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Pediatrics Board ⭐️ > GIT / Nutrition > Flashcards

GIT / Nutrition Flashcards

1
Q

Xerophthalmia, corneal opacity, bitot spots, night blindness, growth failure, and recurrent infection

A

Vitamin A deficiency

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2
Q

Gingival bleeding, anemia, corkscrew-coiled hairs, anorexia, and irritability

A

Vitamin C deficiency

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3
Q

Breastfed children should be supplemented with which vitamin from birth?

A

Vitamin D

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4
Q

Child with a history of cystic fibrosis presents with ataxic gait, diminished deep tendon reflexes in the lower extremities, as well as generalized weakness in the lower extremities

A

Vitamin E deficiency

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5
Q

Vitamin that affects prothrombin, factor VII, factor IX, factor X

A

Vitamin K

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6
Q

Child is receiving a prophylactic antibiotic for the last few months. Prothrombin time (PT) and partial thromboplastin time (PTT) are mildly prolonged

A

Vitamin K deficiency

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7
Q

Foot and wrist drop, ataxia, ophthalmoplegia, confusion, abnormal sensation, heart failure, dyspnea, and edema

A

Vitamin B1 deficiency (thiamine)

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8
Q

Redness and fissuring of lips (cheilitis), soreness of tongue, anemia, fatigue

A

Vitamin B2 deficiency (riboflavin)

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9
Q

Diarrhea, dementia, dermatitis, and death in severe cases

A

Vitamin B3 deficiency (niacin) pellagra disease

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10
Q

Which vitamin is needed to supplement a child on a strict vegan diet?

A

Vitamin B12 (other supplements to consider: iron, zinc, and calcium)

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11
Q

The site of vitamin B12 absorption

A

Ileum

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12
Q

Infant drinks goat’s milk, looks pale, CBC shows macrocytic anemia

A

Folic acid deficiency

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13
Q

Acute illness with diarrhea, fever, and vomiting for 2days, followed by persistent diarrhea for 3weeks, 6–9 episodes of liquid stools without visible blood or mucus, associated with generalized abdominal pain, distended and flatulent since the acute illness. A positive reducing substance in the stool. What is the best management?

A

Lactose-free diet and lactase supplement (lactose intolerance)

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14
Q

Taste and smell impairment, night blindness, and depressed immunity

A

Zinc deficiency

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15
Q

Deficiency associated with recurrent diarrhea, alopecia, and rash (acrodermatitis enteropathica)

A

Zinc deficiency

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16
Q

Child previously healthy is living with stepfather, generalized loss of muscle mass, and no subcutaneous fat

A

Marasmus and possible calorie deprivation

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17
Q

Child lives in a shelter, poor nutrition, failure to thrive, weakness, edema, moon facies, a swollen abdomen (potbelly), dark, dry skin, with pale areas between the cracks, depigmentation of hair, and fatty liver

A

Kwashiorkor (protein-energy malnutrition)

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18
Q

An exclusively breastfed infant has not stooled for 5days with no other symptoms. The stool is soft with no rectal bleeding. The infant is gaining weight

A

Reassurance (breastfed infants may go several days or even a week between bowel movements)

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19
Q

A 1-week-old child with frequent spit-ups, otherwise doing well

A

Reassurance (newborn reflux is normal)

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20
Q

What are the upper GI series useful for?

A

To rule out anatomic or motility problems. Does not diagnose reflux

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21
Q

A 3-week-old first newborn boy presents with nonbilious projectile vomiting, hypochloremic, hypokalemic metabolic alkalosis, and dehydration

A

Pyloric stenosis

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22
Q

What is the next best step in cases with suspected pyloric stenosis?

A

Abdominal US (pylorus)

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23
Q

Weight loss, abdominal pain, nausea, effortless postprandial regurgitation after at least 1 meal daily for 1month, regurgitated food occasionally reswallowed, rechewed, or spit out

A

Rumination syndrome

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24
Q

Child with no known health problem woke up suddenly vomiting blood. The child is stable and acting normal. What is the most likely cause?

