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Paediatrics RACP Exam Study > Paediatric Gastroenterology 1 > Flashcards

Paediatric Gastroenterology 1 Flashcards

1
Q

What does bifid uvula signify?

A
  • normal or associated with a submucous cleft of the soft palate
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2
Q

What are the diagnostic criteria for cyclical vomiting sydrome?

A
  • At least 5 attacks in any interval OR 3+ episodes during a 6-mo period
  • Recurrent intense vomiting and nausea lasting 1 hr to 10 days, at least 1 wk apart
  • Each “attack”/”episode is similar
  • Vomiting occurs ≥4 times/hr for ≥1 hr
  • Return to baseline health between episodes
  • Not attributed to another disorder
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3
Q

How does erythromycin work to stimulate gastric motility?

A

Motilin agonist

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4
Q

How does metoclopramide work?

A

Dopamine ANTagonist

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5
Q

What is the mechanism of action of ondansetron?

A

Serotoninergic 5-HT 3 antagonist

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6
Q

What is normal stool output for an infant?

A

5 mL/kg/day

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7
Q

What is GDNF/RET and what is it associated with?

A
  • glial derived neurotrophic factor / receptor
  • neurocyte migration for gut
  • Hirschsprung
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8
Q

What are the essential amino acids?

A
  • Phenylalanine
  • Valine
  • Tryptophan
  • Threonine
  • Isoleucine
  • Methionine
  • Histidine
  • (Arginine - can be synthesized from glutamine but premmies can’t do this)
  • Leucine
  • Lysine
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9
Q

What is the ion gap formula for stool?

A

Ion gap=Stool osmolality−[(Stool Na+stool K]×2]

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10
Q

What are the clinical findings with Peutz-Jeghers syndrome?

A
  • hyperpigmented macules
  • GI polyps
  • usually STK11 gene
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11
Q

What is the marker of active replication and infectivity for Hepatitis B?

A

HBeAg

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12
Q

What does HbSAg positivity indicate?

A

Infected with hepatitis B

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13
Q

What cancer do you get with h.pylori?

A

Gastric Lymphoma

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14
Q

Where do foreign bodies get stuck in the oesophagus?

A
  • Cricoid (most common)
  • Aortic arch
  • Lower oesophageal sphincter
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15
Q

What is the “6 food elimination diet”?

A

Exclude: dairy, egg, soy, treenut and peanut, wheat, seafood

Treatment for EO

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16
Q

What are the macroscopic and microscopic features of EO?

A
  • Macro: linear erosions, white patches, textbook describes circumferential
  • Micro: >15 eosinophils per HPF, often transmucosal infiltration with microabscesses
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17
Q

What is the major protein component of cow’s milk?

A

Casein

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18
Q

Which autoantibody is most specific for

coeliac disease?

A

IgA endomysial.

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19
Q

Where is iron absorbed?

A

Duodenum (and upper jejunum)

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20
Q

Where is zinc absorbed?

A

Jeju­num via Zip4 transporter

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21
Q

When does nutritive sucking start?

A

34/40

22
Q

Which syndromes are associated with coeliac disease?

A

Down, Williams, and Turner

23
Q

What are the biopsy findings in coeliac disease?

A
  • partial to total villous atrophy
  • elongated crypts
  • increased mitotic index in the crypts
  • infiltrations of plasma cells,lymphocytes, mast cells, eosinophils, basophils in lamina propria
  • increased intraepithelial lymphocytes
  • flattened, cuboidal, and pseudostratified epithelium.
24
Q

What other illnesses have similar biopsy findings to coeliac?

A
  • cow’s milk or soy protein hypersensitivity
  • heavy infestation with Giardia lamblia
  • primary immunodeficiencies
  • tropical sprue
  • small bowel bacterial overgrowth
  • intestinal lymphoma
25
Q

What does SGLT1 transport?

A

Na-glucose and galactose

26
Q

What HLA is associated with coeliac?

A

HLADQ2 and DQ8

27
Q

Where are bile salts reabsorbed?

A

Ileum

28
Q

Which bug mimics appendicitis?

A

Yersinia

29
Q

Where is calcium mostly absorbed?

A

Duodenum and upper small intestine

30
Q

Which vitamins help with chronic diarrhoea in malnourished children?

A

Vitamin A supplementation reduces diarrhoea-related mortality and diarrhoeal severity in developing countries. Similarly, zinc supplementation during diarrhoeal illness shortens the illness duration.

31
Q

What is sucrose?

A

Glucose and fructose

32
Q

What is lactose?

A

Glucose and galactose

Most common sugar in milk

33
Q

What is maltose?

A

Two glucoses

34
Q

What is absorbed in the duodenum and proximal jejunum?

A 
Ca
Mg
Phosphate
Iron
Folic acid.
35
Q

What is absorbed in the distal ileum?

A

B12

Bile acids

36
Q

What does glucokinase do?

A

Enzyme helping glucose phosphorylate to G6P

In liver, pancreas, gut and brain

37
Q

How common is growth failure in Crohn’s?

A

15-40%

38
Q

Inheritance of IBD?

A

30-35% monozygotic twins

8-10% other 1st degree relatives

39
Q

What autoantibodies are associated with type 1 autoimmune hepatitis?

A

ANA and SMA

40
Q

What autoantibodies are associated with type 2 autoimmune hepatitis?

A

LKM

41
Q

What is the difference between Type 1 and 2 IBD associated arthritis?

A

Type 1 related to flare of disease - pauciarticular, large joints, HLAB27/HLAB35/HLADR related
Type 2 more chronic - polyarticular, small joints, upper limbs/MCPJs, maybe a/w uveitis

42
Q

KCal per g for carbs, protein and fats…

A

4, 4, 9

43
Q

Having primary sclerosing cholangitis puts you increased risk for which Ca?

A

Cholangiocarcinoma

Colorectal cancer

44
Q

What does calprotectin show?

A

Neutrophil mediated inflammation in the gut

45
Q

Low albumin with high protein is a clue for…?

A

Autoimmune process as may have high IgG pushing total protein up

46
Q

What do you chelate copper with?

A

Penicillamine

Trientine

47
Q

Crohn’s v.s. UC histology - cardinal differences?

A

Crohn’s - transmural, granulomas,

UC - mucosal layer only,

48
Q

What is the gender distribution of IBD?

A

Crohn’s is male dominant

UC equal

49
Q

What % of primary sclerosing cholangitis have IBD?

A

40%, usually UC

However only 4% of IBD have PSC

50
Q

How does azathioprine work?

A

Inhibition of purine metabolism and DNA synthesis

Suppresses bone marrow (can be toxic!)

Paediatrics RACP Exam Study (30 decks)

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