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Clin Med IV: Pediatrics > Pediatric GI > Flashcards

Pediatric GI Flashcards

1
Q

What can Bile-stained emesis indicate

A

intestinal obstruction
requiring IMMEDIATE evaluation

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2
Q

what is regurgitation of stomach contents

A

GERD

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3
Q

what is the presentation of GERD in pediatric populations

A

recurrent splitting up and vomiting of infants
poor feeding and irritability in infants
heartburn in children
abdominal discomfort

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4
Q

what are pathologic symptoms of GERD

A

FTT, dysphagia or chronic respiratory symptoms, apnea spells

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5
Q

what is the treatment of GERD

A

Dietary education
acid suppression
surgery

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6
Q

What is Encopresis

A

involuntary bowel movement

repeated passage of stool into inappropriate places by child who is chronologically or developmentally older than 4 years

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7
Q

what is the presentation of encopresis

A

avoid having BM due to pain
overflow incontinence
stomach pain and cramps
decrease urge sensations
+/- lower abdominal tenderness or distension

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8
Q

what is the treatment of Encopresis

A

end tx will be combination of medical and behavioral

behavioral should be first line and is preferred

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9
Q

what is pyloric stenosis

A

stenosis that occurs due to hypertrophy of muscle surrounding the pylorus

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10
Q

what is the presentation of pyloric stenosis

A

projectile non-bilious vomiting or regurgitation within 2 hours of feeding
palpable olive-shaped mass in RUQ
peristaltic waves across abdomen prior to vomiting

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11
Q

what are lab abnormalities with pyloric stenosis

A

increased Cl, decreased K+, increased bilirubin
elevation of Hgb/HcT secondary to dehyrdation

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12
Q

what imaging confirms that diagnosis of pyloric stenosis

A

Ultrasound

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13
Q

what is the treatment of pyloric stenosis

A

surgery (pyloromyotomy- Ramstedt procedure)

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14
Q

what is a proximal segment of the intestine that “prolapses” into distal segment of the intestine

A

intussusception

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15
Q

what is the most common cause of intestinal obstruction in first 2 years of life

A

intussusception

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16
Q

wehre is the palpable sausage-shaped mass found with intussusception

A

hepatic flexure (not always present)

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17
Q

what is the preferred imaging for intussusception

A

Ultrasound
Barium or air enema is diagnostic and therapeutic

18
Q

what is a life-threatening complication of laprotation of intestine or stomach

A

volvulus

19
Q

what is the clinical presentation of volvulus

A

ill appearing with possible signs of shock; usu acute
sudden abdominal pain; colicky
bilious vomiting
may or may not have a fever

20
Q

what is a “coffee bean” sign on x-ray indicative of

A

volvulus

21
Q

what is the management of volvulus

A

usu. emergent surgcial intervention (can consider flex sig first but usu used more in adults)

22
Q

what is atresia

A

a condition in which an orifice or passage in the body is closed or absent
OR
an absence or abdominal narrowing or an opening or passsage int he body

23
Q

when do symptoms of atresia usually present

A

within first few hours of life

24
Q

what is the presentation of CEA

A

hypersalivation
choking
cough
respiratory distress
cyanosis
inability to pass nasogastric tube into stomach

congenital esophageal atresia

25
Q

what is the treatment of CEA

A

stabilize infant; airway and suction; feeding tube
emergent surgical repair

26
Q
A
27
Q

what needs to be completed prior to surgery for CEA to rule out right-sided heart aortic arch

A

ECHO

28
Q

what is a structure of the intestine

A

bowel atresia

29
Q

what are the types of bowel atresia

A

pyloric (rare), duodenal, jeunoileal (4 subtypes)

30
Q

what is the clinical presentation of Duodenal atresia

A

vomiting
abdominal bloating
bilious vomiting
scaphoid abdomen (sunken and hollow)
‘double-bubble sign” on XR

31
Q

what is the treatment of duodenal atresia

A

nasogastric/orogastric decompression
fluid replacement
treat any life=threatening anomalies
surgery - emergent repair once stabilized

32
Q

when is it called when the abdominal organs herniate through a defect in the diaphragm

A

diaphragmatic hernia

33
Q

what is the presentation of diaphragmatic hernia

A

respiraotry distress (usu.w/in first 24 hours of life)
scaphoid abdomen
decreased breath sounds
distant heart sounds

34
Q

what is seen on xray with diaphragmatic hernia

A

bowel loos seen in chest with medistinal shift

35
Q

what is the treatment of diaphragmatic hernia

A

stabilization (intubation, mechanical vent, decompression of GI tract)
Surgery

36
Q

what are long term complications of diaphragmatic hernias

A

pulmonary HTN
GERD
neurodevelopmental problems
behavioral problems
hearing loss
poor growth

37
Q

what is a congenital aganglionic megacolon

A

Hirschprung’s disease

38
Q

what is hirschsprungs disease

A

birthd efect where nerve cells are missing at the end of childs bowel causing bowel to not function correctly, causing blockages
associated with downs

39
Q

how does hirschprungs disease present

A

failure to thrive
constipation
delayed passage of meconium (>24 hours)
odorous ribbon-like stools
distended abdomen
hypo-proteinemia

40
Q

what is the treatment of hirschsprungs

A

surgery

(surgery - staged procedures depending on area)

41
Q

what is A-A-I-I-M-M

ddx of pediatric bowel obstruction

A

Adhesion
appendicitis
intussusception
inguinal hernia
malrotation
miscellaneous

42
Q

what are signs/symptoms of a emergent surgery

A

absent bowel sounds
bilious vomiting
blood diarrhea or occult blood in stool
elevated temp
rebound tenderness
rigidity
voluntary guarding

Clin Med IV: Pediatrics (16 decks)

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