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Murtaghs GP > Paeds > Flashcards

Paeds Flashcards

1
Q

What is a good rule to follow when assessing abdominal pain in children?

A

Rule out a urinary infection with urinalysis

This helps in identifying potential causes of abdominal pain.

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2
Q

What does ‘infant colic’ refer to?

A

Regular, unexplained periods of inconsolable crying in a well baby

Occurs usually in the late afternoon and evening, typically between 2 weeks and 16 weeks of age.

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3
Q

True or False: Infant colic occurs in babies with identifiable physical health issues.

A

False

Infant colic occurs in a well baby with no apparent cause for distress.

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4
Q

Fill in the blank: About one in ______ will have a surgical cause for abdominal pain.

A

15

This statistic emphasizes the need for proper assessment.

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5
Q

What organs are located in the right hypochondrium?

A

gall bladder, biliary tract, liver

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6
Q

List three conditions associated with the right hypochondrium.

A
  • biliary colic
  • cholecystitis
  • acute hepatitis
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7
Q

What are the potential causes of periumbilical pain?

A
  • jejunum/ileum
  • appendix
  • aorta
  • small bowel obstruction
  • gastroenteritis
  • appendicitis (early)
  • ruptured AAA
  • mesenteric ischaemia
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8
Q

Which organs are involved in pain located in the right iliac fossa (RIF)?

A
  • appendix
  • caecum/ileum
  • kidney/ureter
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9
Q

What are the common causes of pain in the groin area?

A
  • torsion of testis
  • hernial orifices (check with SBO)
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10
Q

Name the organs associated with epigastric pain.

A
  • oesophagus
  • stomach
  • duodenum
  • gall bladder
  • liver
  • pancreas
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11
Q

What serious conditions can cause left hypochondrium pain?

A
  • kidney
  • spleen
  • urinary infection
  • splenic infarct/rupture
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12
Q

What conditions can lead to lower abdominal pain?

A
  • large bowel obstruction
  • descending colon diverticulitis
  • renal/ureteric colic
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13
Q

List the causes of suprapubic pain.

A
  • ovaries
  • ruptured ectopic
  • fallopian tubes
  • acute PID
  • bladder
  • ruptured ovarian cyst
  • torsion of ovary
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14
Q

What are common causes of abdominal pain in children?

A
  • infant ‘colic’
  • gastroenteritis
  • mesenteric adenitis
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15
Q

What serious conditions should not be missed in children with abdominal pain?

A
  • intussusception
  • acute appendicitis
  • bowel obstruction/strangulated hernia
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16
Q

List some pitfalls in diagnosing abdominal pain in children.

A
  • child abuse
  • constipation/faecal impaction
  • torsion of testes
  • lactose intolerance
  • peptic ulcer
  • infections (e.g., mumps, tonsillitis, pneumonia, UTI)
  • adnexal disorders in females
17
Q

What are some rare causes of abdominal pain?

A
  • Meckel diverticulitis
  • Henoch-Schönlein purpura
  • sickle crisis
  • lead poisoning
18
Q

What is included in the seven masquerades checklist for abdominal pain?

A
  • type 1 diabetes
  • drugs
  • UTI
19
Q

True or False: Psychogenic causes of abdominal pain in infants occur in about one-third of cases.

A

True

20
Q

What are the clinical features of infant colic?

A
  • Baby between 2 and 16 weeks old
  • Prolonged crying (at least 3 hours)
  • Occurrence at least 3 days a week
  • Crying worst at around 10 weeks of age
  • Crying during late afternoon and early evening
  • Child flexing legs and clenching fists
  • Normal physical examination
21
Q

Fill in the blank: Management of infant colic includes reassurance and explanation, and advising parents to use _______.

A

gentleness

22
Q

What is intussusception?

A

A condition where a segment of bowel telescopes into the adjoining distal segment, causing intestinal obstruction.

It is usually idiopathic but may have a pathological lead point.

23
Q

What age group is most commonly affected by intussusception?

A

Children aged between 3 months and 2 years, typically 5-24 months.

Male babies are more frequently affected than female babies.

24
Q

What are the typical clinical features of intussusception?

A
  • Sudden-onset acute pain with a shrill cry
  • Vomiting
  • Lethargy
  • Pallor with attacks
  • Intestinal bleeding: redcurrant jelly

60% of patients present with redcurrant jelly stools.

25
Q

What is the significance of early diagnosis in intussusception?

A

Early diagnosis within 24 hours is essential to reduce morbidity and mortality.

After this time, there is a significant rise in complications.

26
Q

What are the signs of intussusception during a physical examination?

A
  • Pale, anxious and unwell appearance
  • Sausage-shaped mass in right upper quadrant
  • Signe de dance (emptiness in RIF to palpation)
  • Alternating high-pitched active bowel sounds with absent sounds
  • Rectal examination: + blood + hard lump

The sausage-shaped mass may be difficult to feel during attacks.

27
Q

How is intussusception diagnosed?

A
  • Ultrasound
  • Enema using oxygen or barium (with caution)

Enemas can be used for both diagnosis and treatment.

28
Q

What is the preferred treatment for intussusception?

A
  • Hydrostatic reduction by air or oxygen
  • Barium enema
  • Surgical intervention may be necessary

Air or oxygen from the ‘wall’ supply is preferred for hydrostatic reduction.

29
Q

What differential diagnoses should be considered for intussusception?

A
  • Acute gastroenteritis
  • Impacted faeces
  • Other causes of intestinal obstruction (e.g. irreducible inguinal hernia, volvulus)

Gastroenteritis typically presents with loose watery stool and fever, which help differentiate it from intussusception.

30
Q

True or False: Drugs are generally recommended for treating intussusception.

A

False

Some preparations like simethicone may have traditional backing but lack scientific support.

31
Q

Fill in the blank: Intussusception is often characterized by _______ abdominal pain occurring at intervals.

A

[severe colicky]

Murtaghs GP (1 decks)

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