33

males

Question 34

s/sx diverticulum

Answer 34

Painless rectal bleeding Abdominal pain Hematochezia – currant jelly stool Intussusception

Question 35

dx diverticulum

Answer 35

Radio nuclear imaging

Question 36

tx diverticulum

Answer 36

surgical removal IVF NG – LWS