Paeds gastro Flashcards
What is encopresis? What is it usually a sign of?
- Faecal incontinence
- Chronic constipation
What is the first line laxative for constipation?
Movicol
What is the main preventative medication for abdominal migraine? What drug is it?
Pizotifen - a serotonin agonist
Management of more problematic GOR?
- Gaviscon with feeds
- Thickened milk/formula
- PPI when other methods are inadequate
What is Sander’s Syndrome? What are the key features?
- When GOR is associated with brief episodes of abnormal movement
- Torticollis
- Dystonia
What is pyloric stenosis?
Hypertrophy of the pylorus
What are the key features of pyloric stenosis?
- Projectile vomiting
- Olive mass in abdomen
- Blood gas showing hypochloric metabolic alkalosis
Pyloric stenosis:
1. Diagnostic Ix?
2. Rx?
- Abdominal USS
- Laparoscopic pyloromyotomy
What are the 2 key antibodies in coeliac disease? What else should you measure? Why?
- Anti-tissue transglutaminase and anti-endomysial
- IgA as some patients have IgA deficiency and if so the coeliac test can be negative even though they have the condition
What should you always screen new T1DM patients for? Why?
Coeliac disease, the conditions are often linked
What will endoscopy and intestinal biopsy show in coeliac disease?
- Crypt hyperplasia
- Villous atrophy
How does intussusception present?
- Abdo pain
- ‘Redcurrant jelly stool’
- ‘Sausage shaped’ mass (RUQ)
- Unwell child
- Intestinal obstruction
What commonly precedes intussusception?
Viral illness
Intussusception:
1) Diagnostic Ix?
2) Rx?
1) USS
2) Air/water enema, surgical resection if bowel becomes gangrenous or perforates
What colour vomit do you get in bowel obstruction?
Green (bilious vomit)
What will an abdo XR show in bowel obstruction?
Dilated loops of bowel proximal to the obstruction, the absence of air in the rectum
What is the management of bowel obstruction?
- Admit to surgical unit
- Nil by mouth
- NG tube to drain stomach
- IV fluids
- Manage underlying cause
Biliary atresia:
1) What is it?
2) What does it result in?
3) How does it present?
4) Ix?
5) Rx?
1) A congenital condition where a section of the bile duct is narrowed or absent
2) Results in cholestasis
3) Persistent jaundice
4) Unconjugated and conjugated bilirubin (conjugated will be high)
5) Surgery - ‘Kasai portoenterostomy’
What signs on examination suggest peritonitis caused by a ruptured appendix?
- Rebound tenderness
- Percussion tenderness
What is the classical finding on a blood gas of pyloric stenosis?
Hypochloraemic, hypokalaemia alkalosis
What is condition coeliac commonly associated with?
T1DM
What type of antibodies are anti-tissue transglutaminase and anti-endomysial?
IgA
What genes is coeliac associated with?
HLA-DQ2 and HLA-DQ8
What is the first line management of inducing remission for 1) Crohns and 2) Ulcerative colitis?
- Steriods e.g. pred or IV hydrocortisone
- Aminosalicylate e.g. mesalazine (if sever disease would be IV hydrocortisone)
