GI Pt2 Flashcards
GERD
Passive transfer of gastric contents into esophagus
What causes infants to get GERD?
Lower esophageal sphincter is more relaxed in infants
CNS probs
Developmental exaggerated reflux-spitting up
Risk factors increasing risk of GERD
Premature
Bronchopulmonary dysplasia
Esophageal scar tissue
Neuro disorders
Scoliosis
Asthma
Cystic fibrosis
infant sx GERD
spitting up
Hematemesis
Melena
Intermittent vomiting
Back arching
ALTE/apnea
Aspiration, pneumonia
children sx GERD
heartburn, chest pain
Anemia
Aspiration, pneumonia
Chronic cough
Difficulty swallowing
Tx GERD
UGI, 24 hour
PH probe
Endoscopy, labs
Antacids
PPI
Prokinetic meds
surgery – nissen fundoplication
Hypertrophic pyloric stenosis
Circular muscle of pylorus becomes thick, causing obstruction of gastric outlet
Is the cause of HPS known?
no, genetic component
Who is HPS more likely in?
males
what is the hallmark sign for HPS?
Projectile vomiting
Olive shaped mass
tx HPS
pyloromyotomy
Hydration
intussusception
Invagination/telescoping of one portion of intestine to another
Who is most common to get intussusception?
6 to 9 months
Male
Cystic fibrosis patients
What is most likely the cause of intussusception?
90% idiopathic
s/sx intussusception
spasm pain
Paroxysmal abdomen
draws knee to chest
Sausage shaped mass URQ
currant, jelly stools
Tender Abd
dx intussusception
Free air enema
X-ray
tx intussusception
Nonsurgical hydrostatic reduction
Surgical reduction and resection
Air/barium enema
NG tube
Antibiotics
Hydration
celiac disease
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
sx celiac disease
secondary deficiency – anemia, rickets
Watery, pale, foul smell stool
Anorexia, muscle wasting
dx celiac disease
jujunal biopsy
Elevated endomysial, and anti-tissue transglutaminase antibodies
tx celiac disease
eliminate barley, wheat, Rye, oats
Increase calories and protein
Decrease fat
Supplemental Iron and vitamins
short bowel syndrome
Malabsorption disorder
Result of decreased mucosal surface area
Increase transit time for intestinal continents
causes of short bowel syndrome
Congenital abnormalities
Ischemia, trauma
Large segment resection
tx short bowel syndrome
TPN
Lipids
IVF
acute appendicitis
Inflammation of veriform appendix
Obstruction of lumen of appendix
is appendicitis common less than two years old
No
s/sx appendicitis
colic pain – RLQ
McBurney’s point
Rebound tenderness
Sudden release of pain – rupture
What would a fever indicate with appendicitis?
perforation
> 102
tx appendicitis
Appendectomy
T/F enemas and heating pads should be used with appendicitis patients
False
T/F the patient should wait for the surgeon to release them for sports
True, about 4 to 6 weeks
Meckel diverticulum
Fibrous band, connecting small intestine to umbilicus
Who is this more common in?
males
s/sx diverticulum
Painless rectal bleeding
Abdominal pain
Hematochezia – currant jelly stool
Intussusception
dx diverticulum
Radio nuclear imaging
tx diverticulum
surgical removal
IVF
NG – LWS
