Pediatric GI Disorders and Pediatric Jaundice Flashcards
what is the most helpful study to quantify the severity of reflux in peds?
24-hour intra esophageal pH and impedance monitoring
what does impedance testing measure?
the direction of bolus movement in the esophagus
where do most cases of intussusception occur?
at the ileocecal junction
when is pyloric stenosis most common?
2-4 weeks of life
what lab findings would you expect to see in a patient with pyloric stenosis?
hypochloremic, hypokalemic, and metabolic alkalosis
what is the characteristic sign of Hirschsprung disease?
failure to pass meconium within the first 24-48 hours of life
what is very suggestive of hirschsprung disease?
palpable stool throughout the abdomen, empty rectal vault, history of never having an unassisted stool
how do you make a definitive diagnosis of hirschspring disease?
a rectal biopsy is a must
rotavirus used to be huge- filling up hospitals and such; why is it not so much anymore?
a rotavirus vaccine given in infancy (3 doses) as greatly reduced the incidence of this illness
which form of hyperbilirubinemia can deposit in the brain?
unconjugated: it is not bound to albumin so therefore is lipid soluble and can cross the BBB
the babies most at risk for hyperbili are those born to moms who are what blood type?
type O or Rh negative
when is the direct Coombs test used?
in situations where hyperbili is felt to result from hemolysis, especially ABO incompatibility in newborns; it is a test that looks for antibodies directly on the rbc’s of the baby
what is the most common cause of conjugated hyperbilirubinemia in a new born?
biliary atresia
what are the signs and symptoms of biliary atresia?
cholestatic jaundice (conjugated hyperbili), hepatomegaly, acholic stools
how does phototherapy decrease bilirubin levels in infants?
it isomerizes unconjugated bilirubin making it water soluble
