Pediatric Gastroenterology Flashcards
Some common gastroenteritis pathogens
rotavirus, adenovirus salmonella, campylobacter, shigella, E. coli parasitic inorganic food contents emotional stress
Indications for testing stool with gastroenteritis?
Symptoms greater than 72 hours
Bloody stool present
What pathogens require 2 negative stool cultures before returning to day care?
E. coli and shigella
When to consider antibiotics for gastroenteritis
Greater than 8-10 stools per day or if organism is isolated
What is the first antibiotic of choice for gastroenteritis?
Bactrim (TMP/SMZ, trimethoprim/sulfamethoxazole)
Indications for GERD work up in kids
weight loss
choking
Risk of long term PPI in kids?
increased risk of anemia
Pyloric stenosis
3 weeks to 4 months old
projectile nonbilious vomiting after eating
hungry after vomiting
visible peristalsis waves
“pyloric olive” after vomiting
Abd US, Abd XR shows “string sign”, refer to surgery
Intussusception
- most occur under 2 yrs old
- colicky pain, vomiting, “currant jelly stool”, sausage shaped mass in the RUQ
- US or XR, immediate surgery referral
Hirschsprung’s Disease (Aganglionic Megacolon)
- bilious vomiting, abdominal distention, infrequent explosive BM, tight anal sphincter with empty rectum
- abd US or XR, biopsy
- refer to surgery
Appendicitis
- most common in males 10-30yo
- umbilical pain that shifts to RLQ
- low grade temp, elevated WBC, nausea with 1-2 episodes vomiting, pain with cough
- PROM on physical exam
- refer to surgery
Malabsorption
- cystic fibrosis, celiac disease, gluten intolerance, infection
- chronic diarrhea, steatorrhea (bulky, foul smell), failure to thrive
- intensive work up, refer to GI
Cystic Fibrosis dietary modifications
Replace pancreatic enzymes (lipase, amylase, trypsin)
Replace fat soluble vitamins (A, D, E, K)
At what age does the liver reach adult size and function?
10 years old
Signs of severe dehydration (≥10 percent)?
decreased BP and HR, prolonged capillary refill time
