Brainscape's Knowledge GenomeTM

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


See full index

Phase 3A content > Paeds GI and Liver > Flashcards

Paeds GI and Liver Flashcards

1
Q

What is pyloric stenosis?

A

Thickening and narrowing of the pylorus

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

When does pyloric stenosis present?

A

First 2-8 weeks of life

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

What is the vomit like in pyloric stenosis?

A

Projectile vomit

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

Why is there projectile vomiting in pyloric stenosis?

A

Increasing peristaltic waves in the stomach
Food cannot pass to duodenum due to hypertrophy
Results in projectile vomiting.

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

Findings on examination in pyloric stenosis?

A

Firm round mass in upper abdomen

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

What do blood gas results show in pyloric stenosis?

A

Hypochloric metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which investigation diagnoses pyloric stenosis?

A

Abdo USS

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

What is the management of pyloric stenosis?

A

Laparoscopic pylorotomy (incision in the smooth muscle of the pylorus to widen the canal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is infant colic?

A

Baby draws up their knees and is accompanied by inconsolable crying before passing wind

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the clinical features of CMPA?

A

Symptoms 2 hours post feed
Pruritus
Erythema
Angioedema around lips
Nausea
Vomiting
Diarrhoea
Colicky pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is CMPA diagnosed?

A

Diagnosed clinically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Management of CMPA?

A

Hydrolysed formula milk
Soya milk (over 6months)

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

What is intussuception?

A

Invagination of one part of the bowel into another

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

What are the consequences of intusseption?

A

Bowel obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When does intussuception commonly occur?

A

Ages 3months to 2 years

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

What are the clinical features of intussusception?

A

Paroxysmal colicky pain
Sudden onset of inconsolable crying episodes
Red current jelly stools

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

What are the stools like in intussuception?

A

Red current jelly stools

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

What can be felt on examination in intussuception?

A

Sausage shaped abdo mass in the right upper quadrant

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

Which part of the bowel does intussuception most commonly occur?

A

Ileocaecal valve

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

What is the preferred method of diagnosis for intussuception?

A

USS

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

What signs can be seen on transverse plane with USS in intussuception?

A

Doughnut sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the management of intussuception?

A

Fluids
NG tube
Air or contrast enema to reduce intussuscepted bowel
Surgical reduction

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

What is Meckel’s diverticulum?

A

Remnant from the growing foetus of stomach or pancreas tissue, usually asymptomatic but can begin to secrete acid and form ulcers in the small intestine

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

Symptoms of meckel’s diverticulum?

A

Blood in the stoolS
Abdo pain

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

What are the risk factors for acute apendicitis?

A

Genetics
Caucasian
More common in summer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the pathophysiology of appendicitis?

A

Direct luminal obstruction of the appendix
Faecolith or impacted stool
Bacteria accumulate cause acute inflammation
Reduced venous drainage, and inflammation causing increased pressure and ischaemia of the appendix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Symptoms of appendicitis?

A

Anorexia
Vomitting
Abdo pain initially centrally then localising to the right hand side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Signs of appendicitis?

A

Rebound tenderness at mc burnleys point
Rosving’s sign (RIF pain on palpation of the LIF)
Guarding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which score is used for appendicitis?

A

RIFT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What investigations should be carried out in cases of suspected appendicitis?

A

Urinalysis (rule out UTI)
Pregnancy test to rule out ectopic
USS or CT if clinical features are inconclusive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is Hirschsprung disease?

A

Impaired nerve supply to the distal portion of the colon
This impacts peristalsis and can cause bowel obstruction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the clinical features of hirschprungs?

A

Severe constipation
Not passing meconium within 24 hours
Abdo distention
Bile stained vomit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the gold standard investigation for hirschprungs?

A

Rectal suction with biopsy of the submucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the management of Hirschprungs?

A

Resection of the bowel with impaired nerve supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the most common causes of gastroenteritis?

A

Rotavirus
Campylobacter
Norovirus
Adenovirus
E.coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Clinical features of gastroenteritis?

A

Loose/watery stool
Vomiting
Abdocramps/pain
Mild fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Management of gastroenteritis?

A

Assess how dehydrated the child is, in order to determine fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What must you not give in cases of gastroenteritis with diarrhoea?

A

Antidiarrhoeal agents as this prevents the excretion of the causative organisms.

39
Q

What symptoms of gastroenteritis suggest an alternative diagnosis?

A

Temp above 38C
Breathlessness or tachypnoea
Altered GCS
Blood/mucus in the stool

40
Q

How do you assess weight loss in children whom you do not have a previous weight?

A

Calculate how much they should weigh based off age, and work out difference between that and current weight.
(age +4) x2

41
Q

Which fluids should be given in neonates?

A

10% glucose

42
Q

What are the rules for maintenance fluid prescribing in paediatrics for a 24 hour period?

A

100ml/kg for first 10kg
50ml/kg for 10-20kg
20ml/kg for over 20kg
Divide by 24 if you want per hour

43
Q

What is the max amount of fluids that can be prescribed for girls?

A

2L

44
Q

What is the max amount of fluids that can be prescribed for boys?

A

2.5L

45
Q

What is the first line type of fluids for children?

A

0.9% saline plus 5% glucose

46
Q

What are the features of 5% dehydration?

A

Reduced urine output
Well ish but some signs
Unsettled
Normal skin
Slightly sunken eyes
Reduced tears
Dry mouth

47
Q

What are the features of 10% dehydration?

A

Lethargic and confused
Unwellm
Weak peripheral pulses
Prolonged cap refil
Cold extremities
Pale and mottled
Hypotension is late sign

48
Q

How do you calculate the fluid deficit?

