Module 6 Flashcards
What is the only vein with oxygenated blood
Pulmonary vein
The left ventricle contracting and forcing a volume of blood with each beat is referred to as
Stroke volume
Are arteries or veins thicker
Arteries due to a greater smooth muscle layer
The ability of veins to stretch and expand
Dissension
Narrowing of aorta is called
Coarctation
Blood vessel inflammation with narrowing
Vasculitis
Where do the jugular veins empty into
Superior vena cava
2 layers of arteries/veins that are thinner in veins
Elastic membrane and tunica media
The interarterial formen ovale closes by the shifting pressures between
The right and left sides of heart
Does SVR increases or decrease in pregnancy
Decreases
An increase in __________________, may lead to elevated BP in older adults
Peripheral vascular resistance
Pain in the built on or calf with walking
Claudication
Is the bell or diaphragm used to auscultate carotids
Bell
Pain in the buttock May signify an obstruction in what artery
Common iliac
Patients with ________________ often present with often demonstrate pain, pulselessness, paresthesias, paralysis, pallor, and poikilothermia
Acute limb ischemia (ALI)
What 3 instances make it difficult to asses jugular venous pressure
- Severe Rt HF, tricuspid insufficiency,constrictive pericarditis, cardiac tamponade
- Severe hypovolemia
- Obesity
Hepatojugular reflux is exaggerated when ___________ is present
Right heart failure
What should be suspected if Significant swelling, pain, and tenderness occur in an extremity over a deep vain
DVT
In an infant, a bounding pulse is associated with
Patent ductus arteriosus
In an infant, a difference in pulse Amplitude between the upper extremities or between the femoral and radial pulses, or the femoral pulses are weak or absent are associated with
Coarctation of the aorta
In an infant, a capillary refill time > 2 seconds indicates
Dehydration or hypovolemia shock
An inflammatory disease of the branches of the aortic arch, including the temporal arteries
Temporal arteritis (giant cell arteritis)
Arterial wall thickening and thrombosis can lead to reduced blood supply and ischemia of structures such as the masseter muscle, tongue, or optic nerve; area Over temporal artery may be rd, swollen, tender, and nodular
Temporal arteritis
A localized dilation, which is generally defined as 1.5 times the diameter of the normal artery, caused by a weakness in the arterial wall
Arterial aneurysm
A pathologic communication between an artery and a vein
Arteriovenous fistula
Most common cause of arteriovenous fistulas
Damage to vessels cause by catheters
Stenosis of the blood supply to the extremities by atherosclerotic plaques
Peripheral arterial disease
An exaggerated spasm of the digital arterioles (occasionally in the nose and ears) usually in response to cold exposure
Raynaud phenomenon
associated with an underlying connective tissue disease such as scleroderma or systemic lupus erythematosus
Secondary raynaud phenomenon
Emboli that are dispersed throughout the arterial system; may be caused by thrombus, Atherosclerotic plaques, infectious material from fungal and bacterial endocarditis; Atrial myxomas (a mass of connective tissue)
Arterial embolic disease
Thrombosis can occur suddenly or gradually and with varying severity of symptoms; can be the result of trauma, a hypercoagulable state, or prolonged immobilization
Venous thrombosis
The backflow of blood into the right atrium during systole; seen in up to 75% adult population
Tricuspid Regurgitation
A stenosis seen most commonly in the descending aortic arch near the origin of the left subclavian artery and ligamentum arteriosum
Coarctation of the aorta
About 12% of girls born with coarctation of the aorta have
Turners syndrome
An acute small vessel vasculitis that may result in the development of coronary artery aneurysms; strawberry tongue is common symptom
Kawasaki disease
A syndrome specific to pregnancy with hypertension that occurs after the 20th week of pregnancy and the presence of proteinuria; may cause seizures when pt has no PMH of seizures
Preeclampsia-eclampsia
Results from chronic venous insufficiency in which the lack of venous flow leads to lower extremity venous hypertension; obstruction may result from incompetent valves, obstruction of blood flow, or the loss of the pumping effect of the leg muscles
Venous ulcers
extend from the connective tissue layer through the breast and attach to the underlying muscle fascia, providing further support
Suspension ligaments (cooper ligaments)
Vascular supply to the breast is primairily from
Internal mammary artery and the lateral thoracic artery
What is the breast tissue extending from the quadrant into the axilla called
Tail of Spence
In the breast: superficial lymphatics drain the _________, and deep lymphatics strain the ________________
Skin, mammary lobules
The _____________nodes are high in the axilla close to the ribs and the ______________ nodes lie along the lateral border of the scapula and deep in the posterior axillary fold. the ____________ nodes can be felt along the upper humerus
Midaxillary (central); posterior axillary (sub scapular); lateral axillary (brachial)
Breast development in children is classified using the five __________________
Tanner stages
In the tanner stages, it is unusual for menses to begin before stage ____
3
The average interval from the appearance of the breast bud (stage 2 in Tanner stages) to menarche is ___ years
2
T or F: the areolae become lighter and larger in diamter in pregnancy
F: they become darker in pigmentation and larger in diameter
In pregnancy, Montgomery tubercles develop from what
Sebaceous glands hypertrophying
What causes colostrum to be replaced by milk 2-4 days after delivery
Surging prolactin levels, declining estrogen, and stimulation of sucking
At the termination of lactation, involution occurs over a period of about ____ months.
