Pediatric GI Disorders and Pediatric Jaundice Flashcards

1
Q

What is the most helpful study to quantify the severity of GERD?

A

24-hour intraesophageal pH and impedance monitoring

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2
Q

What does impedance testing measure?

A

Direction of bolus movement in the esophagus

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3
Q

Where is intussusception most common?

A

Ileum invaginating into the colon at the ileocecal junction

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4
Q

What do 80% of kids with intussusception present with?

A

Rectal bleeding (currant jelly stools)

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5
Q

When is pyloric stenosis most common?

In which sex is it more common?

What does it present with?

A

1) Age 2-4 weeks
2) Boys
3) Projectile vomiting

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6
Q

What does pyloric stenosis lead to?

A

1) Hypochloremia
2) Hypokalemia
3) Metabolic alkalosis

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7
Q

Hirschsprung disease is more common in what sex?

It is due to?

A

1) Boys

2) Failure of ganglion cells to migrate down the developing colon

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8
Q

What is Hirschsprung disease characterized by?

A

Failure to pass meconium within the first 24-28 hours of life

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9
Q

What findings suggest an infant has Hirschsprung disease?

A

1) Palpable stool throughout abdomen
2) Empty rectal vault
3) Hx of never having unassisted stool

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10
Q

What is required for a definitive diagnosis of Hirschsprung disease?

A

Rectal biopsy

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11
Q

Elevated conjugated bilirubin is suggestive of problems in?

A

Liver/biliary tree

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12
Q

Elevated unconjugated bilirubin at high levels can be deposited in?

This will result in what condition?

A

1) Basal ganglia and brainstem

2) Bilirubin Induced Neurologic Dysfunction (BIND) also called kernicterus

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13
Q

The direct Coombs test is performed on the newborns rbc’s in situations where hyperbilirubinemia is felt to result from?

A

ABO incompatibility

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14
Q

The passage of stool is an important way that the infant gets rid of?

Stool remaining in the gut for a longer period of time allows for more breakdown of?

A

1) Excess bilirubin

2) Conjugated bilirubin and more reabsorption into the blood

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15
Q

Which infants are most at risk for hyperbilirubinemia?

A

Those born to moms who are Type O or Rh negative

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16
Q

What does Crigler-Najjar type 1 (Total UDPGT deficiency) results in?

What about Crigler-Najjar type 2 (partial UDPGT deficiency)?

A

1) Severe hyperbilirubinemia with high risk of BIND/Kernicterus
2) Mild hyperbilirubinemia with low risk of BIND/Kernicterus

17
Q

What decreases bilirubin levels in infants by isomerizing the unconjugated bilirubin making it water soluble?

A

Phototherapy

18
Q

What is the most common cause of elevated conjugated bilirubin levels in infants?

A

Biliary atresia

19
Q

What are the symptoms of biliary atresia?

A

1) Cholestatic jaundice (conjugated hyperbilirubinemia)
2) Hepatomegaly
3) Acholic stools