A

% dehydration x Weight (kg) x10

49
Q

What is a fluid challenge?

A

5ml every 5 mins of squash to see if they can keep it down

50
Q

Which part of the bowel does crohns affect?

A

Mouth to anus

51
Q

What is the characteristic appearance of crohn’s?

A

Transmural inflammation
Discontinuous with skip lesions
Non-caseating granulomatous inflammation
Deep ulcers and fissures

52
Q

What are the characteristic symptoms of crohns?

A

Abdo pain
Diarrhoea
Weight loss
Oral lesions
Uveitis
Erythema nodosum

53
Q

What are the extra intestinal features of crohns?

A

Erythema nodosum
Oral lesions
Perianal skin tags
Uveitis
Arthralgia

54
Q

What investigations would you do for crohns?

A

Faecal calprotectin
Stool sample (rule out infectious cause)
Colonoscopy

55
Q

Which drugs are used to maintain remission in crohns?

A

Azathioprine

56
Q

What kind of diet should be encouraged to maintain remission in crohns?

A

Polymeric diet (liquid diet/entral diet)

57
Q

Which part of the bowel does UC affect?

A

Colon

58
Q

What are the findings in UC on histology?

A

Continuous ulcers
Mucosal inflammation
Crypt damage

59
Q

How to treat mild UC?

A

Mesalazine

60
Q

What are the symptoms of UC?

A

Rectal bleeding
Diarrhowa
Colicky pain
Erythema nodosum
Arthritis

61
Q

What can be prescribed in children with constipation?

A

Movicol

62
Q

What is kwashiorkor?

A

Deficiency of protein in the diet

63
Q

What is marasmus?

A

Deficiency of all nutrients from the diet

64
Q

Characteristic symptoms of kwashiorkor?

A

Stomach oedema
Inability to gain weight or grow
Oedema of hands and feet

65
Q

What is the treatment of marasmus and kwashiorkor?

A

Slowly increasing calorie intake through several small meals.
Multivitamins
Protein supplements

66
Q

What is coeliac disease?

A

Immunological respinse to gliadin

67
Q

What are autoantibodies developed against in coeliac disease?

A

Tissue transglutaminase

68
Q

What is the gold standard test for coeliac disease?

A

Duodenal biopsy

69
Q

Common symptoms of coeliac disease?

A

Loose stools
Steatorrhea
Failure to thrive and weight loss

70
Q

What is the cause of jaundice?

A

High levels of unconjugated bilirubin in the blood causing yellowing of the skin

71
Q

When is jaundice considered normal?

A

2-14 days old

72
Q

When is jaundice abnormal?

A

< 24 hours old jaunduce is always abnormal

73
Q

When should you be concerned about the length of time jaundice is lasting?

A

Lasts longer than 2 weeks this can be pathological

74
Q

What is the usual cause of jaundice less than 24 hours old?

A

Haemolysis

75
Q

What is rhesus haemolytic disease?

A

Mum us Rh -ve and baby is +ve
Blood mixing during delivery can cause haemolysis, leading to jaundice

76
Q

How is rhesus haemolytic disease prevented?

A

Anti D at 28 weeks and after delivery

77
Q

What is ABO incompatibility?

A

WHen mum is O and baby is either A or B.
Mum can develop anti A or Anti B just by immune respinse to common pathogens
These can pass across the placenta causing haemolysis in baby

78
Q

Which test is used to diagnose ABO incompatibility?

A

Coombes test

79
Q

What are the TORCH infections?

A

Toxoplasmosis
Syphilis
Parovirus
Varicella zoster
Rubella
CMV
Herpes/hepatitis

80
Q

Other causes of jaundice in babies under 24 hours old?

A

TORCH
ABO incompatibility
G6PD deficiency
Hereditary spherocytosis

81
Q

What are the causes of jaundice between 2-14 days old?

A

Physiological jaundice due to liver not working as fast
Breast milk jaundice (feeding difficulties leading to dehydration and impaired bilirubin elimination)

82
Q

What are the causes of jaundice lasting longer than 2 weeks?

A

Breast milk jaundice
Congenital hypothyroidism
CF
Biliary atresia

82
Q

What are the causes of jaundice lasting longer than 2 weeks?

A

Breast milk jaundice
Congenital hypothyroidism
CF
Biliary atresia

83
Q

What is kernicterus?

A

Acute bilirubin encephalopathy

84
Q

What is the pathophysiology of kernicterus?

A

Deposition of bilirubin in the basal ganglia and brainstem

85
Q

Symptoms of kernicterus?

A

Seizures
Hypertonia
Opisthotonus (dramatic abnormal posture causing arched back)

86
Q

What is the treatment for jaundice?

A

Phototherapy is first line

87
Q

What is biliary atresia?

A

Obstruction or absence of the lumen in the bile duct. So CBD may be missing or even the gall bladder itself

88
Q

What is the pathophysiology of biliary atresia?

A

Bile duct is blocked, leading to build up of bile back to the liver
Increase pressure in the liver
Causes unconjugated bilirubin to leak into the blood

89
Q

Treatment for biliary atresia?

A

Kasai procedure (surgical treatment)
Liver transplant

90
Q

What is a choledochal cyst?

A

Congenital abnormality of the bile duct causing a swelling. Bile backs up into the liver

91
Q

Symptoms of choledochal cyst?

A

Abdo mass
Pain in RUQ
Jaundice
N&V
Fever

92
Q

What signs are seen on USS in intussuception?

A

Target sign

93
Q

After starting phototherapy how often should serum bilirubin be checked?

A

Every 4-6 hours
Can be lowere to 12 hours when bilirubin is stable

Phase 3A content (15 decks)

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