Pediatric GI

Question 1

Age of Infantile Hypertrophic Pyloric Stenosis?

Answer 1

3-5 weeks

Question 2

Vomiting in Infantile Hypertrophic Pyloric Stenosis?

Answer 2

Projectile vomiting after eating, hungry after

Question 3

Appearing of baby with Infantile Hypertrophic Pyloric Stenosis?

Answer 3

“Thin” or “emaciated”

Question 4

What’s palpable in Infantile Hypertrophic Pyloric Stenosis? When?

Answer 4

“Olive” on lateral edge of rectuc abdominus in RUQ after vomiting

Question 5

DX for Infantile Hypertrophic Pyloric Stenosis?

Answer 5

Ultrasound. Endoscopy if U/S inconclusive.

Question 6

What labs to check in Infantile Hypertrophic Pyloric Stenosis?

Answer 6

Lytes to assess hydration

Question 7

What first thing to treat in Infantile Hypertrophic Pyloric Stenosis?

Answer 7

Correct hydration status

Question 8

Treatment of choice in Infantile Hypertrophic Pyloric Stenosis?

Answer 8

Surgical pylormyotomy

Question 9

Etiology of Intussusception?

Answer 9

75% idiopathic

Question 10

What is most common obstruction in 6-36mo old?

Answer 10

Intussusception

Question 11

Intussusception most common in what age?

Answer 11

3-5 months

Question 12

Intussusception due to?

Answer 12

Intestinal invagination most commonly at ileocecal junction

Question 13

Where does Intussusception happen most?

Answer 13

Ileocecal junction

Question 14

Describe pain in Intussusception

Answer 14

Severe, sudden, crampy pain. Legs drawn up, inconsolable. 15-20 minutes long then OK until next episode.

Question 15

Describe stool in Intussusception

Answer 15

Blood or currant jelly in stool

Question 16

Describe mass in abdomen in Intussusception

Answer 16

Sausage shape abdominal mass

Question 17

Dx of Intussusception?

Answer 17

• X-ray

- U/S

Question 18

What will U/S show in Intussusception?

Answer 18

Bulls Eye or Coiled Spring

Question 19

Tx of Intussusception if stable and no perforation?

Answer 19

Edema with barium or pressurized air. 80-95% success.

Question 20

Tx for Intussusception if perforation or necrosis?

Answer 20

Surgery

Question 21

Etiology of Phenylketonuria?

Answer 21

Deficiency of Phenylalanine Hydroxyurase (PAH) to convert Phenylalanine to Tyrosine

Question 22

What disability does Phenylketonuria cause?

Answer 22

Intellectual disability

Question 23

Blood and urine smell in Phenylketonuria?

Answer 23

“Mousy” smell

Question 24

Dx of Phenylketonuria?

Answer 24

Newborn screening from heel stick

Question 25

Tx of Phenylketonuria?

Answer 25

Restrict Phenylalanine from diet ASAP, definitely <1 week

Question 26

How often to monitor Phenylketonuria?

Answer 26

Weekly in first year, twice a month 1-12 years, monthly in 12+ years

Question 27

Most common age in Appendicitis?

Answer 27

5-12 y/o

Question 28

Fever and pain where in Appendicitis?

Answer 28

Low grade fever, complain of hip pain

Question 29

WBC in Appendicitis shows what?

Answer 29

Elevated WBCs with increased polys

Question 30

U/S in Appendicitis if what?

Answer 30

Young and thin

Question 31

What test to use if U/S inconclusive in Appendicitis?

Answer 31

CT

Question 32

Tx of non-perforated Appendicitis?

Answer 32

• NPO, IV fluids, control pain/puke/fever

- Surgery w/n 6h

Question 33

Pre-op abx in Appendicitis if non-perforated?

Answer 33

Cefoxitin

Question 34

Tx of perforated Appendicitis?

Answer 34

• NPO, IV fluids, control pain/puke/fever

- Surgery ASAP

Question 35

Abx in perforated Appendicitis?

Answer 35

Triple Amp/Gent/Flagyl

Question 36

Tx of constipation in infants?

Answer 36

Flycerine suppositories, lubricated thermometer

Question 37

Tx of constipation in older kids?

Answer 37

Glycerine suppositories, Miralax