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Systems- Paeds > Peads GI > Flashcards

Peads GI Flashcards

1
Q

Does GORD usually reslove spontaneoulsy?

A

Yes it does

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2
Q

What 3 conditions result in GORD not being self-limitng

A

Cystic fibrosis

Neurological disorders

Motility disorders

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3
Q

how do you get bullous vomiting

what does it mean

A

It means bowel obstruction

but only at a level below the jejunum

this is cause bile is released from the gallbladder and into the jejunum

so, the obstuction must occur below cause else would it be travelling upwards for you to spew it up

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4
Q
A
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5
Q

what to the following AXR/US signs mean…

  1. double bubble
  2. triple bubble
  3. soap bubble
  4. football sign, loops of bowel & bowel oedema
  5. pneumatosis intestinalis (intramural gas)
  6. target sign
A
  1. duodenal artresia
  2. jejuno-ileo artresia
  3. mecnoium ileus
  4. NEC (perforated)
  5. NEC
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6
Q

If an AXR shows a soap bubble, what is it

what other condition is the kid deffo gonan have

how do you get it

A

Meconium ileus

Deffo gonna have CF

The meconium is way too sticky, so it doesn’t budge

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7
Q

If they have billous vomit & the baby has not yet passed meconium, what are the 3 differentials & why

A

Meconium ileus -> poo too sticky due to CF

Hirschprungs -> ganglion cells haven’t buggered off (not migrated)

Ano-rectal malformation -> rectum is buggered, so poo can’t physically leave lol

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8
Q

What are these…

  1. vomiting & regurgitation after feegding, nothing else wrong
  2. billous vomit, intramural gas (pneumotosis intestinalis), loops of bowel + oedema on AXR
  3. very sore, knees up to chest, sausage shapped mass
  4. congenita diaphragmatoc hernia, ompalocele
A
  1. GORD
  2. NEC
  3. intusseception
  4. malrotation
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9
Q

what’s the best imaging for intusseception & pyloric stenosis

A

USS

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10
Q

3 day old kid

Green vomit

Not passed meconium yet

Genetics show MEN 2B

what’s this

what is the diagnostic test

how do you treat

A

Hirschprungs disease

Rectal biopsy

1st line -> rectal washout/bowel irrigation

2nd line -> surgery

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11
Q

what genetic condition is hirschprugs associated with

A

MEN-2b

also associated with…

medullay thyroid ca

Phaenochromocytoma

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12
Q

when is mssconium usually passed

A

within 24hrs

start to worry if after 48

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13
Q

what is the big bad risk factor for meconium aspiration

A

post-term

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14
Q

Child

Painless GI bleeding

Can cause appendicitis like abdo pain

Needs blood transfusion

What is it

whats it a remnant of

whats it the main cause of

A

Meckel’s diverticulum

Yolk sac

Painless GI bleeding

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15
Q

what is a serious GI cause of death in premature babies

A

NEC

Nectorising EnteroColitis

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16
Q

Billous vomiting

Nappy is a bit red (blood)

Not feeding right

Abdo pain

Whats this

what investigation

management

A

NEC

AXR

Management

NBM

Lapratomty + abxs (broad spectrum)

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17
Q

what happens to the bowel in intusseception

A

One bit invaginates into another

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18
Q

colicky abdo pain

Knees to the chest

Billous vomit

“red currant jelly” in stool

whats this

what would the mass feel like on palpation

investigation to do

Management

A

Intussception

Sausage-shapped

USS

1st line -> air enema (reduction by air insufflation)

2nd line -> surgery & abxs

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19
Q
A
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20
Q

intussception

What does the mass feel like

When does billous vomiting occur

Most common location

A

Sauage-shapped

POST-natal period

Ielo-cecal valve

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21
Q

Fairy liquid vomit

Scaphoid abdomen

A
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22
Q

Red currant jelly in stool is sign of what

A

Intussception

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23
Q

what are the key signs of malrotation

A

Fairy liquid vomit

Sacphoid abdo

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24
Q

what sorta pain does intussecption present with

A

Colicky abdo pain

Knees drawn to chest as a result

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25
Q

Fairy liquid vomit

Scaphoid abdomen

May have omphaocele & congenital diaphragmatic hernia

whats this

investigation

management

whats going on if baby is unwell

A

Malrotation

USS + UGI contrast study

surgery -> Lapraotomy & LAD’s procedure

Volvulus

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26
Q

whats the main cause of billous vomit until proven otherwise

A

Malrotation

Small intesine is all tangeled up

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27
Q

What are the causes of billous vomiting

A

Anything that causes bowel obstruction below the jejunum

Malrotation

INtussecption

Duodenal & jejuno-ileal artresia

Meckels diverticulum

NEC

Hirchbrungs

Ano-rectal malformation

Mecnoium ieleus

Strangulated hernia

28
Q

does pyloric stenosis cause billous vomiting

A

Absolutley not

cause the obstruction is clearly above the jejunum

29
Q

Effotless vomiting is a sign of…

A

GORD

30
Q

Effortless vomiting

whats this gonna be

when is it not self-limiitng

Investigations

Management

A

GORD

Not self-limiting -> cerbral palsy

investigations

Feeding trial (main)

Barrium swallow & video fluroscopy

Endoscopy

management

Change feeding position

v

Food thickeners

v

gaviscon

v

PPI

v

Surgery - nissan fundoplication

31
Q

what surgery can be done for GORD

what are the indications

A

Nissan fundoplication

FTT

Recurrent aspiration

32
Q

What are the different types of diarrhoea

A

Motility

Secretory

Osmotic

Inflammatory

33
Q

Give causes for the following typrs of diarrhoea

Motility

Secretory

Osmotic

Inflammatory

A

Motility -> toddlers diarrhoea, IBS

Osmotic -> allergies, celiacs, CF (malabsorption)

