Brainscape's Knowledge GenomeTM

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


See full index

Year 4 Paediatrics > Paediatric Gastroenterology > Flashcards

Paediatric Gastroenterology Flashcards

1
Q

Red flags for abdominal pain

A 
Persistent or bilous vomiting 
Severe chronic diarrhoea 
Fever 
Rectal bleeding 
Weight loss or failure to thrive 
Dysphagia 
Nocturnal pain 
Abdominal tenderness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Abdominal migraine features

A

Migraine associated with central abdominal pain lasting more than 1 hour

May have:

  • nausea and vomiting
  • anorexia and pallor
  • photophobia
  • aura
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Management of abdominal migraines

A
  • low stimulus environment - dark, quiet room
  • paracetamol or NSAIDs
  • Sumatriptans
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of recurrent abdominal migraines

A

Prophylaxis - propanolol or pizotifen (serotonin agonist)

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

Secondary causes of constipation

A

Hirschprung’s disease
Cystic fibrosis
Hypothyroidism
Intususseption

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

Constipation history

A
  • Frequency - normal vs now - less than 3 per week
  • consistency
  • blood or mucous in stool
  • abdominal pain
  • passed meconium
  • straining
  • diet and hydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Red flags for constipation

A

Not passing meconium within 48 bours of birth
Neurological signs/ symptoms in lower limbs
Vomiting
Ribbon stool - anal stenosis
Failure to thrive
Acute severe abdo pain and bloating

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

Management of constipation

A
  • increase fibre in the diet
  • increase hydration
  • increase physical activity
  • movicol first line
  • praise toilet visits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of reflux

A 
Physiological 
GORD 
CMPA
Overfeeding 
Pyloric stenosis - non bilous 
Intersusseption - bilous vomiting
Intestinal obstruction 
UTI 
Appendicitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Signs of secondary reflux

A 
Chronic cough 
Hoarse cry 
Distress after feeding 
Reluctance to feed 
Pneumonia 
Failure to thrive
Dehydration - not wetting nappies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Red flags for reflux

A 
Not keeping down any food - pyloric stenosis
Projectile fomiting - pyloric stenosis 
Bilous - intestinal obstruction 
Haematemesis or maleana - peptic ulcer 
Abdominal distension - obstruction
Reduced consciousness - meningitis 
Resp symptoms - aspiration 
Blood in stools - CMPA or gastroenteritis 
Rash - CMPA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Reflux advice

A

Small frequent meals
Burping regularly
Not over feeding
Keep baby upright after feeding

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

Management of reflux

A

Gaviscon
Thickened milk or specific formulas
PPI and omeprazole

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

Sandifer’s syndrome

A

Condition causing brief episodes of abnormal movements associated with reflux

  • torticollis - forceful contraction of the neck muscles causing twisting
  • dystonia - twisting and arching of the back or unusual postures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pathophysiology of pyloric stenosis

A

Hypertrophy of the pylorus causing stenosis

After feeding, there is powerful peristalsis which causes projectile vomiting

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

Presentation of pyloric stenosis

A

Projectile vomiting
Failure to thrive
Olive like mass on abdo examination

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

Blood gas result for pyloric stenosis

A

Hypochloric hypokalaemic metabolic alkalosis

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

Investigations for pyloric stenosis

A

USS abdomen

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

Treatment of pyloric stenosis

A

Laparoscopic pyloromyotomy - Ramstedt’s operation

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

Gastroenteritis pathophysiology

A

Inflammation of the stomach and intestines commonly due to a viral infection

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

Gastroenteritis presentation

A 
Nausea 
Vomiting 
Diarrhoea 
Dehydration
Abdominal cramps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Causative organisms of gastroenteritis and method of infection

A

Rotavirus
Norovirus

E.coli
Campylobacter jejuni - travellers diarrhoea, unpasterised milk
Shigella - faecal contamination
Salmonella - raw eggs and poultry
Bacillus cereus - uncooked food - fried rice
Yersinia enterocolitica - pigs, rats and rabbits

Giardiasis (parasite)

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

Why should antibiotics be avoided in gastroenteritis caused by E.Coli?

A

E.Coli produces shiga toxin which can cause haemolytic ureamic syndrome. Antibiotics can increase the risk of HUS

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

Which bacterial cause of gastroenteritis causes lymphadenopathy

A

Yersinia enterocolitica - mesenteric lymphadenitis can mimic appendicitis

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

Management of gastroenteritis

A

Good hygiene
Isolation
Stay of school for 48 hours after symptoms have resolved
Hydration - fluid challenge and dioralyte
Antibiotics - may not be required

26
Q

Investigations of gastroenteritis

A

Stool sample - microscopy, culture and sensitivity

27
Q

Coeliac disease pathophysiology

A

Autoimmune reaction to gliadin factor present in gluten which targets epithelial cells of the intestines and causes atrophy

28
Q

Investigations for coeliac disease

A

Remain on gluten diet:

  • Bloods - Anti TTG and anti endomysial A antibodies
  • endoscopy and biopsy - crypt hypertrophy and villous atrophy
  • IgA levels - rule out IgA deficiency
29
Q

Conditions associated with Coeliacs disease

A 
Type 1 diabetes 
Thyroid disease 
Autoimmune hepatitis
Primary biliary cirrhosis 
Primary sclerosing cholangitis 
Down’s syndrome
Dermatitis herpetiformis
30
Q

