pediatric GI Flashcards
What is the most common tracheoesophageal fistula?
esophageal atresia with distal tracheoesophageal fistula
When does pyloric stenosis present? How does it present?
a few weeks after birth with nonbilious, projectile emesis. may have a palpable epigastric olive sized mass
What are the lab findings of pyloric stenosis?
hypochloremic, hypokalemic metabolic alkalosis
What is necrotizing eneterocolitis and which patients are affected?
idiopathic mucosal necrosis and epithelial cell sloughing seen in pts with preterm birth or low birth weight
How does NEC present? Labs?
bilious vomiting, lethargy, poor feeding diarrhea, hematochezia, abd distension and tenderness, shock. Pts have a metabolic acidosis and low Na
What are the radiographic findings of NEC?
air in the bowel wall, bowel distension, portal vein gass, free air under the diaphragm
what is the tx for NEC?
TPN, abx, NG suction, surgery of affected bowel
What are risk factors for intussusception? Where does intussusception most often occur?
occurs often proximal to the ileocecal valve
risk factors include meckel diverticulum, HSP, adenovirus infection, CF
most common in kids 6 months-2 yrs
What are the findings that suggest intussusception?
episodic abd pain, pallor, sweating, vomiting, bloody mucus in stool (currant jelly stool), palpable, sausage like mass
What is the tx for intussusception?
barium enema, surgery if refractory. can lead to bowel ischemia
What is the ddx for neonatal jaundice?
- physiologic (physiologic undersecretion, breast feeding failure)
- increased hemolysis: maternal-fetal ABO incompatibility, heretidary RBC abnormalities, G6PD deficiency,
- bilirubin overproduction without hemolysis: hemorrhage, transfusion
- hepatic problems- gilbert, crigler-najjar, biliary atresia
How soon does physiologic jaundice resolve?
usually within 2 wks
What is kernicterus? Where is the abnromality/affected organ?
-deposition of bilirubin in the basal ganglia and hippocampus.
may cause permatnent damage; may cause seziures/apnea
What are signs that the jaundice is NOT physiologic?
jaundice within first 24 hrs after birth, t-bili >15, direct bilitrubin >2
How does malrotation present?
gut failed to rotate in usual counter clockwise direction.
usually presents in the first month of life with bilious vomiting, and abd distension. barium enema shows the cecum in the upper quadrant; UGI shows that duodenum failed to cross midline or shows a beak
