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Pediatrics II > Pediatrics: GI Conditions > Flashcards

Pediatrics: GI Conditions Flashcards

1
Q

A patient presnts with:

FTT
Esophagitis
Refusal of feeding
Dystonic Neck Posturing

What are you concerned for?

A

GERD

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2
Q

How should GERD be treated?

A

lifestyle modification, upright feeding

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3
Q

When should medications like omeprazole or ranitidine be considered for GERD?

A

refractory cases

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4
Q

A patient presents with the following:

Olive-like mass in RUQ

Post-Prandial Projectile Emesis

Dehydration, FTT

Hx of Macrolide ABX during 1st week of life.

What are you concerned for?

A

Hypertrophic Pyloric Stenosis

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5
Q

What test should be 1st line for pyloric stenosis?

A

US

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6
Q

If US is inconclusive for pyloric stenosis, what can be ordered?

A

Barium Contrast Study

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7
Q

On Barium Contrast Study, you notice a (+) String Sign. What condition is this indicative of?

A

hypertrophic pyloric stenosis

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8
Q

What is the tx of choice for pyloric stenosis?

A

surgery

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9
Q

A patient presents with the following:

Bilious Emesis w/in 48 hours of birth

Failure to pass meconium

Abdominal Distension

What is this concerning for?

A

congenital intestinal atresia

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10
Q

The following conditions increase the risk for what?

CF
Down Syndrome
Maternal TOBB use

A

congenital intestinal atresia

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11
Q

What would you expect to see on X-Ray with duodenal congenital intestinal atresia?

A

Double Bubble Sign on X-Ray

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12
Q

What would you expect to see on X-Ray with jejunoileal/colonic congenital intestinal atresia?

A

dilated loops

air fluid levels

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13
Q

What test is used for confirmation of congenital intestinal atresia?

A

GI Contrast Study and Contrast Enema

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14
Q

What is the progression of treatment for congenital intestinal atresia

A

broad spectrum abx

withhold feeding, IV hydration

Surgery

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15
Q

A patient presents with:

Bilious/Yellow Vomit
Abdominal Pain
Hemodynamic Instability

Abd. Distension
Abd. Tenderness

What is this concerning for?

A

Midgut Malrotation

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16
Q

Why should you order an X-Ray for midgut malrotation?

A

r/o perforation

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17
Q

What is the test of choice to dx midgut malrotation, and what should you expect to find?

A

Upper GI Contrast Study:

Corkscrew Appearance

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18
Q

What surgical intervention is used in midgut malrotation to prevent ischemia and recurrence?

A

LADD procedure

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19
Q

A patient presents with the following:

Abdominal Pain
Abdominal Mass
Currant Jelly Stool 
Sausage shaped mass
Sudden onset abd. pain
A

Intussusception

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20
Q

You suspect a patient has intussusception. What is the test of choice, and what should you expect to see?

A

Abdominal US: Target Sign/Coiled Spring Sign

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21
Q

What treatment for intussusception is also diagnostic?

A

Hydrostatic/Pneumatic Enema

22
Q

What is the most common pediatric surgical emergency?

A

Appendicitis

23
Q

A patient presents with:

Anorexia

Migrating pain from periumbilical to RLQ

Fever

Vomiting

A

Appendicitis

24
Q

What physical exam tests should you expect to be positive with appendicitis?

A

Guarding
Rebound Tenderness
Obturator Sign
Iliopsoas Sign

25
Q

What diagnostic imaging can be useful in appendicitis?

A

US

Low dose CT

26
Q

What is the most common etiology of diarrhea?

A

viral (Norovirus, Rotavirus, Adenovirus)

27
Q

Would the following indicate increased or decreased severity of diarrhea?

Fever
Pain
Blood in stool
Recent Abx
Dehydration
Leukocytosis
A

Serious.. Red Flags

28
Q

Is a stool culture needed for routine diarrhea?

A

no

29
Q

What tests can be ordered for diarrhea with red flags?

A 
CBC
CMP
Celiac Testing
Urine Cx
Stool Tests
30
Q

Should you prescribe abx for bloody diarrhea in well-appearing children? Why or why not?

A

no, risk of HUS

31
Q

What is the recommended tx for diarrhea?

A

hydration

32
Q

Are antimotility agents recommended for tx of diarrhea?

A

no

33
Q

A patient presents with the following:

Anemia
FTT
IgA Abs to TTG

A

Celiac

34
Q

Celiac Disease

Allergic Enteropathy

Malapsorption

Functional Diarrhea

These are all causes of…

A

chronic diarrhea

35
Q

UC or Chron?

Transmural Inflammation
Skip Lesions
Cobblestone Appearance
Mouth to Anus

A

Chron

36
Q

UC or Chron?

Rectum to Colon
Mucosal layer

Diffuse/continuous erythema, friability, ulcer

A

UC

37
Q

The following medications can be used for what condition?

Aminosalicylates

Immunomodulating/Biologic Agents

Steroids

A

IBD

38
Q

Patients presenting with the following should be concerning for…

Diarrhea
Abd. Pain
Tenesmus

A

IBD

39
Q

Which condition has the following characteristics:

2% of the population

2:1 m:f ratio

2% have complications

2ft. from ileocecal valve

A

Meckel’s Diverticulum

40
Q

A patient presents with painless rectal bleeding. What is this concerning for and what test confirms?

A

Meckel’s Diverticulum

Technetium-99 Scan

41
Q

What is the treatment of choice for Meckel’s Diverticulum?

A

Surgery

42
Q

What condition can mimic Meckel’s Diverticulum?

A

Appendicitis

43
Q

The following are causes of…

Anal stenosis
Hypothyroidism
Hypercalcemia
Celiac Dz
CF
Fibrosis
Hirschprung
A

Organic Constipation

44
Q

The following are characteristics of…

Failure to pass meconium

FTT

Abd. Distension

Lumbosacral/Neuro involvement

Occult blood in stool

A

Organic Constipation

45
Q

What is the preferred tx for constipation?

A

fluids, gradual increase of fiber intake

Decrease dairy

Juice (apple, pear)

46
Q

What imaging should be ordered to r/o impaction in constipation?

A

X-Ray

47
Q

This condition is characterized by:

Failure to pass meconium

Bilious Vomiting

Abd. Distension

(+) Squirt Sign

A

Hirschsprung Disease

48
Q

This condition is an absence of ganglion cells that occurs < 6 weeks of age…

A

Hirschsprung Disease

49
Q

What is the test gold standard for Hirschsprung disease? What is often used instead?

A

Rectal Biopsy

Contrast enema

50
Q

What is the definitive Tx for Hirschsprung disease?

A

surgical resection of affected area

51
Q

What is the definition of acute diarrhea?

A

3+ loose stools/day x 5 days or less

Pediatrics II (5 decks)

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