PAEDS GI ISSUES Flashcards
Genetics of Coeliac in kids?
HLA DQ2 (90%) HLA DQ8 (80%)
Jejunal biopsy of coeliac?
Villous atrophy
What are useful antibody screening tests?>
What is the test of choice?
Anti-endomysial antibodies
Anti-gliadin antibodies
Test of choice = TTG (IgA tissue transglutaminase)
most common causes of paedatric gastroenteritis?
Rotavirus
Management of CMPA/I if formula fed?
EHF (extensive hydrolysed formula)
If FAILS
USE Amino acid based formula (AAF)
Management of CMPA/I if breastfed?
Eliminate maternal cows milk
Continue breast feeding
Use EHF when stopping breastfeeding
When does GORD in children usually present?
Before 8 weeks (vomiting / regurg / milky vomits)
CMPI vs CMPA
CMPI (non IgE mediated)
CMPA (IgE mediated)
Management of GORD in children?
Conservative (30* angle, smaller frequent feeds)
Trial thickener
Trian aliginate (gaviscon)
Only trial PPI if decreased growth, distressed or refusing feeds
Purpura on legs and buttocks is suggestive of what?
HSP
Nectotising enterocolitis
One of the most common causes of death amongst premature babies
Symptoms of NEC?
Feeding Intolerance
Abdominal distension
Bloody stools
CAN progress to abdominal discolouration, perforation and peritonitis
Signs of NEC on AXR?
Asymmetrical dilated bowel loops
Bowel wall oedema
Pneumatosis intestinali
Portal venous gas
Pneumoperitoneum
RIGLERS sign (air inside and outside the bowel wall)
FOOTBALL sign (air around the falciform ligament)
Epidemiology of pyloric stenosis
15% have family history
4x more common in boys
Acid base status of pyloric stenosis
Hypochloraemia, hypokalaemia metabolic alkalosis
How is pyloric stenosis Dx?
USS
Management of pyloric stenosis
Ramstedt Pylromyotomy
