Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Unit 1 Peds II > L2 Peds Gastroenterology > Flashcards

L2 Peds Gastroenterology Flashcards

1
Q

causes of bilious vomit

A

OBSTRUCTION- URGENT
malrotation +/- volvulus
congenital intestinal atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

causes of bloody vomit

A

maternal ingestion
esophageal varices
foreign body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

unhappy spitters/GERD may present

A

failure to thrive, esophagitis, respiratory complications, fussy, dystonic neck posturing, feeding refusal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

GER treatment

A

patient education, reassurance, normal for <6 month olds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

GERD treatment

A

upright eating
hypoallergenic diet or thickened feeds
avoid overfeeding, tobacco smoke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

meds for refractory/complicated GERD tx

A

proton pump inhibitor

H2 blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

omeprazole

A

proton pump inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ranitidine

A

H2 blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

can cause infantile hypertrophic pyloric stenosis

A

macrolide antibiotic use during first few weeks of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

classic presentaiton of hypertrophic pyloric stenosis

A

first born male

M>F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

happy spitter

A

GER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

unhappy spitter

A

GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

hungry vomiter

A

pyloric stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

projectile vomiting immediately after feeding in an infant 3-6 weeks

A

pyloric stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

olive-like mass in RUQ

A

pyloric stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

string sign

A

narrowed lumen seen on barium contrast study of pyloric stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

test of choice for pyloric stenosis

results

A

ultrasound

elongation and thickening of pylorus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

when to order a upper GI barium contrast study

A

suspected pyloric stenosis with non-diagnostic utlrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

treatment of pyloric stenosis

A

pyloromyotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

most common site of congenital intestinal atresia (absent/obstruction)

A

duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

intestinal atresia is more common in patients with

A

down syndrome

cystic fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Vomiting +/- bile in first 48 hour
Abdominal distention
Failure to pass meconium

A

congenital intestinal atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

dilated loops of bowel with air fluid levels on xray

A

jejunoileal/colonic atresias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

double bubble sign due to gas dilation in both stomach and duodenum on xray

A

duodenal atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

uses of upper GI and contrast enema in congenital atresia

A

confirm diagnosis

further identify obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

volvulus

A

small bowel twists around the superior mesenteric artery –> risk of small bowel ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q 
bilious green/yellow vomiting
abdominal pain
hemodynamic instability
\+/- hematochezia
 abdominal distention and tenderness
A

midgut malrotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what needs to be ruled out in midgut malrotation and how

A

bowel perforation

xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

gold standard test to detect malrotation +/- volvulus

A

upper GI contrast imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

corkscrew appearance of duodenum on upper GI contrast imaging

A

midgut malrotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

surgery for midgut malrotation

A

ladd procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

most common cause of abdominal emergency in kids under 2

A

intussusception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

sudden, intermittent, severe, crampy abdominal pain
Inconsolable crying, legs drawn to chest
Vomiting

A

intussusception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

intussusception triad

A

abdominal pain
abdominal mass
currant jelly stools (blood and mucous)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Palpable sausage shaped mass

A

intussusception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

lead point

A

a lesion/variation in the intestine which is dragged by peristalsis into a distal segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

causes of lead point

A 
Meckel's diverticulum (most common)
polyp/tumor/cyst
Crohn's/Celiac/Cystic fibrosis
gastroenteritis
Rotashield
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Target sign, coiled spring on ultrasound

A

intussusception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

test of choice intussusception

A

ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

perforated intussusception, or refractory to enema

A

immediate surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

treatment of intussusception

A

hydrostatic/pneumatic enema guided by ultrasound or fluorscope
90% succes rate

42
Q

appendicitis age group

A

2nd decade of life, rare before 5 years old

43
Q

Anorexia, migration abdominal pain (RUQ), vomiting, fever, peritoneal irritation

A

appendicitis

44
Q

Signs of peritoneal irritation in appendicitis

A

Positive rovsing, obturator, iliopsoas signs

45
Q

2/3 of the way between umbilicus and ASIS

A

McBurney’s point

location of appendix

46
Q

imaging for appendicitis

A

Classic presentation may proceed to surgical consult prior to imaging
Ultrasound
CT scan

47
Q

appendicitis labs

A

WBC >100,000

48
Q

diarrhea definition

A

> 3 loose watery stools/day

49
Q

most common cause of acute diarrhea

A

Viral: rotavirus, adenovirus, calcivirus

50
Q

diarrhea red flags

A

fever, severe pain, blood in stool, recent abx, persistent sx, dehydration, leukocytosis, growth and development affected