Secretory -> infections

Inflamatory - >IBD

34
Q

What are the differneces between osmeotic and secretory diarrhoea

A

osomtoic

Smaller stool volume

Goes away after you stop eating

Caused by malabsoprtion (allergies, coeliacs, CF)

secretory

Larger stool volume

Doesn’t stop after eating

caused by infections

35
Q

Casues of malabsoroption

A

Coeliacs

Crohns

CF

36
Q

Diarrhoea

Dehydrated

Can’t eat

Fever

whats this

management

are abxs usually used

A

Gastrotenteriris

stable -> Encourage fluids

unstable -> Oral rehydration therapy

very unstable -> IV fluids

Abxs are not usually used, only if like septic

37
Q
A
38
Q
A
39
Q

bloody diarrhoea

just visited a zoo

whats the cause

A

E.coli 0157

40
Q

a child presents with a puffy face

kinda looks like an allergy but unsure

what investigation needs to be done & wh7

A

Urine dip -> check for protein

Could be minimal change disease

41
Q

how would you describe the vomiting in pyloric stenosis

A

Persistent & projectile

Low Cl & K

ALKALOTIC

42
Q

if the diarrhoea is full of undigested food, what is the cuase

A

toddler’s diarrhoea

43
Q

gastroeneteritis

Main cause

cause if you get loose stools after recovering from it

A

Rotavirus

Lactose intolerance

44
Q

Diarrhoea

Causes of acute & chronic pls

A

acute -> gastroenteritis

Chronic

CMPA

Toddler’s diarrhea

Coeliacs

45
Q

Kid is very jittery

Hypertonia

Hyperreflexia

Been having diarrhoea

What is going on

A

Hypernatraremic deyhradation

too much salt

46
Q

causes of bloody diarrheoa in kids

A

E.coli

campylobacter

Salmonella

Shigella

Protozoa

47
Q

Projectile vomiting

Visible gastric peristalsis

Mass in abdomen

weight loss

Low Cl & K

whats this

what shape is the mass

Inestigations

management

A

Pyloric stenosis

Olive shapped

USS

IV fluids & surgery (pyloromyotomy)

48
Q

what surgical procedure is done for pyloric stenosis

A

Pyloromyotomy

49
Q

causes of constipation in a kid

A

TOILET ANXIETY

Dehydration

Anal fissures

Hirschprungs

Opiates

Psychological -> sexual abuse

50
Q

how is constipation treated

A

1st line -> movicol

2nd line -> add senna

51
Q

what type of laxatives are movicol and senna

A

movicol -> osmotic

senna -> stimulant

52
Q

how can impaction lead to overflow

A

Since stool is always sitting against the anal sphincter, the muscle weakens

so some shit is squirted out

53
Q

diarrhoea/constipation

just started formula feeds

whats this

A

CMPA

cows milk protein allergy

54
Q

whats like the normal range of stool frquency

A

4 per day -> 1 per week

55
Q

whats the cycle of toliet anxiety that can lead to

A

Stool sits in rectum

v

stool absorbs water & gets bigger

v

Next poo is painful due to size

v

kid doesn’t want to go to toliet again

v

from the top now y’all

56
Q

what is a complication of constipation & what are some signs

A

Imapaction

Pain

Pooing themselves (overflow)

57
Q

what type of exams should you do if a kid presents with chronic constipation

A

Neuro of lower limbs

PR

58
Q

CMPA

Is it IgE mediated?

Investigation

Management

A

No

Milk-free feeding trial

Hydrolysed feeds, PPIs

59
Q

Few weeks old baby

Dark urine

Pale poo

Poor appetite

Hepatosplenomegaly

Most likely diagnosis

Type of raised bilirubin

investigations

management

A

Biliary artresia

CONJUGATED

Investigations

Bloods -> bilirubin & LFTs

USS of biliary tree

Management

Surgery -> kasai procedure

60
Q

What do these surgical procedures treat…

  1. Nissan fundoplication
  2. Pyloromyotomy
  3. Kasai procedure
A
  1. GORD
  2. pyloric stenosis
  3. biliary artresia
61
Q

what complication of jaundice can serious fuck up your brian

it’s the basal ganglia thats fucked

A

Kernickerus

62
Q

Is jaundiced baby just after birth normal

A

Absolutley not

it’s ALAYS PATHOLOGICAL

63
Q

Jaundiced baby at birth

Commonish/unexciting cause

where must you see it

Management

A

Bruising

Must be seen in the sclera

Management

Measure bilirubin within 2hrs

Blood film

Referral to PAU

Phototherapy (incubator)

Maybe IV fluids

64
Q

Causes of conjugated & unconjugted jaundice

A

Conjugated

Biliary artesia

Neonatal hepatitis

Unconjugated

Hypothyroid

Gliberts

65
Q

3 histologicla signs of coeliacs

A

Total villous atrophy

Crypt hyperplasia

WC infiltreation

66
Q

causes of abdo pain in peads

  1. 5yo, RIF pain, no guarding/tenderness, recent viral infection
  2. 5yo, RIF pain, guarding & tenderness, raised CRP/ESR
  3. RIF pain, +ve urine dip
  4. 2yo, severe RIF pain, lots of rectal bleeding, needs transfusion
  5. <9m old, severe colicky abdo pain, knees to chest, red jelly stool
A
  1. mesenteric adenitis
  2. acute appendicitis
  3. pyleonephritis
  4. meckles diverticulum
  5. intussecpetion

Systems- Paeds (20 decks)

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