Presentation of coeliacs disease

A 
Failure to thrive 
Abdominal distention 
Diarrhoea 
Fatigue 
Weight loss 
Mouth ulcers
Anaemia - B12 deficiency 
Dermatitis herpetiforms
31
Q

Genetic associations for coeliacs disease

A

HLA - DQ2

HLA - DQ8

32
Q

Complications of untreated coeliacs disease

A 
Vitamin deficiency - vit B12
Anaemia 
Osteoporosis
Ulcerative jejunitis 
Non hodgkins lymphoma 
Small bowel adenocarcinoma 
Enteropathy associated T cell lymphoma (EATL)
33
Q

Treatment of coeliacs disease

A

Lifelong gluten free diet

34
Q

Features of Crohns disease

A
  • entire GI tract can be affected
  • skip lesions
  • terminal ileum most affected and transmural inflammation - strictures and fistulas
  • smoking exacerbates condition
35
Q

Features of ulcerative colitis

A
  • continuous inflammation
  • rectum always involved
  • superficial mucosa affected
  • smoking is protective
  • blood and mucous in stools
  • associated with primary sclerosing cholangitis
36
Q

Presentation of inflammatory bowel disease

A

Abdominal pain
Diarrhoea
Weight loss
Anaemia

37
Q

Extra intestinal manifestations of inflammatpry bowel disease

A 
Finger clubbing 
Erythema nodosum 
Pyoderma gangrenosum 
Iritis and episcleritis 
Inflammatory arthritis
38
Q

Investigations for inflammtory bowel disease

A

Bloods - FBC (anaemia), TFTs, LFTs, U+Es
Faecal calprotectin
Endoscopy and biopsy
CT abdomen

39
Q

General management of inflammatory bowel disease

A

MDT

Monitor growth and pubertal development

40
Q

Inducing remission in Crohns

A
  1. Steroids - oral prednisolone or IV hydrocortisone
  2. Add azathioprine, mercaptopurine or methotrexate
  3. Infliximab
41
Q

Maintaining remission in Crohns

A
  1. Azathioprine or mecaptopurine
  2. Methotrexate
  3. Infliximab
  4. Surgical resection of the terminal ileum
42
Q

Inducing remission in ulcerative colitis

A

Mild to moderate - aminosalicylate e.g. mesalazine or 2nd line - prednisolone

Severe - IV hydrocortisone or IV ciclosporin

43
Q

Maintaining remission in ulcerative colitis

A
  1. Aminosalicylates - mesalazine
  2. Azothioprine
  3. Mercaptopurine
  4. Panproctocolectomy
44
Q

Pathophysiology of Hirschsprung’s disease

A

Absence of the parasympathetic ganglion cells in the form of myenteric plexus nerve cells in the distal portion of the bowel and rectum therefore lack of peristalsis

45
Q

Total colonic aganglionosis

A

Entire colon lacks parasympathetic ganglion cells

46
Q

Conditions associated with Hirschsprung’s disease

A

Downs syndrome
Neurofibromatosis
Multiple endocrine neoplasia type II

47
Q

Presentation of Hirschsprungs disease

A 
Delay in passing meconium - more than 24 hours 
Chronic constipation since birth 
Abdominal pain and distention 
Vomiting
Failure to thrive
48
Q

Hirschsprung associated enterocolitis

A

Inflammation and obstruction associated with hirschsprungs disease causing fever and features of sepsis

Can cause toxic megacolon and perforation

Requires urgent abx, fluid resuscitation and decompression

49
Q

Investigations for hirschsprungs disease

A

Rectal biopsy

Abdominal xray

50
Q

Management of hirschsprungs disease

A

Fluid resuscitation
NGT
IV antibiotics are required if there is HAEC
Surgical removal of the aganglionic section of the bowel

51
Q

Intussusception pathophysiology

A

Bowel invaginates into itself, narrowing the lumen of the bowel and causes obstruction

52
Q

Who does intussusception commonly present in

A

Infants 6 months - 2 years old boys

53
Q

Conditions associated with intussusception

A 
Concurrent viral illness 
Henoch Schonlein purpura 
Cystic fibrosis 
Intestinal polyps 
Meckel diverticulum
54
Q

Presentation of intussusception

A 
Severe colicky abdominal pain 
Pale, lethargic and unwell child 
Redcurrant jelly stool 
Sausage shaped mass in right upper quadrant 
Vomiting 
Intestinal obstruction
55
Q

Investigations for intussusception

A

Abdominal USS

56
Q

Management of intussusception

A

Therapeutic enemas - contrast, water, air

Surgical reduction

57
Q

Complications of intussusception

A

Obstruction
Gangrenous bowel
Perforation
Death

58
Q

Pathophysiology of appendicitis

A

Inflammation of the appendix caused by infection or impacted faecolith

59
Q

Peak incidence of appendicitis

A

Between the ages of 10 - 20 years old

60
Q

Presentation of appenditis

A

RIF pain and tenderness
Fever
Nausea and vomiting
Loss of apetite

Rovsings sign
Guarding
Rebound tenderness

61
Q

Investigations for appendicitis

A

Bloods - FBC, CRP
Abdominal USS

If symptomatic but investigations are negative - diagnostic laparoscopy

62
Q

Management of appendicitis

A

Emergency admission

Appendicectomy

Year 4 Paediatrics (19 decks)

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