3
In older adults, the breasts tend to hang more loosely from the chest wall as a result of the tissue changes and relaxation of the
suspensory ligaments
Patients with female breasts with an inherited BRCA1 or BRCA2 mutation have a ____________% chance of developing breast cancer during their lifetime
45% to 80%
T or F: Nulliparity or late age at birth of first child (after age 30) is associated with an increased risk for breast cancer
T
appearance of the skin that indicates edema of the breast caused by blocked lymph drainage in advanced or inflammatory breast cancer. It is often first seen in the areola
Peau d’orange (orange skin)
Unilateral venous patterns can occur in the breast as a result of
Increased blood flow to malignancy
Recent unilateral inversion of a previously everted nipple suggests
Malignancy
In some cases, supernumerary nipples may be associated with
congenital renal or cardiac anomalies
Breast examination technique: sweep downward from clavicle to nipple, feeling for superficial lumps
Chest wall sweep
Breast examination technique: place palm side up hand under breast, with fingers of other hand, walk across the breast tissue, feeling for lumps as you compress the tissue
Bimanual digital palpation
Palpable sentinel nodes are indicators for invasion of the lymphatics by
Cancer
T or F: In breasts that have been surgically augmented, do not palpate the breast
F: In breasts that have been surgically augmented, palpate as usual
Which assessment technique for palpation of the breasts are more thorough: vertical strip pattern or concentric circle pattern
Vertical strip
When examining the breasts, a method where the examiner palpate from the center of the breast in radial fashion, returning to the areola to begin each spoke
Wedge method
T or F: Nipple compression to provoke discharge is no longer performed as part of routine clinical breast examination
T
The breasts of many newborns are enlarged for a relatively brief time as a result of passively transferred
Maternal estrogen
A small amount of clear or milky white fluid from a newborns breast bud called witches milk, is caused by
maternal estrogen
T or F: in a patient who has had a mastectomy, if a malignancy recurs, it will not be never be at the scar site
F: “it may be at the scar site”
A condition where pubescent male breasts may enlarge
Gynecomastia
A breast condition in males that can be associated with the use of either prescription or illicit drugs, particularly marijuana and alcohol
Gynecomastia
During the second trimester, ___________________________ may develop on the upper chest, arms, neck, and face as a result of elevated levels of circulating estrogen
telangiectasias (called spider angiomas or vascular spiders)
may result from either inadequate emptying of the breast or a bra that is too tight; left unattended may result in ____________
Clogged milk duct; mastitis
Are light or dark colored nipples more prone to cracking/damage from breast feeding
Light-colored
In the breast, are fibrocystic changes and fibroadenomas generally unilateral or bilateral
Bilateral
Benign fluid-filled cyst formation caused by ductal enlargement; usually bilateral, most common ages 30-55; associated with a long follicular or literal phase of the menstrual cycle
Fibrocystic changes
Benign tumors composed of stromal and epithelial elements that represent a hyperplastic or proliferative process in a single terminal ductal unit; tumors generally regress after menopause and do not fluctuate with menstrual cycle
Fibroadenoma
Ductal carcinoma arises from the epithelial lining of ducts, while lobular carcinoma originates in the glandular tissue of the lobules; peak incidence between 40-75 years of age
Malignant breast tumors
Benign breast lump that occurs as inflammatory response to local injury; Necrotic fat and cellular debris become fibrotic and may contract into a scar
Fat necrosis
Benign tumors of the subareolar ducts that produce nipple discharge; Epithelial hyperplasia produces a wartlike tumor in a lactiferous duct