51
Q

celiac labs

A

IgA antibodies to tissue transglutaminase, small bowel biopsy

52
Q

Failure to thrive, anemia, +/- foul smelling stools

A

celiac disease

53
Q

6mos-5 years, self limited

A

toddler’s diarrhea

54
Q

stool testing indications

A

NOT recommended for most diarrheas

when red flags are present

55
Q

biggest tx for acute diarrhea

A

hydration

56
Q

antidiarrheal (antimotility) agents and acute diarrhea

A

not recommended

57
Q

why not give abx if a pathogen is unknown in acute diarrhea

A

risk of hemolytic uremic syndrome

58
Q

2 subtypes of inflammatory bowel disease

A

Crohn

Ulcerative colitis

59
Q

ages of inflammatory bowel disease

A

15-30 years

60
Q

smoking and IBD

A

2x increased risk of crohn’s

50% decreased risk of ulcerative colitis

61
Q

diarrhea, abdominal pain, +/- hematochezia, growth failure/delayed puberty, anemia, malabsorption

A

IBD

62
Q

Extraintestinal manifestations of IBD

A

mouth, skin, joints, liver, eye, can occur before GI sxs

63
Q

diagnosis of IBD

A

colonoscopy

64
Q

Skip lesions, cobblestone appearance, perianal fissures, fistulas,

A

crohn’s disease

65
Q

involvement of IBD

A

crohn’s: mouth to anus

ucerative colitis: rectum and large colon

66
Q

inflammation of IBD

A

crohn’s: transmural inflammation

ulcerative colitis: mucosal layer only

67
Q

diffuse/continuous edema, erythema, friability, ulcerataion of colon

A

ulcerative colitis

68
Q

has an increased risk of colon cancer

A

ulcerative colitis

69
Q

5 ASA

A

aminosalicylate

70
Q

sulfasalazine

A

aminosalicylate

71
Q

mesalamine

A

aminosalicylate

72
Q

mercaptopurine

A

Immunomodulating agent

73
Q

methotrexate

A

Immunomodulating agent

74
Q

azathioprine

A

Immunomodulating agent

75
Q

tx of IBD

A

Immunomodulating agent
aminosalicylate
Biologics
steroids (acute flair)

76
Q

infliximad

A

Biologics

77
Q

remicade

A

Biologics

78
Q

concerns with steroids

A

bone density, growth, development

use for IBD acute flair

79
Q

Rule of 2’s:

A

2% of the population
2:1 M:F ratio
2% develop a complication (usually before age 2)
2 feet from the ileocecal valve

80
Q 
Vitelline duct (embryonic remnant) leads to formation of diverticulum (outpouching) of intestinal and gastric epithelium
Gastric acid production → damage→ mucosal ulceration → bleeding
A

Meckel’s diverticulum

81
Q

Meckel’s diverticulum symptoms

A

painless rectal bleeding
obstruction (volvulus or intussusception)
diverticulitis (can mimic appendicitis)

82
Q

Technetium-99 scan aka

A

Meckel’s scan

83
Q

functional constipation

A

psychological/psychosomatic

diet

84
Q

organic constipation

A 
anal stenosis
 hypothyroidism
celiac disease
Hirschsprung’s
hypercalcemia
cystic fibrosis
85
Q

encopresis

A

leakage of retained stool, can be seen with impacted constipation

86
Q

periods when kids are most likely to develop constipation

A

intro to solid food/cow’s milk
toilet training
start of school

87
Q

recommended fiber intake

A

<2 years old: 5 g/day

>2 years old: age + 5-10 g /day

88
Q

Findings suggestive of organic cause of constipation

A 
failure to pass meconium
failure to thrive
abdominal distention/obstructive symptoms
anterior placed anus
occult blood in stool
89
Q

presentation of constipation

A

abdominal discomfort (general/LLQ)
impacted→ hypoactive bowel sounds
anal fissures

90
Q

constipation red flags

A 
weight loss
poor growth
anorexia
fever
vomiting
hematochezia
history of delayed passing of meconium (CF)
acute onset
failure to respond to conservative measures
91
Q

constipation management

A 
fluids
gradually increase fiber
decrease dairy
juice
relieve impaction
92
Q

meds for constipation

A

Miralax
Lactulose
enemas
suppositories

93
Q

first line to relieve impacted constipation

A

Polyethylene glycol (miralax)
*****

94
Q

hirchsprung disease aka

A

congenital aganglionic megacolon

95
Q

Absence of ganglion cells in mucosa/mucosal layers of colon → spasm and abnormal motility→ possible obstruction

A

hirchsprung disease

96
Q

higher risk for hirchsprung disease

A

down syndrome

97
Q

hirchsprung disease presentation

A

failure to pass meconium in first 48 hours of life (classic)

Bilious vomiting, abdominal distention (clinical)

98
Q

gold standard for hirchsrpung disease diagnosis

A

Rectal biopsy: confirms absence of ganglion cells

99
Q

squirt sign

A

hirchsrpung disease

tight anal sphincter, explosive release of gas/stool when finger removed

100
Q

test unprepped to localize transition zone from narrowed aganglionic segment to dilated proximal colon

A

contrast enema of hirchsrpung disease

Unit 1 Peds II (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions