GIT

Question 1

Reflux
Ph study 
Barium radiology 
Nuclear medicine milk scan
Endoscopy

Answer 1

Ph over 24 h (relates to apnea/ acid reflux ( not alkaline
Barium malrotation stricture
Nuclear medicine milk scan :acid or alkali reflux
Endoscopy oseophagitis

Question 2

Celiac

Peutz–Jeghers syndrome

Answer 2

Wheat, rye, barley, oats( ??
Small bowel third p of duodenum/ Crosby capsule proximal jejunum
Subtotal villous atrophy , crypt hypertrophy
Small bowel lymphoma
HLA B 8
Dermatitis herpetiform
Peutz-Jeghers syndrome (PJS) AD polyps in the gastrointestinal tract, mucocutaneous pigmentation, and an increased risk of gastrointestinal and extraintestinal cancer.
male patients should be examined for signs of feminization (eg, gynecomastia) and for testicular tumors with testicular palpation and US. an STK11 mutation should be offered the option of a pre-implantation genetic diagnosis
Colonoscopy, video capsule endoscopy, and upper gastrointestinal endoscopy initially at age eight years and repeated every three years if polyps are found.

Question 3

HSv

Answer 3

— Immunoglobulin A vasculitis (IgAV; Henoch-Schönlein purpura [HSP]) is a systemic vasculitis of by palpable cutaneous purpura /abdominal pain, arthralgia.ages of 3 and 15 years. 50 percent of patients /gross or occult gastrointestinal bleeding, and up to 50 percent develop renal disease. The abdominal pain in IgAV (HSP) is due to the presence of purpuric lesions within the gastrointestinal tract, or may be caused by intussusception,

Question 4

HUS

Answer 4

Hemolytic-uremic syndrome — microangiopathic hemolytic anemia, thrombocytopenia, and acute renal injury. children under the age of five years.prodromal infection with an enteropathogen producing a shiga-like toxin, such as E. coli 0157:H7, in which case diarrhea mostly bloody. HUS typically develops 5 to 10 days after the onset of the diarrhea.HUS can complication of infectious colitis, rather than an independent cause of colitis.

Question 5

Rare lower GIT bleeding

Answer 5

LGIB in children and adolescents include:

●Vascular malformations – eg, associated with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome), blue rubber bleb
/familial adenomatous polyposis or one of its variants because of a high risk of developing colorectal cancer. (
●Gastrointestinal stromal tumors (GIST) – Carney’s syndrome (GIST, pulmonary chondromas, paraganglioma, adrenal cortical adenoma, and esophageal leiomyoma), and are located most frequently in the stomach, especially in the antrum in neurofibromatosis type 1 (NF 1), but in this condition they tend
●Typhlitis – Typhlitis is an enterocolitis of the ileocecal region that occurs in patients with neutropenia, most commonly in children with hematologic malignancies. It presents with fever and abdominal pain, and sometimes with bloody
Malignancies /They may present with rectal bleeding with or without other associated symptoms such as weight loss, abdominal pain, and symptoms of obstruction. Malignancies may be primary (eg, GIST discussed above, lymphoma, adenocarcinoma) or represent metastatic disease from a variety of primary sites. Patients with polyposis syndromes and IBD

Question 6

Intermittent asthma

Answer 6

Less than 2 days/ week and less than 2 nights per month
Mild persistent more than 2 days per week/ 3 to 4 nights / month
Moderate persistent daily and more than night month