A

Epistaxis (nose bleeding is the most common source in healthy children)

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25
Q

Nausea and vomiting every 1–2months, each episode lasts for few hours, otherwise healthy, no symptoms in-between episodes, positive family history of migraine

A

Cyclic vomiting syndrome

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26
Q

A 7-year-old healthy child, with periumbilical abdominal pain worse in the morning prior to school, improves during weekends with normal growth parameters

A

Reassurance (functional abdominal pain)

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27
Q

High achieving adolescent complains of crampy abdominal pain, diarrhea, and at other times, constipation; pain is relieved with stooling

A

Irritable bowel syndrome

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28
Q

Adolescent presents with recurrent episodes of abdominal pain, diarrhea, and sometimes constipation in the previous 3months. No weight loss and all labs are normal. What is the best treatment?

A

Peppermint oil, diet modifications, cognitive behavioral therapy

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29
Q

A mother brought her toddler with a diaper full of undigested food, the child is holding a large bottle of apple juice

A

Toddler diarrhea

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30
Q

The best management of toddler’s diarrhea

A

Juice restriction and allow normal dietary fat

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31
Q

Child with a low-grade fever, 6 episodes of diarrhea, otherwise reassuring medical exam. What is the treatment of choice?

A

Oral rehydration therapy (avoid anti-diarrheal agents)

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32
Q

What is the major concern of using antimotility drugs such as Loperamide?

A

May induce ileus

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33
Q

An infant presents with bright red blood stool, poor weight gain, diarrhea, and fussiness; the infant is breastfeeding, supplemented with standard infant formula; stool guaiac test is positive

A

Cow milk protein intolerance

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34
Q

Child with dysphagia, recurrent food impaction; biopsy shows an increased eosinophil?

A

Eosinophilic esophagitis

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35
Q

Adolescent with recurrent headaches takes ibuprofen as needed, presents with dysphagia and chest discomfort (does not like to drink water with medicine)

A

Pill-induced esophagitis

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36
Q

Child accidentally swallowed caustic liquid 6h ago, presents with dysphagia, oral pain, chest pain, nausea, and vomiting

A

Endoscopy in 12–24h after ingestion

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37
Q

Swallowed a coin, no symptoms, and radiograph showed the coin still in the esophagus

A

Observe for 12–24h, removal of the coin if it does not pass to the stomach or if the patient became symptomatic

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38
Q

Swallowed a coin, no symptoms, and radiograph showed the coin in the stomach

A

Checking the stool for passage for 4weeks, with weekly radiographs, if indicated

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39
Q

4 weeks passed and the coin still in the stomach with no symptoms

A

If the coin does not pass through the stomach by 4weeks or if the patient is symptomatic, removal by endoscopy should be considered

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40
Q

Swallowed a coin, excessive drooling, and chest pain, and radiograph showed the coin still in the esophagus

A

Immediate removal

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41
Q

Swallowed a button battery (BB), and passed to the stomach with symptoms

A

Immediate removal

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42
Q

Swallowed a BB, and passed to the stomach without symptoms

A

Urgent removal (if age

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43
Q

Swallowed a BB that got stuck in the esophagus

A

Immediate removal

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44
Q

Swallowed small pieces of magnet metals; the abdominal radiograph showed the pieces in the stomach

A

Immediate removal

45
Q

An older child with bloating, constant burping, sharp epigastric pain that awakens the child from sleep

A

Helicobacter pylori infection

46
Q

The most common cause of chronic gastritis in pediatrics

A

H. pylori

47
Q

The best and most definitive test for peptic ulcer disease

A

Endoscopy

48
Q

What is the treatment of H. pylori infection?

A

Amoxicillin or metronidazole + clarithromycin + PPI for 2weeks

49
Q

Infant suddenly develops bilious vomiting, abdominal distension, tenderness, and fussiness. What is the diagnostic test of choice?

A

Upper GI series with follow through

50
Q

In the infant above, the GI series shows a bird’s beak sign of the second portion of the duodenum

A

Volvulus

51
Q

Intermittent crampy abdominal pain, lethargy, bilious vomiting, and a palpable mass in the right upper quadrant

A

Intussusception

52
Q

What is the best initial diagnostic test of choice in cases of intussusception?