Intraductal Papillomas and Papillomatosis
Benign condition of the subareolar ducts that produces nipple discharge; Subareolar ducts become dilated and blocked with desquamating secretory epithelium, necrotic debris, and chronic inflammatory cells; Occurs most commonly in menopausal women
Duct ectasia
Lactation not associated with childbearing; Elevated levels of prolactin, resulting in milk production, occur as a result of disruption of the communication between the pituitary and hypothalamus glands; Common causes include pituitary-secreting tumors, hypothalamic-pituitary disorders, systemic diseases, numerous medications and herbs, physiologic conditions, or local factors
Galactorrhea
Common causes of galactorrhea include: amenorrhea, pregnancy, post abortion, hypothyroidism, Cushing syndrome, and ___________
Chronic renal failure
Surface manifestation of underlying ductal carcinoma; Migration of malignant epithelial cells from the underlying intraductal carcinoma via the lactiferous sinuses into nipple skin; Tumor cells disrupt the epithelial barrier, allowing extracellular fluid to seep out onto the nipple surface
Paget disease
Paget disease appears eczematous but unlike eczema, it does not respond to what medication
Steroids
Inflammation and infection of the breast tissue; Most infections are staphylococcal, often Staphylococcus aureus
Mastitis
Breast enlargement in children assigned female at birth, younger than 8 years of age; most onset in females <2 years old; In most cases, breasts continue to enlarge slowly throughout childhood until full development is reached during adolescence; other signs of sexual maturation may be absent
Premature thelarche
a tendinous band—is located in the midline of the abdomen between the rectus abdominis muscles. It extends from the xiphoid process to the symphysis pubis and contains the umbilicus
Linea alba
extends from the anterior superior spine of the ilium on each side to the pubis
Inguinal ligament (poupart ligament)
runs from the mouth to the anus and includes the esophagus, stomach, small intestine, and large intestine; is about 27 feet long
Alimentary tract
—a collapsible tube about 10 inches long—connects the pharynx to the stomach
The esophagus
Part of the stomach lying above and to the left of the cardiac orifice
Fundus
The middle 2/3 of stomach
Body
The most distal portion of the stomach that narrows and terminates in the pyloric orifice.
Pylorus
____________ acts to digest proteins, whereas ______________ acts on emulsified fats
Pepsin; gastric lipase
Begins at the pylorus and joins the large intestine at the ileocecal valve
Small intestine
First 12 inches of the small intestine that curves around the pancreas; the common bile duct and pancreatic duct open into this part of the small intestine
Duodenum
Within the duodenum, Where do the common bile duct and pancreatic duct open into the small intestine at
Duodenal papilla
The small intestine order is the duodenum then the
Jejunum
makes up the remaining 12 feet of the small intestine and meets the large intestine at the ileocecal valve
Ileum
between the ileum and large intestine prevents backward flow of fecal material
The ileocecal valve
completes digestion through the action of pancreatic enzymes, bile, and several other enzymes
The small intestine
The functional surface area of the small intestine is increased by its
Circular folds and villi
The large intestine begins at the __________, a blind pouch about 2-3 inches long
Cecum
The ascending colon turns toward the midline at the
Hepatic flexure
The transverse colon crosses the abdominal cavity toward the spleen and turns downward at the
Splenic flexure
Live bacteria decompose undigested food residue, unabsorbed amino acids, cell debris, and dead bacteria through a process of
putrefaction
What is the heaviest organ in the body
The liver @ 3 lbs
The ______________ artery transports blood to the liver directly from the aorta, and the ____________ vein carries blood from the digestive tract and spleen to the liver.
