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Specialties > Paediatric GI Disorders > Flashcards

Paediatric GI Disorders Flashcards

1
Q

What are the types of vomiting?

A

Vomiting with Retching
Projectile vomiting
Bilious vomiting
Effortless vomiting

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2
Q

What drugs cause constipation?

A

Gaviscon

Opiates

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3
Q

What social factors cause constipation?

A

Poor diet - insufficent fluids, excessive milk

Potty training/school toilets

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4
Q

Pre-ejection phase of vomiting with retching

A

Pallor
Nausea
Tachycardia

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5
Q

Ejection phase of vomiting with retching

A

Retch

Vomit

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6
Q

Post-ejection phase of vomiting with retching

A

Weakness
Shivering
Lethargy

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7
Q

Causes of vomiting centre stimulation

A 
Enteric pathogens
Intestinal inflammation
Metabolic derangement
Infection
Head injury
Visual stimuli
Middle ear stimuli
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8
Q

When does pyloric stenosis typically occur?

A

Babies 4-12 weeks

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9
Q

Is pyloric stenosis more common in boys or girls?

A

Boys

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10
Q

Is pyloric stenosis more common in boys or girls?

A

Boys

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11
Q

Causes of bilious vomiting

A 
Intestinal obstruction until proved otherwise
Intestinal atresia 
Malrotation +/- volvulus
Intussusception
Ileus
Crohn’s disease with strictures
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12
Q

What is generally the cause of effortless vomiting?

A

Gastro-oesophageal reflux

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13
Q

In which cases is it less certain that effortless vomiting is self limiting with spontaneous resolution?

A

Cerebral palsy
Progressive neurological problems
Generalised GI motility problem
Oesophageal atresia

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14
Q

Presentation of gastroesophageal reflux

A 
Vomiting
Haematemesis
Feeding problems (failure to thrive)
Apnoea
Cough
Wheeze
Chest infections
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15
Q

Treatment of reflux

A

Feeding advice
Nutritional support
Medical treatment
Surgery

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16
Q

Feeding advice for reflux

A

Thickeners for liquids
Appropriateness of foods (texture, amount)
Behavioural programme (oral stimulation, removal of aversive stimuli)
Feeding position

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17
Q

Paediatric UC

A 
Pancolitis (higher rate of colectomies)
Diarrhoea
Rectal bleeding
Abdominal pain
(Not as many systemic symptoms)
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18
Q

Paediatric Crohn’s

A 
Panenteric disease
Weight loss
Growth failure
Abdominal pain
(Less often bloody diarrhoea)
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19
Q

Nutritional support for reflux

A

Calorie supplements
Exclusion diet
Nasogastric tube
Gastrostomy

20
Q

Reflux medical treatment

A

Feed thickner (gaviscon, thick & easy)
Prokinetic drugs
Acid suppressing drugs (H2 receptor blockers, proton pump inhibitors)

21
Q

Diagnosis of IBD

A

Faecal calprotectin

22
Q

Indications for surgery in reflux

A

Failure of medical treatment

Persistent

  • Failure to thrive
  • Aspiration
  • Oesophagitis
23
Q

Treatment of Crohn’s

A

Nutritional therapy

Steroids

24
Q

Treatment of UC

A

5-ASAs

Steroids

25
Q

How is remission maintained in Crohn? (and UC?)

A

Thiopurines

5ASAs
Thiopurines

26
Q

Step up therapy in Crohn’s and UC

A

Anti-TNF

27
Q

Surgery in Crohn’s

A

For complications - not curative

28
Q

Surgery in UC

A

For failure to respond to medical therapy - curative

29
Q

5ASA

A

Aspirin like drug with a carrier

30
Q

Antibiotics for UTI

A

Trimethoprim

31
Q

Chronic diarrhoea deifinition

A

4 or more stools per day

For more than 4 weeks

32
Q

Causes of diarrhoea

A

Modality disturbance
Acute secretion
Malabsorption of nutrients

33
Q

Modality disturbance diarrhoea

A

Toddler diarrhoea

IBD

34
Q

Active secretion diarrhoea

A

Acute infective diarrhoea

IBD

35
Q

Malabsorption of nutrients diarrhoea

A

Food allergy
Coeliac disease
Cystic fibrosis

36
Q

What are the trpes of diarrhoeas?

A

Osmotic
Secretory
Motility
Inflammatory

37
Q

Osmotic diarrhoea

A

Movement of water into the bowel to equilibrate osmotic gradient
Usually a feature of malabsorption
Generally accompanied by macroscopic and microscopic intestinal injury
Clinical remission with removal of causative agent

38
Q

Toxin production from which organisms is secretory diarrhoea classically associated with?

A

Vibrio cholerae

E. coli

39
Q

How is intestinal fluid secretion predominantly driven in secretory diarrhoea?

A

Active Cl-secretion via CFTR

40
Q

Inflammatory diarrhoea

A

Malabsorption due to intestinal damage
Secretory effect of cytokines
Accelerated transit time in response to inflammation
Protein exudate across inflamed epithelium

41
Q

Causes of fat malabsorption

A

Pancreatic disease

Hepatobiliary disease

42
Q

Pancreatic disease

A

Diarrhoea due to lack of lipase and resultant steatorrhoea

Classically cystic fibrosis

43
Q

Hepatobiliary disease

A

Chronic liver disease

Cholestasis

44
Q

Coeliac disease presentation

A 
Abdominal bloatedness
Diarrhoea
Failure to thrive
Short stature
Constipation
Fatigue
Dermatitis herpatiformis
45
Q

Screening tests for coeliac disease

A

Serological Screens
duodenal biopsy
Denetic testing

46
Q

Serological screens in coeliac disease

A

Anti-tissue transglutaminase

Anti-endomysial

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