Pediatric GI Flashcards
what is the definition of GER?
the passage of gastric contents into the esophagus
“the happy spitter”
what is the definition of GERD?
when symptoms and/or complications are present as a result of GER
ex: unable to gain weight, difficulty eating, failure to thrive
how do you distinguish GER vs GERD?
based on history of presenting illness
what is the treatment for GERD?
kids should sleep on their back hypoallergenic formula smaller feeds more frequently upright position during and after feeding for 30 minutes medications: H2 antagonists or PPI surgery: fundoplication
what is intussusception?
telescoping of one part of the intesting (most commonly ileocecal) resulting in impaired venous return, bowel ischemia, edema, necrosis or perforation
what is the clinical presentation of intussusception?
episodes of irritability, colicky pain and emesis
currant jelly stools
palpable tubular mass in RUQ
coiled spring apperance on air enema
what is the treatment for intussusception?
fluid resuscitation
hydrostatic reduction with contrast enema OR pneumatic reduction with an air enema
open reduction is needed if it won’t reduce with enema or if reoccurance
what is pyloric stenosis?
gastric outlet obstruction due to hypertrophied pyloric junction
M > F
usually presents in the first 2-3 months of life
what is the clinical presentation of pyloric stenosis?
projectile vomiting
dehydration (decresed urine output)
poor weight gain
what is the classic metabolic picture of pyloric stenosis?
hypochloremic
hypokalemic
metabolic alkalosis
what PE findings are associated with pyloric stenosis?
olive sized, muscular, mobile, nontender mass in the epigastrium
peristaltic waves
“string sign” on upper GI
thickened, elongated pylorus on US
what is the treatment for pyloric stenosis?
pyloromyotomy
what is hirschsprung dz?
failure of the ganglion cells of the myenteric plexus to migrate into the developing colon
tonically contracted colon
what is the clinical presentation of Hirschsprung dz?
infant fails to pass meconium within first 24-48 hours of life OR infant who requires repeat rectal stimulation to induce BM
poor feeding
bilious vomiting
abdominal distention
what are PE findings associated with hirschsprung dz?
palpable stool throughout the abdomen
empty rectal vault
never having unassisted stool
what PE findings would be associated with a short segment affected by hirschsprung dz?
failure to grow
intermittent bouts of intestinal obstruction
bloody diarrhea
occasional bowel perforations
*may be undetected until later in childhood
what will the XR show for Hirschsprung dz?
distention of the proximal bowel
no gas or feces in the rectum
what is the treatment for Hirschsprung dz?
first stage: divertion colostomy with bowel that contains ganglion cells
second stage: aganglionic portion is removed and the ganglionic segment is anastomosed to the rectum
what is the clinical presentation of celiac dz?
diarrhea failure to thrive abd distension abd pain vomiting fatigue constipation
what is the MOA of celiac dz?
- innate immune detection of gluten antigen
- T-cell development
- T-cell and B-cell co-stimulation
- cytokines promote inflammation