Hepatic; portal
Three hepatic veins carry blood from the liver and empty into the
inferior vena cava
The liver also can convert amino acids to
Glucose
are oxidized to two-carbon components in preparation for entry into the tricarboxylic acid cycle.
Fats
Cholesterol is used by the liver to form
Bile salts
Synthesis of fats from _______________ and _____________ also occurs in the liver
carbohydrates and proteins
Proteins are broken down to amino acids through __________________, and their waste products are converted to ____________ for excretion by the kidneys
Hydrolysis; urea
The ___________ is responsible for the production of the majority of proteins circulating in the plasm
Liver
How does the liver serve as an excretory organ
- Synthesis of bile
- secretion of organic wastes into bile
- conversion of fat-soluble wastes to water-soluble material for renal excretion
concentrates and stores bile from the liver
Gallbladder
The gallbladder concentrates and stores bile from the liver. In response to ________________—a hormone produced in the duodenum—the gallbladder releases bile into the cystic duct
cholecystokinin
The cystic duct and hepatic duct join to form the
common bile duct
serves to maintain the alkaline pH of the small intestine, permitting emulsification of fats so that absorption of lipids can be accomplished
Bile
As an exocrine gland, the acinar cells of the pancreas produce digestive juices containing inactive enzymes for the breakdown of
Proteins, fats, and carbohydrates
Collecting ducts of the pancreas empty into the pancreatic duct called the:
duct of Wirsung
As an endocrine gland, ____________ scattered throughput the pancreas produce the hormones insulin and glucagon
islet cells
Is right or left kidney slightly higher
Right kidney
Each kidney receives about ____________ of the cardiac output through the renal artery
1/8
Normal GFR is __________ mL/min/1.73 m^2 or higher
90
Urinary volume controlled by
ADH (antidiuretic hormone)
Urinary bladder can hold approximately ________mL urine
400-600
The kidney also serves as an endocrine gland responsible for the production of ________, which controls aldosterone secretion,it is also the primary source of erythropoietin production in adults, thus influencing the body’s red cell mass
Renin
produces the biologically active form of vitamin D
Kidneys
In pregnancy, dilation of the ureter is greater on the ________ side, probably because it is affected by displacement of the uterus to the __________ by an enlarged ________ ovarian vein.
Right; right; right
an anatomic landmark one-third of the distance from the anterior superior iliac spine to the umbilicus
McBurney point
hereditary nonpolyposis colorectal cancer
Lynch syndrome
associated with non-cancer tumors of skin, soft tissue and bones
Gardner Syndrome
A bluish periumbilical discoloration suggests intra-abdominal bleeding
Cullen sign
Most striae blue, silver, white but in Cushing it is
Purple
A pearl-like, enlarged and sometimes painful umbilical nodule from cancer metastasis, known as _________________, may be the first sign of an intra-abdominal malignancy
Sister Mary Joseph’s nodule
two other common causes of paralytic ileus
Narcotics and hypothyroidism
Loud prolonged gurgles/stomach growling
Borborygmi
is a semilunar region defined by the sixth rib superiorly, the midaxillary line laterally, and the left costal margin inferiorly
Traube space
tensing of the abdominal musculature to protect inflamed organs—should alert you to move cautiously through the remainder of the examination.
Guarding
is a board-like hardness of the abdominal wall overlying areas of peritoneal irritation
Rigidity
If the abdomen is distended or the abdominal muscles tense, the usual techniques for determining the lower liver border may be challenging, and the___________ may be useful
scratch test
T or F: a healthy gallbladder will not be palpable
T
a palpable and tender gallbladder indicates ___________ while a non tender, palpable gallbladder indicates ________________
Choleycstitis; common bile duct obstruction
As the inflamed gallbladder comes in contact with the examining fingers, the patient will experience pain and abruptly halt inspiration, this is called
Murphy’s sign
a pathologic increase in fluid in the peritoneal cavity
Ascites
When diagnosing abdominal pain: the farther from the umbilicus the pain, the more likely it will be organic in origin
apley rule
is the most common indication for emergency abdominal surgery
Appendicitis
Diagnosing appendicitides, the MANTRELS score is used, what does it stand for
M= migration of pain A= anorexia N= Nausea/vomiting T= tenderness in RLQ R= Rebound pain E= elevated temp L= leukocytes is S= shift to left
uses patient age, history, physical examination, and laboratory findings, is another tool to help identify patients at low, moderate, and high risk of having appendicitis
OhmAnn score
To diagnose appendicitis in children: uses pain with cough, hopping, or rebound tenderness with percussion in place of right lower quadrant pain
PAS= pediatric appendicitis score
The two most vials clinical prediction rules for diagnosisng appendicitis in children are
- Alvarado score
2. PAS (pediatric appendicitis score)
T or F: ectopic pregnancy is often diagnosed before rupture because symptoms are severe
F: ectopic pregnancy is often not diagnosed before rupture because symptoms are mild
A test where you Ask the patient to raise the right leg, flexing at the hip, while you push downward… Pain with this techniques is considered a positive _______ sign, indicating irritation of the ____________ muscle.
