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GI- Week 3 > Musckovitz: GI Developmental Cases > Flashcards

Musckovitz: GI Developmental Cases Flashcards

1
Q

3 week infant w/ projectile vomiting immediately after fed that looks like breast milk. Mobile mass mid xiphoid. Jaundiced.

A

Congenital hypertrophic pyloric stenosis

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2
Q

What causes congenital hypertrophic pyloric stenosis?

A

hypertrophy of the muscles at the distal end of hte stomach

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3
Q

How do you treat congenital hypertrophic pyloric stenosis?

A

Normalize electrolytes

Call a surgeon to perform the Ramstedt procedure

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4
Q

Why is a baby w/ congenital hypertrophic pyloric stenosis jaundiced?

A

Starvation increases the enterohepatic recirculation of bilirubin

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5
Q

What are the RFs for congenital hypertrophic pyloric stenosis?

A

First born M

SE of erythromycin in infants

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6
Q

17 d old M, bilous vomiting, lethargy, difficulty passing stools. Non-specific diffuse mass felt in the lower abdomen. Abdomen is somewhat tender to palpation. Rectal exam yields soft yellow stools.

A

Hirschsprung disease

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7
Q

What is the embryology of Hirschprung disease?

A

absence of autonomic ganglion cells in the distal myenteric plexus

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8
Q

How do you initially manage Hirschprung disease?

A

Stop feeds, decompress stomach, start broad spectrum antibiotics

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9
Q

What is the definitive therapy for Hirschprung disease?

A

surgical exploration and repair

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10
Q

8 mo M

Lethargy, vomiting and irritability. 2 days of intermittent vomitting and pain. Spasms last between 5 and 10 mins. Bile in vomit. Abdomen is moderately distended and tender to palpation. Currant jelly stool.

A

Intussusception

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11
Q

How do you treat intussusception?

A

Barium enema

Surgical consult

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12
Q

What anomaly might be present w/ intussusception?

A

Meckel diverticulum

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13
Q

What is the embryology associated with intussusception?

A

ileal outpouching that often contains gastric or pancreatic tissue

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14
Q

Pregnancy complicated by size greater than dates. Large quantity of amniotic fluid was expelled. Baby developed respiratory distress which improved w/ suctioning of pharynx. Distended epigastrium, decreased bowel sounds and low tone.

A

Duodenal atresia

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15
Q

What is the embryology of duodenal atresia?

A

Failure of reformation of hte duodenal lumen

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16
Q

What global diagnosis fits w/ duodenal atresia?

A

Down syndrome = size greater than dates, flat occiput, extra nuchal skin, almond shaped eyes

17
Q

What other tests would be useful in a pt with duodenal atresia?

A

Chromosome analysis for aneuploidy
Cardiac echo
CBC w/ peripheral smear

18
Q

Most infants w/ Down syndrome are born to young or old women?

A

young

GI- Week 3 (15 decks)

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