GI_UW_pretest Flashcards

1
Q

Mesenteric adenitis presents how?

A

RLQ pain, abdominal guarding, and tenderness

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2
Q

Recurrent self limiting episodes of V/N without an apparent cause with family hx of migraines suggests?

A

Cyclic vomiting syndrome

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3
Q

Pyloric stenosis leads to what electrolyte derangement

A

Hypokalemia hyponatremia metabolic alkalosis

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4
Q

Tx for pyloric stenosis

A

IV rehydration, correction of electrolyte imbalances to reduce risk of post op apnea, and then pyloromyotomy

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5
Q

Pyloric stenosis found in what population and typically diagnosed when?

A

First born males. Diagnosed at ages 3-5 weeks.

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6
Q

What is the first line modality for ID-ing intususseption

A

U/S

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7
Q

What is the classic sign for intussusception on U/S?

A

Target sign

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8
Q

What are characteristic signs of biliary cysts?

A

Abdominal pain, jaundice, palpable mass. Majority of cysts present

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9
Q

Hirschsprung disease aka

A

Congenital aganglionic megacolon

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10
Q

Meconium ileus is pathognominic for

A

Cystic fibrosis

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11
Q

Hirschsprung is a/w which disorder?

A

Down syndrome

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12
Q

Primary diagnoses consideration in infant that fails ot pass meconium within 48 hours

A

Hirschsprung and meconium ileus

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13
Q

Why is there polyhydramnios with duodenal atresia

A

inability to swallow and remove amniotic fluid

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14
Q

What does x ray show for duodenal atresia

A

Air trapped in stomach, and duodenum => double bubble. No air in distal part of the GI tract.

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15
Q

Duodenal atresia is strongly a/w

A

Down Syndrome

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16
Q

What is a volvulus

A

Small bowel twists around the superior mesenteric artery resulting in vascular compromise to large portions of midgut

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17
Q

How does midgut volvulus usually present

A
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18
Q

What is the fastest and most accurate way to diagnose a volvulus?

A

Contrast in a corkscrew pattern => volvulus

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19
Q

What is the Ladd procedure

A

Fixing the bowel in a non-rotated position to minimize recurrent volvulus risk.

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20
Q

Pellagra classic ppt

A

Diarrhea, dermatitis dementia and if severe, death

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21
Q

Pellagra is due to deficiency in what?

A

Vitamin B3 (niacin)

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22
Q

Riboflavin deficiency presentation

A

Cheilosis, glossitis, seborrheic dermatitis (often affecting genital areas), pharyngitis and edema/erythema of the mouth

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23
Q

Pyridoxine deficiency is a known risk factor for?

A

Venous thromboembolic disease and atherosclerosis

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24
Q

What solution should be used for IV fluid resuscitation in children?

A

Isotonic crystalloid is the only crystalloid solution recommended - isotonic saline

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25
Q

Presentation of Beckwith-Wiedemann Syndrome

A

Overgrowth disorder. PE = macrosomia, macroglossia, ompahlocele or umbilical hernia, hemihyperplasia.

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26
Q

What are the complications of Beckwith-Widemann

A

Wilms Tumor, hepatoblasoma

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27
Q

NEC presentation

A

Feeding intolerance, increased gastric residual volume, abdominal distension, bloody stools.

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28
Q

Risk factors for NEC

A

Prematurity,low birth weight, hypotension, congenital heart disease.

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29
Q

Hallmwark x-ray finding for NEC

A

Pneumostasis intestinalis and portal venis air

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30
Q

PE findings and X -ray findings for osteosarcoma

A

Large tender mass. X-ray finding: sun-burst periosteal pattern and “codman” triangle.

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31
Q

Lymphoblast histology/staining

A

Lack peroxidase positive material, often contain +PAS staining material, 95% immunostain for TdT. (TdT is only present in pre B and T lymphocytes)

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32
Q

Example of clotting disorders

A

Hemophilia A and B

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33
Q

Activated PTT time in hemophilias

A

Increased activated PTT

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34
Q

Examples of platelet defects

A

Von Willebrand and Bernard Soulier Syndrome

35
Q

Ewing’s sarcoma is often confused with

A

Osteomyelitis because of the intermittent fevers, leukocytosis, malaise, joint swelling

36
Q

Characteristic x-ray findings for Ewing’s sarcoma

A

Lytic, central bone lesion with periosteal reaction leading to onion skin appearance, followed by mottled appearance/moth eaten and extension into soft tissue

37
Q

Cobalamin deficiency presents as

A

Macrocytic anemia

38
Q

Most common inherited bleeding disorder

A

Impaired Von Willebrand factor

39
Q

Primary dose limiting side effect of hydroxyurea

A

Myelosuppression

40
Q

Brainstem is composed of

A

Midbrain, pons, medulla

41
Q

Pineal gland secretes

A

Melatonin

42
Q

What is parinaud syndrome

A

Downward gaze preference (sun setting gaze) with limited upward gaze, ptosis, upper eyelid retraction, pupillary abnormalities

43
Q

What are the clinical sx of pineal gland mass

A

Parinaud syndrome, obstructive hydrocephalus, precocious puberty (if the pineal gland mass is a germ cell tumor that secretes b-HCG)

44
Q

What are the clinical sx of obstructive hydrocephalus

A

papilledema, vomiting, headache, ataxias

45
Q

What kind of masses can arise from pineal gland?