Psoas; iliopsoas
This test can be performed when you suspect a ruptured appendix or a pelvic abscess due to irritation of the obturator muscle; Pain in the right hypogastric region is a positive sign, indicating irritation of the ______________
obturator muscle
Pain or distress occurs in area of patient’s heart or stomach on palpation of McBurney point; may be associated with appendicitis
Aaron sign
Fixed dullness to percussion in left flank and dullness in right flank that disappears on change of position; may be associated with peritoneal irritation
Ballance test
Rebound tenderness; may be associated with peritoneal irritation and appendicitis
Blumberg sign
Absence of bowel sounds in right lower quadrant; may be associated with intussusception
Dance sign
Ecchymosis of flanks
Gray turner sign
Abdominal pain radiating to left shoulder; may be associated with splenic rupture, renal calculi, or ectopic pregnancy
Kehr sign
Patient stands with straightened knees, then raises up on toes, relaxes, and allows heels to hit floor, thus jarring body; action will cause abdominal pain if positive; associated with peritoneal irritation or appendicitis
Markle (heel jar) sign
Pain down the medial aspect of the thigh to the knees; may be associated with Strangulated obturator hernia
Romberg-howship sign
Right lower quadrant pain intensified by left lower quadrant abdominal palpation; may be associated with appendicitis or peritoneal irritation
Rovsing sign
is a palpation technique used to assess an organ or a mass
Ballottment
Spider nevi in newborn may indicate
Liver disease
____ arterie(s) and _____ vein(s) should be present in the umbilical cord. A single umbilical artery should alert you to the possibility of congenital anomalies
2; 1
intestinal structure present in the umbilical cord or protruding into the umbilical area and visible through a thick transparent membrane suggests an
omphalocele
Once the stump (of the umbilical cord) has separated, typically by 2 weeks of age, serous or serosanguineous discharge may indicate a ____________ when no other signs of infection are present
Granuloma
A small umbilical hernia is common in children; it will typically close by what age
1-2 years old
How long after birth should you hear bowel sounds in newborn
1-2 hours
An enlarged spleen may indicate congenital____________ disease or sepsis in an ill-appearing infant
hemolytic
More than half of all masses detected in newborns are ________________ in origin
genitourinary
Three or more watery or loose stools per day; Camping or well water exposes individuals to Giardia and Campylobacter through untreated water; may be caused from international travel in food, undercooks beef, meat
Acute diarrhea
feeling of incomplete defecation
Tenesmus
Backward flow of gastric contents, which are typically acidic, into the esophagus; Caused by relaxation or incompetence of the lower esophageal sphincter; Delayed gastric emptying is a predisposing factor; More common among older adults and in pregnant individuals
Gastroespohageal reflux disease
Functional chronic gastrointestinal disorder with symptoms of pain and change in stooling patterns; consisting of abdominal pain, bloating, constipation; or abdominal pain, urgency, and diarrhea; or mixed constipation and diarrhea estimated 10%–15% of U.S. adults affected; more often in women;
Irritable Bowel Syndrome
Part of the stomach passes through the esophageal hiatus in the diaphragm into the chest cavity; About 95% are classified as sliding hernias where the gastroesophageal junction is displaced above the diaphragm; associated with obesity, pregnancy, heavy lifting, hard coughing, and straining with bowel movements
Hiatal Hernia
Chronic circumscribed break in the duodenal mucosa that scars with healing; Typically develops from infection with Helicobacter pylori resulting in increased gastrin production and acid secretion; May be caused by Zollinger- Ellison syndrome
Duodenal ulcer (Duodenal Peptic Ulcer Disease)
a rare disorder where one or more tumors (gastrinomas) secrete gastrin
Zollinger- Ellison syndrome
