Infant disorders Flashcards

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1
Q

what is cleft lip?

A

unfused maxillary & nasal

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2
Q

at what period does cleft lip often happen

A

approx at 5 weeks gestation (some periods of gestation where some systems are more susceptible than others)

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3
Q

what does cleft lip look like?

A

indentation/fissure that is uni or bilateral (on one or both sides)

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4
Q

how many babies are affected by cleft lip

A

approx 1 in 700 live births

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5
Q

what causes cleft lip?

A

-genetic and congenital (but mostly congenital from TERATOGENS)

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6
Q

what are is the main teratogen that causes cleft lip and some others?

A

the main teratogen is SMOKING, other ones are viral infections & folic acid deficiency

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7
Q

cleft lip and cleft palate are often _____

A

combined

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8
Q

what is cleft palate

A

-incomplete fusion of palatine structures

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9
Q

at what time does cleft lip happen

A

in week 9-12 of gestation

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10
Q

what does cleft palate look like?

A

-malformed nasal structures (these can cause problems with nasal passages & breathing)

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11
Q

cleft palate has a strong link to being caused by?

A

smoking in pregnancy

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12
Q

how many babies are affected by cleft palate?

A

aprox 1 in 2000 live births

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13
Q

what is required to treat cleft palate

A

surgery

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14
Q

what is the pyloric sphincter in the stomach

A

-pyloric region of stomach is the distal portion which as sphincter

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15
Q

what is pyloric stenosis

A

muscle hypertrophy at pyloric region of stomach causing constriction at pylorus

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16
Q

when does pyloric stenosis occur

A

2-8 weks (after birth)

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17
Q

how many babies are affected by pyloric stenosis?

A

aprox 1 in 100 births

18
Q

are males or females more affected by pyloric stenosis

A

ratio: 4 males get it to 1 female

19
Q

what is the etiology (cause) of pyloric stenosis

A
  • unclear what causes the hypertrophy (idiopathic)

- linked to hypergasternemia (increase in gastrin), PGE (prostaglandin E) & eryhromyocin exposure (antiboitic)

20
Q

path of pyloric stenosis

A
  • hypertrophy at pyloric region of stomach
  • causing constriction of pyloric sphincter
  • inflammation
  • obstruction
  • projectile vomiting
  • this causes projectile vomiting to cause dehydration & malnourishment)
21
Q

diagnosing pyloric stenosis

A

-Hx & Px (gently palpate mass in upper right quadrant) cannot rely on this also need to do ultrasound

22
Q

how do you treat pyloric stenosis

A

surgery

23
Q

gastroesophageal reflux is a _______ GI problem

A

common GI problem that affects approx 50% from birth to 3 months old (this is when most common)

24
Q

etiology of gastroesophageal reflux

A

neuromuscular etiology

25
Q

gastroesophageal is mostly cured by _____

A

itself because it is self limiting and appox in 1 yr

26
Q

gastroesophageal reflux can cause

A

esophagitis, whcih with severe esophagitis can have growth problems

27
Q

how to deal/treat gastroesophageal reflux

A
  • symptom treatment
  • modify feeds by: thickening feeds, feed baby in upright position not in supine
  • if reflux becoming a problem same drugs as adults- but pediatric dosing
  • Fundoplication (sx not done often, but may be done if sever GERD & drugs are not working)
28
Q

what is gastroesophageal reflux

A
  • reflux via lower esophagel sphincter,
  • after feeds stomach fills, sphincters close for mechanical churning, then sphincter @ bottom has to open, top sphincter also opens even though shouldnt and lets acid into esophagus (esophageal sphincter incompetent)
29
Q

simple patho of gastroesophageal reflux

A
  • esophageal sphincter incompetent
  • gastric contents
  • esophagus
  • esophagitis
30
Q

Hirschsprung disease affects how many babies?

A

approx 1 in 500 births

31
Q

what gene is effected causing Hirschsprung disease

A

RET gene, Chr 10 (has mutation on this gene)

32
Q

what does the RET gene do?

A

RET gene codes for proteins that act as mediators (helps cells to communicate with eachother) instruct cells into formation, into different types of cells & then tissues FOR HIRSCHSPRUNG DISEASE specifically affect cells differentiating into neurons

33
Q

what is the patho of Hirschsprung disease

A
  • area of colon lacks parasympathetic ganglia
  • no peristalsis (localized)
  • accumulation of contents
  • colon distention
  • abdominal distention
34
Q

what do the neurons in the colon do that are affected by Hirschsprung disease

A

neurons in colon, has neurons for peristalsis with Hirschsprung disease one specific part of colon lacks neurons (parasympathetic neurons) cannot do peristalsis)

35
Q

treatment of Hirschsprung disease

A

aganglionic (part that lacks neurons) segment removed (Sx only option)

36
Q

what is intussusception?

A

-bowel invaginates into adjoining part

37
Q

how many babies are affected by intussusception

A

1 in 4 in 1000 births

38
Q

what are the serious complications that may happen from intussesception?

A

necrosis, perforation & peritonitis possible (infant cannot deal with that extent of the problem)

39
Q

patho of intussussception

A
  • invagination
  • obstruction
  • inflm
  • edema
  • ischemia
40
Q

where does intussusception usually occur?

A

in the terminal ileum (right side of body in descending colon) b/c peristalsis pulls bowel that way

41
Q

Treatment of intussusception?

A
  • hydrostatic reduction (not a surgery): water soluble contrast medium & air pressure DO NOT DO THIS if there is an obstruction!!! could rupture the bowel
  • surgery (for complications such as ruptured colon or obstruction)