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child health > high yield- GI > Flashcards

high yield- GI Flashcards

1
Q

why do babies get GORD?

A

-babies have immature lower oesophageal sphincter

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2
Q

how does GORD present?

A
  • regurgitation
  • chronic hiccups
  • presents in 1st 2 months of life and improves in first year
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3
Q

investigations for GORD?

A
  • clinical diagnoses
  • older kids= 24 hour ambulatory oesophageal pH monitoring
  • Suspect oesophagitis= endoscopy
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4
Q

treatment for GORD?

A
  • self resolves in 1 year
  • avoid over feeding, feed in prone
  • gaviscon immediately after feed
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5
Q

how does pyloric stenosis occur?

A

progressive hypertrophy of pyloric sphincter muscle which leads to gastric obstruction

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6
Q

how does pyloric stenosis present?

A
  • projectile vomiting (roughly 30 mins after feed)
  • child remains hungry and eager to feed
  • weight loss
  • dehydration + constipation
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7
Q

what investigations are done for pyloric stenosis?

A

examination- olive shaped mass in RUG

USS- hypertrophic pyloric muscle (DIAGNOSTIC)

Blood gas- hypochloraemia, hypokalaemia + metabolic alkalosis

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8
Q

treatment for pyloric stenosis?

A

Ramstedt pyloromyotomy

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9
Q

what is intussusception?

A
  • telescoping of small bowel leading to obstruction
  • usually involving the ileocecal valve
  • can cause bowel necrosis if left untreated
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10
Q

presentation of intussusception?

A
  • child unwell/ floppy
  • palpable ‘sausage’ mass
  • red current jelly in stool
  • vomit + episodic colicky abdo pain
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11
Q

investigations for intussusception?

A

USS- kidney bean or target/ bulls eye sign

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12
Q

treatment for intussusception?

A

conservative= air enema retraction

surgical= laparascopic surgery

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13
Q

what causes malrotation with volvulus?

A
  • absent mesentery attachments

- allows organs to wrap around eachother (leading to volvulus)

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14
Q

presentation of malrotation with volvulus?

A

-green, bilious vomit is malrotation with volvulus until proven otherwise

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15
Q

investigations for malrotation with volvulus?

A 
1st= Abdo Xray
2nd= upper GI contrast
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16
Q

treatment for malrotation with volvulus?

A

immediate referral to srugery

17
Q

what is Cow’s protein allergy?

A

-immune mediated response to casein + weigh

18
Q

how does Cow’s milk protein allergy present?

A
  • Urticaria, atopic eczema
  • colic, irritability, crying
  • wheeze, cough
19
Q

investigations for Cow’s milk protein allergy?

A
  • elimination diet

- skin prick or RAST (radioallergosorbent test)

20
Q

treatment for Cow’s milk protein allergy?

A

1st= use extensive hydrolysed formula (eHF)

severe= amino acid based formula

21
Q

presentation coeliac?

A
  • pale stool
  • abdo pain/ bloating
  • failure to thrive
  • crypt hyperplasia, villi flattening
22
Q

investigations for coeliac?

A

GOLD STANDARD= endoscopy w/ith duodenal biopsy

IgA tissue transglutaminase (TTG)

23
Q

coeliac treatment?

A

Gluten free diet

24
Q

most common cause of gastroenteritis?

A

rotavirus

25
Q

presentation gastroenteritis?

A
  • acute onset vomiting
  • followed by diarrhoea
  • post infection lactose intolerance
26
Q

treatment gastroenteritis?

A
  • oral rehydration therapy (ORT)

- diaorylate

27
Q

treatment for dehydration?

A

1st= encourage breast feeding

2nd= oral rehydration solution (ORS) over 4 hours

severe= 0.9% NaCl (slow infusion over 48 hours)

28
Q

most common cause of lower GI bleed in new born?

A
  • necrotising enterocolitis

- anal fissure

29
Q

most common cause of lower GI bleed in 1 month- 1 year?

A

Intussusception

Anal fissure

30
Q

most common cause of lower GI bleed in 1-2 years?

A
  • polyps

- Meckel’s diverticulum

31
Q

most common cause of lower GI bleed in >2 years>

A
  • polyps
  • intussusception
  • IBD
32
Q

treatment for neonatal sepsis?

A

IV nezyl penicillin + gentamicing

33
Q

presnetation of neonatal sepsis?

A
  • fever, tachy ot bradicardia, hypoxia
  • poor feeding, vomiting, hypoglycaemia
  • resp distress, grunting, apnoea
  • seizures

RED FLAGS:

  • confirmed or suspected sepsis in mum
  • signs of shock (pyrexial or hypothermic)
  • resp distress starting >4 hours after birth
  • seizures
34
Q

what is biliary atresia?

A
  • congenital condition
  • part of the biliary tract is narrowed/ absent leading to cholestasis

cholestasis= liver disease that occurs when the flow of bile from liver is reduced or blocked

35
Q

what are the types of biliary atresia?

A

3= left + right ducts at the level or porta hepatis are narrowed/ absent (>90%)

2= cystic duct + cystic structures are absent

3= proximal ducts are patent but the common duct is not

36
Q

how does biliary atresia present?

A
  • prolonged jaundice (>14 days)= pale stool + dark urine
  • abnormal growth
  • hepatosplenomegaly
37
Q

investigations for biliary atresia?

A

abdominal USS

liver biopsy

38
Q

treatment for biliary atresia?

A

-surgical dissection of abnormalities in ducts

child health (28 decks)

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