Chronic inflammatory disorder that can affect any part of the gastrointestinal tract that produces ulceration, fibrosis, and malabsorption; terminal ileum and colon are the most common sites; occurs from an imbalance between proinflammatory and anti- inflammatory mediators in genetically susceptible individuals; fistula and abcess formation common
Crohn’s disease
Chronic inflammatory disorder of the colon and rectum that produces mucosal friability and areas of ulceration; Active chronic ulcerative colitis predisposes an individual to developing colon cancer; Sclerosing cholangitis (inflammation, scarring and destruction of bile ducts) may present with fatigue and jaundice
Ulcerative Colitis
inflammation, scarring and destruction of bile ducts
Sclerosing cholangitis
Malignancy that arises from epithelial cells of the mucous membrane; One of the most common malignancies worldwide; Twice as common in males; Helicobacter pylori infection is a major risk factor; Most commonly found in lower half of the stomach
Gastric cancer
Small bulges or saclike outpouchings (diverticula) through colonic muscle in the intestine; May involve any part of the gastrointestinal tract; the sigmoid is the most commonly affected location; most patients asymptomatic or with LLQ pain
Diverticula disease
May involve the rectum, sigmoid, proximal, and descending colon; second leading cause of cancer-related death in US
Colon Cancer (Colorectal Cancer)
Inflammatory process characterized by diffuse or patchy hepatocellular necrosis; Most commonly caused by viral infection, alcohol, drugs, or toxins
Hepatitis
Hepatitis __ occurs only in those infected with hepatitis B, either as a coinfection in acute hepatitis B or as a superinfection in chronic hepatitis B
Hepatitis ___ is a self-limited type that may occur after a natural disaster because of fecal-contaminated water or food
D; E
Late stage of liver disease characterized by fibrosis (scarring), alteration of normal hepatic architecture and loss of function; Signs and symptoms occur as a result of decreased liver synthetic function, decreased detoxification capabilities, or portal hypertension
Cirrhosis
Most common type of liver cancer in the United States; Risk factors include hepatitis C infection, hepatitis B infection, excessive alcohol intake, obesity, diabetes, nonalcoholic fatty liver disease and smoking; pt may have clay-colored stools, and tea colored urine
Primary Hepatocellular Carcinoma
Stone formation in the gallbladder occurs when certain substances reach a high concentration in bile and produce crystals; Crystals mix with mucus and form gallbladder sludge; over time, the crystals enlarge, mix, and form stones; Main substances involved in gallstone formation are cholesterol (>80%) and calcium bilirubinate; Chronic disease can result in fibrosis and gallbladder dysfunction and predispose to gallbladder cancer
Cholelithiasis
Inflammatory process of the gallbladder most commonly due to obstruction of the cystic duct from cholelithiasis, which may be acute or chronic; RUQ pain radiates to right scapula; fat intolerance;
Cholecystitis
Spectrum of hepatic disease due to fat stored in the liver in the absence of excessive alcohol intake; most common cause of chronic liver disease worldwide; affects 25% of adults;
Nonalcoholic fatty liver disease
Acute inflammatory process in which release of pancreatic enzymes results in pancreatic glandular autodigestion; biliary disease (cholelithiasis) and chronic alcohol use, accounting for approximately 80% of cases; in severe cases, Cullen and Grey Turner signs may be present
Acute Pancreatitis
Chronic inflammatory process of the pancreas, characterized by irreversible morphologic changes resulting in atrophy, fibrosis, and pancreatic calcifications; most common cause is chronic alcohol use
Chronic Pancreatitis
Most commonly injured organ in abdominal trauma because of its anatomic location; Mechanism of injury can be either blunt or penetrating but is more often blunt; LUQ pain radiates to left shoulder
Spleen Laceration/Rupture
Inflammation of the capillary loops of the renal glomeruli; Accounts for about 20% of chronic kidney disease
Acute Glomerulonephritis
Dilation of the renal pelvis and calyces due to an obstruction of urine flow anywhere from the urethral meatus to the kidneys; Increasing ureteral pressure from urine results in changes in glomerular filtration, tubular function, and renal blood flow; severe renal colic pain in acute obsrtuction