A

Abdominal US (target sign, reflecting a segment of bowel trapped within a distal segment of bowel)

53
Q

What is the therapeutic procedure of choice in cases of intussusception?

A

Air contrast enema (diagnostic and therapeutic)

54
Q

Down syndrome, bilious vomiting, double bubble sign on KUB

A

Duodenal atresia

55
Q

A mother brought her 9-month-old girl with a diaper full of red, maroon stool; the physical exam is normal, and the infant is feeding well and smiling (she is receiving an antibiotic for AOM)

A

Most likely the medicine, e.g., cefdinir may change the stool color to maroon color (bloodlike color)

56
Q

A 2-year-old boy, frank rectal bleeding, anemia, no pain, no other symptoms

A

Meckel diverticulum

57
Q

What are the 2 most common ectopic tissues found in Meckel diverticulum?

A

Gastric and pancreatic

58
Q

How is Meckel diverticulum diagnosed?

A

Technetium 99 scan

59
Q

Infant, failure to thrive, rectal prolapse

A

Cystic fibrosis

60
Q

Most common cause of rectal prolapse in the USA

A

Constipation

61
Q

Rectal bleeding, large and hard stool in the diaper

A

Anal fissure

62
Q

The most common cause of rectal bleeding in infants

A

Anal fissures

63
Q

A 2-year-old boy with chronic constipation, ineffective laxatives, fails to pass meconium in the first 48h of life, explosive stools on rectal exam, KUB showed very distended colon

A

Hirschsprung disease

64
Q

A 48-h old boy did not pass the meconium; the abdomen is slightly distended

A

Hirschsprung disease

65
Q

Most accurate diagnostic test for Hirschsprung disease

A

Full-thickness rectal biopsy performed by surgery

66
Q

Persistent epigastric abdominal pain, vomiting; the pain is referred to the back, tenderness in the epigastric region, elevated amylase, and lipase enzymes

A

Acute pancreatitis

67
Q

Child with Down syndrome, intermittent abdominal pain, and failure to thrive

A

Celiac disease

68
Q

Child with type 1 diabetes mellitus and recurrent abdominal pain

A

Celiac disease

69
Q

Child with a history of recurrent abdominal pain presents with fever, abdominal pain, bloody diarrhea, migratory arthritis, erythema nodosum, ankylosing spondylitis, elevated ESR, positive P-ANCA

A

Ulcerative colitis

70
Q

Recurrent aphthous ulcers, abdominal pain, weight loss, perianal lesions, positive antiSaccharomyces antibodies

A

Crohn’s disease

71
Q

Jaundice, abdominal pain, and fever

A

Cholangitis

72
Q

Jaundice, abdominal pain, and a palpable mass in the right upper quadrant

A

Choledochal cyst

73
Q

Hydrops of the gallbladder can be seen in

A

Kawasaki disease

74
Q

Conditions associated with an increased incidence of cholelithiasis

A

Sickle cell anemia, chronic total parenteral nutrition (TPN), adolescent pregnant females

75
Q

What is the most common complication of cholelithiasis?

A

Pancreatitis

76
Q

A 3-year-old boy presents with failure to thrive, difficulty walking; the metabolic panel shows elevated aspartate transaminase (AST) and alanine transaminase (ALT). Total bilirubin, prothrombin time, blood glucose, TSH and free T4 are all normal, negative hepatitis viral panel. What is the test of choice in this case?

A

Creatinine phosphokinase (CK) (muscular dystrophy most likely)

77
Q

What are the sources of transaminases (ALT and AST)? It is important to consider other sources of transaminases if they are elevated and the liver function is normal

A

Liver, heart, muscles, kidney, and brain

78
Q

The best laboratory test for acute hepatitis A

A

Anti-HAV IgM

79
Q

A mom is asking about prophylaxis for her 4-month-old child after she was recently diagnosed with hepatitis A?

