Pediatric Part 1 Flashcards
If you suspect a TE fistula, what diagnostic should you obtain?
NG tube placement + X-ray
What will be seen on X-ray after NG tube placement if a TE fistula is present?
NG tube coils in the blind esophagus
What diagnostic measure should be obtained when an imperforate anus is present?
Cross table X-ray
What are the 2 treatment options for an imperforate anus?
- Surgery
- Colostomy until surgery later in life
TE fistulas and imperforate anus are part of what group of abnormalities?
VACTERL
- Vertebral
- Anal
- Cardiac
- Tracheal
- Esophageal
- Renal
- Limb
Describe what will be seen with Gastroschisis?
Bowel herniates to RIGHT of midline on the anterior abdomen and it is NOT covered by membrane
Describe what will be seen with an Omphalocele?
Bowel herniates at midline on the anterior abdomen and it IS covered by membrane
What is a treatment option for both Gastroschosis and Omphaloceles?
Silo bag to reduce the bowel back into the abdomen
What condition may look similar to Gastroschisis or Omphalocele?
Extrophy of the Bladder
Describe what will be seen with Extrophy of the Bladder?
Red, Wet and Shining bladder that has herniated at midline of the anterior abdomen
Bowel herniates into the chest with Congenital Diaphragmatic Hernias. What signs will be present?
Scaphoid abdomen
Bowel sounds in the chest
+/- pulmonary hypoplasia = respiratory distress
What diagnostic test will confirm Congenital Diaphragmatic Hernias?
X-ray shows bowel in the chest
What other measures may need to be done if respiratory distress is present with Congenital Diaphragmatic Hernias?
Intubation + Surfactant administration
If Biliary Emesis is present, that means the problem is where?
Distal to where the gallbladder drains into the duodenum
What 2 conditions can present with “double bubbles” on xray?
Duodenal atresia
Annular pancreas
What condition will present with a “triple bubble” on xray? What caused this condition?
Jejunal atresia
– Mother used cocaine while pregnant which caused infarction/vasoconstriction of blood supply to intestines
Duodenal/Jejunal Atresia and Annular pancreas will both present how?
Biliary emesis
If a preemie has a bloody bowel movement, what should you be considered about?
Necrotizing Enterocolitis
What will be seen on X-ray with Necrotizing Enterocolitis?
Pneumatosis Intestinalis = air in the bowel wall
What is the treatment for Necrotizing Enterocolitis?
NPO, TPN, IVF, Antibiotics and resection of dead bowel
A meconium plug often occurs in CF infants. What is the diagnostic and therapeutic measure?
Water-soluble contrast enema
What may be seen on X-ray if a CF infant has a meconium plug?
Gas filled plug
What causes Hirschsprung’s Disease?
Failure of inhibitory neurons to migrate to the distal colon
What will be absent from the distal colon with Hirschsprung’s Disease?
- Myenteric plexus
- Auerbach plexus
- Peristalsis
- Colonic relaxation
The distal colon is unable to relax/aperistaltic with Hirschsprung’s Disease. How may that present in a newborn or toddler?
Newborn = failure to pass meconium
Toddler = overflow incontinence
What is the best diagnostic test for Hirschsprung’s Disease?
Biopsy
What will be seen on X-ray with Hirschsprung’s?
Narrowed distal colon
What signs/symptoms will be present with Intussusception? (3)
- Episodic abdominal pain that is relieved by being in the fetal position
- Currant jelly stool
- Sausage shaped mass
What test is diagnostic and therapeutic for Intussusception?
Air contrast enema
What signs/symptoms will be present with Pyloric Stenosis?
- Projectile vomiting
- Visible peristalsis
- Olive shaped mass
What diagnostic test should be done for Pyloric stenosis and what will you see?
Abdominal US
= Donut sign
What should you do before proceeding with a pyloromyotomy?
Correct the electrolyte disturbances
What electrolyte disturbances are often present with pyloric stenosis?
Hypokalemic Hypochloremic Metabolic Alkalosis
– From the persistent vomiting
What is Biliary Atresia?
Absent biliary tree
What is a sign of Biliary Atresia?
Worsening direct hyperbilirubinemia
How is Biliary Atresia diagnosed?
Phenobarbital HIDA scan
What is the presentation of Choanal Atresia?
Baby turns blue when feeding because they are unable to breathe through their nose
– corrects when not feeding
What is diagnostic of choanal atresia?
Catheter unable to pass through the nares