Hydronephrosis
Infection of the kidney and renal pelvis
Pyelonephritis
Localized infection in the medulla or cortex of the kidneys; bscesses in the renal cortex are often caused by gram-positive organisms (Staphylococcus aureus and Enterococcus fecalis); Medullary abscesses are commonly caused by gram- negative bacilli (E. coli and Klebsiella)
Renal abscess
Stones formed in the pelvis of the kidney associated with obstruction and infections in the urinary tract; Stones are composed of calcium, oxalate, uric acid, cystine, xanthine, and phosphate
Renal Calculi
Prolapse, or telescoping, of one segment of intestine into another causes intestinal obstruction; Sausage-shaped mass may be palpated in the right or left upper quadrant, whereas the right lower quadrant feels empty (positive Dance sign)
Intusussception
Hypertrophy of the circular muscle of the pylorus, leading to obstruction of the pyloric sphincter; Cause is unknown; an association has been found with use of erythromycin; Small, rounded, olive-shaped mass sometimes palpable in the right upper quadrant, particularly after the infant vomits
Pyloric Stenosis
Distal intestinal obstruction caused by thick inspissated impacted meconium in the lower intestine of a newborn; May be the first manifestation of cystic fibrosis (CF); Pancreatic insufficiency or congenital pancreatic anomalies (pancreatic duct stenosis) are thought to be contributing factors
Meconium ileus
Congenital obstruction or absence of some or all of the bile duct system, resulting in bile flow obstruction; most have complete absence of entire extrahepatic biliary tree; In postnatal onset, disease inflammation and necrosis of extrahepatic bile ducts are thought to result from a perinatal insult (e.g., viral infection); can be postnatal or embryonic onset
Biliary atresia
Outpouching of the ileum that varies in size from a small appendiceal process to a segment of bowel several inches long, often in the proximity of the ileocecal valve; Develops from incomplete obliteration of the vitelline duct resulting in a blind- ending pouch that contains all the mucosal layers in the ileum
Meckel Diverticulum
Most common congenital anomaly of the gastrointestinal tract, occurring in about 2% of the general population
Meckel diverticulum
Inflammatory disease of the gastrointestinal mucosa associated with prematurity and gut immaturity; most common GI emergency in neonates; most commonly in the distal ileum and proximal colon
Necrotizing enterocolitis
Solid malignancy of embryonal origin in the peripheral sympathetic nervous system; Although commonly arising from the adrenal medulla, may occur anywhere along the craniospinal axis; Metastases to the periorbital region result in proptosis and infraorbital ecchymoses; Horner syndrome, ataxia, and opsomyoclonus (“dancing eyes and dancing feet”) may be seen on physical examination
Neuroblastoma
Most common intra-abdominal tumor of childhood; painless enlargement of abdomen; usually appears between 3 and 5 years of age; gene is located on chromosome 11 and regulates normal kidney development; about 20% of affected children have mutations of this gene
Wilms Tumor (Nephroblastoma)
Primary absence of parasympathetic ganglion cells in a segment of the colon, which interrupts intestinal motility; Abnormal intestinal innervation results in the absence of peristalsis, which leads to the accumulation of stool proximal to the defect and intestinal obstruction; Most common cause of lower intestinal obstruction in newborns
Hirschsprung Disease (Congenital Aganglionic Megacolon)
Triad of microangiopathic hemolytic anemia, thrombocytopenia, and uremia; One of the most common causes of acute kidney injury in children; common cause in US= Shiga-like toxin produced by Escherichia coli; Risk factors include ingestion of undercooked meat or unpasteurized milk; most have preceding upper respiratory infection
Hemolytic Uremic Syndrome (HUS)
Inability to control bowel movements, leading to leakage of stool; associated with three major causes—fecal impaction, underlying disease, and neurogenic disorders; fecal impact ion is most common cause
Fecal Incontinence