A

variety but most common is the germ cell tumor

46
Q

Wht is the triad of hemolytic uremic sydnrome

A

renal failure, thrombocytopenia and microangiopathic hemolytic anemia

47
Q

clinical ppt of HUS

A

abdominal pain and diarrhea followed by bloody diarrhea. Within 5-7 days => anemia, thrombocytopenia and renal insufficiency.

48
Q

PE of HUS

A

Pallor, jaundice (hemolysis), edema, petechiae, HTN

49
Q

What is the characteristic peripheral smear of HUS

A

Schistocytes and large platelet

50
Q

Lead poisoning causes what kind of anemia

A

Microcytic anemia. Basophilic stippling on peripheral blood smear.

51
Q

Triad of Wiskott Aldrich Syndrome

A

Eczema, thrombocytopenia (from decreased platelet production), hypogammaglobulinemia leading to recurrent bacterial infections.

52
Q

How does polycythemia lead to cyanosis?

A

High red blood cell mass and hyperviscosity leads to cyanosis

53
Q

What is the definition of neonatal polycythemia

A

Hematocrit greater than 65%

54
Q

Wht are the risk factors for neonatal polycythemia

A

Increased erythropoiesis from Maternal diabetes, maternal hypertension, IUGR, smoking. Or erythrocyte transfusion from delayed cord clamping or twin twin transfusion

55
Q

Clinical presentation of neonatal polycythemia

A

Neurologic manifestations (irritability, jitteriness), respiratory distress and hypoglycemia.

56
Q

Doughy skin is indicative of

A

Hypernatremic dehydration

57
Q

Dilated stool filled megacolon on x-ray, stool-filled anal canal with poor tone on PE of a well-grown child supports diagnosis of?

A

Functional constipation

58
Q

Presence of nocturnal abdominal pain and GI bleeding in patient with positive family hx supports diagnosis of

A

PUD

59
Q

Dx of PUD can be made by what procedure?

A

Endoscopy is preferred method althoug upper GI series can sometimes reveal an ulcer.

60
Q

Tx of eosinophilic esophagitis

A

Avoidance of specific food allergens. Inhaled or systemic steroids have been helpful.

61
Q

Sx of eosinophilic esophagitis

A

Similar to GERD but are not relieved with acid blockade.

62
Q

Dilated stomach, proximal loops of bwel, curly Q twist of barium suspicious for?

A

Malrotation.

63
Q

Patients with malrotation commonly present when with what?

A

First weeks of life with bilious vomiting, indicated of bowel obstruction and or intermitted abdominal pain

64
Q

When does pyloric stenosis present?

A

Not until after around 3 wee os life. Presents with non bilious vomiting

65
Q

Intusussception usually presents starting when?

A

Starting around 6 months or older

66
Q

Jujenal and duodenal atresia usually present?

A

Very leafly in life. First day or so.

67
Q

Meconium ileus is pathognomonic for?

A

Cystic fibrosis

68
Q

Most serious complication of ulcerative colitis is

A

Toxic megacolon.

69
Q

Intractable chronic constipation without fecal soiling- suspsect dx of?

A

Hirschsprung disease.

70
Q

Cholecystitis and cholelithiasis are unusual in children and are almost always a/w

A

CF, pregnancy, hemolytic anemia, Crohns, obesity, or prior ileal resection. Dx confirmed on U/S of gallbladder

71
Q

Usual presentation of intusussecption of infant? Age and sx

A

Usually 4-10 months of age, sudden onset of abdominal colicky abdoinal pain. Passage of stool containing blood nad mucus, described as currant jelly. Early exam can be unremarkable but passage of time shows sausage shaped mass in URQ.

72
Q

What is Sandifer syndrome

A

Bending or arching of the neck caused by reflux.

73
Q

Classic triad of Crohn’s disease. Other ppt?

A

weight loss, diarrhea and abdominal pain. A/w with transmural, granulomatous intestinal lesions that are discontinus. Can appear in both small and large intestines. Risk of colonic carcinoma is increased but not to same degree as UC.

74
Q

Giardia dx?

A

Identifying cysts or trophozoites makes the dx.

75
Q

Tx option for Giardia

A

single dose of tinidazole or course of metronidazole.

76
Q

What is mecekls diverticulum

A

Embryonic duct connecting the yolk sac to the intestine fails to regress completely and persists as a diverticulum attached to the ileum.

77
Q

Diagnostic techniques for lactose intoelrance

A

Hydrogen breath test (basically bacterial metabolism of unabsorbed carb in colon into CO2 and h2.) and resolution of sx after removal of lactose from diet.

78
Q

High concnetrations of sugars promotes dental disease in teeth but which teeth remain normal

A

Mandibular frontal teeth.

79
Q

Congenital indirect hernia is a result of

A

incompelte closure of the processus vaginalis. In conrast to less commonly acquired direct inguinal hernia, caused by weakness in musculature of the inguinal canal.

80
Q

activated charcoal can be effective for clearance of?

A

phneobarbital and TCAs (drugs with enterohepatic circulation or with prolonged absorption like sustained release theophylline). Not effect for alcohols, acids, ferrous sulfate, strong bases like drain cleaners and oven cleaners.

81
Q

Lab must use what to assess for enterhemorragic E coli (shiga like toxin)

A

Sorbitol-macConkey agar.

82
Q

Isoniazid competitively inhibits utlization of what vitamin

A

Pyridoxine. Vitamine B6

83
Q

Vitamin A deficiency first manifests with what kind of clinical sx?

A

Visual changes, including night bldiness. Can also cause drying of conjunctiva and sclear. Skin is frequently dry.