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Pediatrics > Pediatric Gastroenterology > Flashcards

Pediatric Gastroenterology Flashcards

1
Q

Second only to respiratory illnesses, this is the most common reason children see us

A

GI complanints

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2
Q

Stomach pain can arise from

A

strep throat
UTI
food allergy

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3
Q

Visual inspection

A

Distention, discoloration, veins, jaundice, scars, ostomies

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4
Q

Bowel sounds

A

Normal, hypo or hyperactive, absent, high pitched

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5
Q

Palpation

A

Organomegaly, retained feces, masses

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6
Q

Rectal exam

A

Masses, fissures, abscesses, fistulas, rectal tone, content

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7
Q

Abdominal Pain in Children

A

Frequent presentation
Often benign or associated with another illness
Can be difficult to assess severity (FACES scale)
For frequent or persistent pain, ask the parent “ Can you tell when the child is in pain, or only if they tell you?”
When pain is severe, (>6/10) a child will not be very functional.
When there are psychological overtones, pain may be experienced as much more severe than appears. Typical for chronic pain

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8
Q

Abrupt onset of abd pain can indicate a

A

bowel obstruction, rupture

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9
Q

Gradual onset of abd pain is likely

A

inflammatory – appendicitis, inflammatory bowel

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10
Q

Common Diagnoses in Children with Acute Abdominal Pain

A 
Viral illness
Acute gastroenteritis
Food intolerance
Pneumonia
Gastritis (food related or post-infectious)
Constipation
UTI
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11
Q

Chronic Abdominal Pain in Children

A

Will affect over 10% of all children at some point
Peak incidence between age 7-12 years
Extensive differential diagnosis
Most children have a benign process

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12
Q

warning signs of underlying illness

A 
Vomiting			
Abnormal lab tests
Fever			
Bilious emesis
Growth failure/weight loss	
Pain wakens child from sleep
Blood in stool or emesis	
Location other than periumbilical
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13
Q

When to assess as opposed to offering reassurance

A

Anxious child
Anxious parent
Missed school

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14
Q

Comprehensive history of chronic abd pain

A

Family history of GI disorders (think about role modeling)
Family history of anxiety
Careful dietary history- especially too much of one thing, not enough variety
Lifestyle history – sleep, meals, school, stressors

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15
Q

Lab assessment of chronic pelvic pain

A

CBC, ESR, CRP
Amylase, lipase
ALT, AST, GGT, bilirubin
Urinalysis

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16
Q

Common Causes of Chronic Abdominal Pain in Children

A

Functional abdominal pain

Irritable bowel syndrome

17
Q

Functional abdominal pain

A

Often will have daily episodes of pain
Not associated with meals, bowel movements
Tendency toward anxiety and perfectionism
No warning signs present

18
Q

Irritable bowel syndrome

A

Subset of functional abd pain
Associated with alternating diarrhea and constipation
Symptoms linked to gut motility

19
Q

Treatment of Functional Abdominal Pain

A

Will rule out any possible causes first
Particularly focus on possible dietary intolerances
Encourage participation in school and activities
Do not treat as “sick”
Avoid giving medications as an initial placebo effect will often drive a demand to try different medications every few weeks as the placebo effect wears off.

20
Q

Vomitting and diarrhea

A

one of the most common office visits

a great place to find zebras

21
Q

newborn V/D

A

special circumstances are rarely typical

22
Q

vomitting in newborn

A 
obstruction
stomach/small bowel/malrotation/imperforate anus
feeding intolerance
ingested maternal blood
metabolic disease
23
Q

diarrhea in newborn

A

allergic diarrhea
overfeeding
malabsorption

24
Q

vomitting infant or child

A

viral illness

normally in an outbreak
febrile
acute onset

25
Q

acute gastroenteritis symptoms

A

vomitting is usually severe
quickly followed by diarrhea
stools are watery without blood or mucus

26
Q

acute gastroenteritis treatment

A

time and rest
slow rehydration
oral anti-emetic ondansetron

27
Q

when is observation not enough (duration)

A 
24hrs vomiting 
10 days diarrhea
persistent high fever 
5-10% weight loss
significant abd pain
28
Q

when is observation not enough (character)

A

blood in stool or emesis

mucous in stools

29
Q

assessment of AGE

A

abd xray/US
Lytes/BUN/Cr/CBC/BCx
UA
stool analysis and cx

30
Q

causes of chronic vomiting

A

GERD
FA
Food intolerance
Metabolic dz

31
Q

food allergey

A

often implicated, rarely proven
food intolerance is non-allergic
true allergey is immune based

32
Q

causes of food intolerance

A

lactase deficiency
GB dz
pancreatic insuffiency

33
Q

food allergey symptoms

A

symptoms are oral/GI/skin/resp/cardio/neuro

occurs seconds to hours after ingestion

34
Q

allergic eosinophilic esophagitis

A

GI tract becomes infiltrated with eosinophils
chronic symptoms of gerd/abd pain
positive skin testing
improves with dietary elimination

Pediatrics (1 decks)

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