GIN Flashcards
Definition of diarrhea
Infant: >10 mL/kg/d
Children: >200 g/24h
Lasting <14 days
Hereditary conditions that manifest as enamel defects
Teeth are covered by only a thin layer of abnormally formed enamel
Amelogenesis imperfecta
Hereditary opalescent dentin
Odontoblasts fail to differentiate normally, resulting in poorly calcified dentin
Dentinogenesis imperfecta
Age of eruption of first primary tooth
Which tooth erupts first?
6.5 mo
Mandibular central incisor
Age of eruption of first permanent tooth
Which tooth erupts first?
6-7 yr
Mandibular central incisor
Surgical closure of cleft lip is performed by __ of age
3 months
Closure of cleft palate is done before __
1 year of age
Loss of LES relaxation and loss of esophageal peristalsis
achalasia
Achalasia, alacrima and adrenal insufficiency
Allgrove syndrome
Barium fluoroscopy reveals smooth tapering of the lower esophagus leading to the closed LES, resembling a bird’s beak. Diagnosis?
Achalasia
Most sensitive diagnostic test for achalasia
Manometry
Surgical procedure of choice for hypertrophic pyloric stenosis
pyloromyotomy
Ramstedt procedure
Pharmacologic therapy fo hypertrophic pyloric stenosis
atropine sulfate
In erect abdominal films, double fluid level with a characteristic beak near the lower esophageal junction. The stomach tends to lie in a vertical plane
Mesenteroaxial gastric volvulus
In erect abdominal films, a single-air fluid level is seen without the characteristic beak. The stomach lies in a horizontal plane
Organoaxial gastric volvulus
Treatment of gastric volvulus
laparoscopic gastropexy
Plan abdominal radiograph finding in duodenal atresia
double-bubble sign
Hallmark of duodenal obstruction
bilious vomiting without abdominal distention, noted on the 1st day of life
Gold standard in the evaluation and diagnosis of malrotation and volvulus
UGIS
UGIS: corkscrew appearance of the small bowel with or without bird’s beak appearance. Diagnosis?
malrotation
Most common congenital anomaly of the GI tract caused by the incomplete obliteration of the omphalomesenteric duct during the 7th week of gestation
Meckel diverticulum
Hernia containing a Meckel’s diverticulum
Littre hernia
Delay or difficulty in defecation present for 2 wk or longer and significant enough to cause distress to the patient
constipation
Triad of anorectal malformations, sacral bone anomalies and presacral anomaly
Currarino triad
Gold standard for diagnosing Hirschsprung disease
Rectal suction biopsy
Treatment of choice for Hirschsprung disease
endorectal pull-through
Treatment of H. pylori-related PUD
Triple therapy: 2 antibiotics + PPI amoxicillin 50 mkday BID x 14 days clarithromycin 15 mkday BID x 14 days metronidazole 20 mkday BID x 14 days PPI 1 mkday BID x 1 mo
Medical treatment for ulcerative colitis
Aminosalicylate -sulfasalazine 50-75 mkday BID-QID max 2-4 g Corticosteroid -prednisone 1-2 mkday OD max 40-60 mg Immunomodulators - azathioprine 2-2.5 mkday - 6-MP 1-1.5 mkday
Management of pouchitis
oral metronidazole or ciprofloxacin
probiotics
Test for reducing substances, stool pH, breath hydrogen test, are tests for?
Carbohydrate malabsorption
Stool a1-antitrypsin is a screening tool for?
Protein-losing enteropathy
Fecal elastase-1 estimation tests for?
Exocrine pancreatic insufficiency
Presence of acanthocytes in the PBS, extremely low plasma levels of cholesterol and triglycerides
Autosomal recessie disorder
Neuro symptoms
Diagnosis?
Abetalipoproteinemia
Chylomicron retention disease
Anderson disease
Deficiency of lysosomal acid lipase
Wolman disease
Small bowel biopsy showing villous flattening, crypt hyperplasia, chronic inflammatory cell infiltrate of the lamina propria with adjacent lipid accumulation in the surface epithelium.
Diagnosis?
Tropical sprue
Treatment of tropical sprue
supplementation of folate and vitamin B12 for 6 mo
tetracycline or sulfonamides
Treatment of Whipple disease
2 weeks of IV ceftriaxone or meropenem, followed by cotrimoxazole for 1 yr
Malabsorption of neutral amino acids
Manifests with aminoaciduria, photosensitive pellagra-like rash, headaches, cerebellar ataxia, delayed intellectual development, diarrhea
Hartnup disease
Rapid onset of nausea and vomiting within 6 hr; fever, abdominal cramps and diarrhea within 8-72 hr, most likely etiology?
S. aureus (preformed toxins)
Watery diarrhea and abdominal cramps after an 8-16 hr incubation period, likely etiology?
C. perfringens, B. cereus (enterotoxin-producing)
Abdominal cramps and watery diarrhea after a 16-48 hr incubation period, likely etiology?
Enterotoxin-producing bacteria, Crystosporidium, Cyclospora, noroviruses, H1N1 influenza virus
Bloody diarrhea and abdominal cramps after 72-120 hr incubation, likely etiology?
Shigella, Shigatoxin-producing E. coli
Familial intrahepatic cholestasis associated with lymphedema of the lower extremities
Episodic cholestasis
Aagenaes syndrome
Cerebrohepatorenal syndrome
Fatal in 6-12 mo
Intrahepatic cholestasis
Zellweger syndrome
Arteriohepatic dysplasia
- Broad forehead; deep-set, widely spaced eyes; long, straight nose; underdeveloped mandible
- ocular abnormalities
- cardiovascular abnormalities (PS)
- vertebral defects
- tubulointerstitial nephropathy
Alagille syndrome
Medical management of persistent cholestasis
- Diet containing medium chain triglycerides
- Vit A 10,000-15,000 IU/day
- Vit E 50-400 IU/day as oral a-tocopherol
- Vit D 5,000-8,000 IU/day of D2 or 3-5 mcg/k/d of 25-hydroxycholecalciferol
- Vit K 2.5-5 mg every other day as water-soluble derivative of menadione
- Calcium, phosphate, zinc supplementation
- UDCA 15-30 mkday
Four features of appropriate complementary feeding
- Timely
- Adequate
- Safe
- Properly fed
Energy needs of infants from complementary foods per age:
6-8 mo
9-11 mo
12-23 mo
6-8 mo: 200 kcal/d
9-11 mo: 300 kcal/d
12-23 mo: 550 kcal/d
Critical window for introduction of lumpy food
10 mo
Children with a family history of allergy should avoid Cow’s milk until \_\_ Egg Peanuts Fish
Cow’s milk 1 yr
Egg 2 yr
Peanuts and fish 3 yr