Lec 34 Flashcards

1
Q

What matters about growth curve?

A

rate of weight gain and growth not where on the curve you are just that your curve is parallel to normal curve

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2
Q

What is usual cause of poor weight gain in kid?

A

rarely due to malabsorption; usually due to poor caloric intake

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3
Q

Whats on the differnetial?

A
  • GE reflux
  • celiac
  • IBD
  • food allergy
  • parasite
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4
Q

What is 72 hr fecal fat test?

A

see what percent of fat intaak comes out in stool; should be < 10%

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5
Q

What does D-xylose test tell us?

A

give D-xylose then measure level in blood; level , 20 tells you problem with absorption

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6
Q

If abnormal fecal fat and abnormal serum d-xylose what should you do next?

A

small intestine biopsy

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7
Q

If abnormal fecal fat and normal serum d-xylose what should you do next?

A

pancreatic work up; sweat test

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8
Q

How is CF inherited? genetics?

A

autosomal recessive due to mutation in the CFTR gene

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9
Q

What is normal function of CFTR gene?

A

regulate secretion of chloride ion from pancreas, bile duct, intestine, lung; reabsorb Cl from sweat

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10
Q

What is most common mutation in CF?

A

delF508

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11
Q

What is possible rectum complication in CF?

A

rectal prolapse = may be presenting sign

due to passage large bulky stools

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12
Q

What should you rule out in a patient with recurrent pancreatitis?

A

cystic fibrosis

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13
Q

What is the most common structural cause of neonatal jaundice?

A

extra hepatic biliary atresia

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14
Q

What happens in extra hepatic biliary atresia?

A

begins at birth and progresses to complete obstruction –> biliary cirrhosis and portal htn
ultimately get end stage liver disease and need transplant

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15
Q

How does patient present with extra hepatic biliary atresia?

A

jaundice
direct hyperbilirubinemia
failure to thrive
hepatosplenomgealy

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16
Q

What is HIDA scan?

A

hepatobiliary scan

give technecium 9 –> gets taken up by liver without excretion into duodenum tells you there is obstruction

17
Q

What is kasai procedure?

A

excise obliterated extrahepatic duct and attach to the small bowel; only a bridge to liver transplant not a permanent solution

best outcome if you do it within 2 months

18
Q

Who gets hirschprugns?

A

more males than females

associated with downs

19
Q

What is pathogenesis of hirschprungs?

A

failure of migration ganglion cell precursors; absence of ganglion cells in messners and auerbachs plexus distally

have lack of relaxation of rectum