A

Administer IG as prophylaxis (

80
Q

Prophylaxis of a 3-year-old child exposed to a documented case of hepatitis A in a child care center

A

Hepatitis A vaccine (>1year)

81
Q

All hepatitis viruses are composed of RNA exceptH

A

Hepatitis B virus is composed of DNA

82
Q

Which virus infection must have hepatitis B?

A

Hepatitis D

83
Q

Child with a family history of lupus disease presents with jaundice, hepatomegaly, weight loss, loss of appetite, positive anti-smooth muscle antibodies

A

Autoimmune hepatitis

84
Q

One week with jaundice, hepatomegaly, slightly elevated ALT and AST, prolonged PT that is not responding to IV vitamin K, and recurrent hypoglycemia

A

Acute hepatic failure

85
Q

An 8-year-old boy has recurrent jaundice, slightly elevated indirect bilirubin; physical examination and all other labs are normal

A

Gilbert syndrome

86
Q

A 1-day-old boy with intense jaundice, unconjugated bilirubin is 25mg/dL, and no conjugated bilirubin; and poor response to phototherapy

A

Crigler–Najjar syndrome type I (exchange transfusion is warranted)

87
Q

Mild conjugated hyperbilirubinemia with black liver

A

Dubin–Johnson syndrome

88
Q

An infant with jaundice, dark urine, light-colored stool, hepatomegaly, and elevated conjugated bilirubin

A

Biliary atresia

89
Q

What is the most valuable study for neonatal biliary atresia?

A

Percutaneous liver biopsy

90
Q

If liver biopsy confirmed biliary atresia, what is the next appropriate test?

A

Intraoperative cholangiography

91
Q

Adolescent presents with depression, psychosis, and elevated liver enzymes

A

Wilson disease

92
Q

Which mineral is affected in Wilson disease?

A

Copper (excess)

93
Q

How to establish the diagnosis of Wilson disease

A

Ceruloplasmin 250ug/g dry weight. Urine copper >100ug/24h. Presence of Kayser–Fleischer rings

94
Q

Broadened forehead, jaundice, pulmonary stenosis, and butterfly hemivertebrae

A

Alagille syndrome

95
Q

Abdominal mass, elevated liver enzyme, and high serum alpha-fetoprotein

A

Hepatoblastoma

96
Q

A 3-month-old, failure to thrive, extreme pruritus, steatorrhea, very high- conjugated bilirubin, hepatosplenomegaly, mutilated skin, elevated serum alkaline phosphatase, and normal gammaglutamyl transferase (GGT)

A

Progressive familial intrahepatic cholestasis (PFIC) type 1

97
Q

Prognosis of all forms of PFIC

A

Lethal during childhood unless treated early

98
Q

Hematochezia, intestinal polyp, pigmented penile lesion, large head, café-au-lait spots, intellectual disability

A

Bannayan–Riley–Ruvalcaba syndrome

99
Q

> 5 juvenile polyps

A

Juvenile polyposis

100
Q

What is the next step in children with ≥5 juvenile polyps or any number of adenomatous intestinal polyps?

A

Genetic testing

101
Q

100 or more adenomatous polyps in the large and/ or small intestines

A

Familial adenomatous polyposis

102
Q

Intestinal polyps, osteoma of the mandible, papillary carcinoma of thyroid, and hepatoblastoma

A

Gardner syndrome

103
Q

Intestinal polyps and brain tumor

A

Turcot syndrome

104
Q

Intestinal polyps, hematochezia, mucocutaneous freckling, and a family history of polyposis

A

Peutz–Jeghers syndrome (increases the risk of cancer)

105
Q

Hamartomas involving many areas of the body, e.g., skin, oral mucosa, thyroid, breast, and colon

A

Cowden syndrome

106
Q

Associated risks of Cowden syndrome

A

Cancer, e.g., thyroid cancer

107
Q

Hemihypertrophy, very large extremities, epidermal nevus, hamartomatous polyps, intellectual disability

A

Proteus syndrome

108
Q

Potential risks of Proteus syndrome

A

Deep vein thrombosis (DVT) and thromboembolism

109
Q

The best diagnostic test for lactose intoleranceH

A

Hydrogen breath test

Pediatrics Board ⭐️ (30 decks)

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