Pediatrics: GI Conditions Flashcards
A patient presnts with:
FTT
Esophagitis
Refusal of feeding
Dystonic Neck Posturing
What are you concerned for?
GERD
How should GERD be treated?
lifestyle modification, upright feeding
When should medications like omeprazole or ranitidine be considered for GERD?
refractory cases
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?
Hypertrophic Pyloric Stenosis
What test should be 1st line for pyloric stenosis?
US
If US is inconclusive for pyloric stenosis, what can be ordered?
Barium Contrast Study
On Barium Contrast Study, you notice a (+) String Sign. What condition is this indicative of?
hypertrophic pyloric stenosis
What is the tx of choice for pyloric stenosis?
surgery
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?
congenital intestinal atresia
The following conditions increase the risk for what?
CF
Down Syndrome
Maternal TOBB use
congenital intestinal atresia
What would you expect to see on X-Ray with duodenal congenital intestinal atresia?
Double Bubble Sign on X-Ray
What would you expect to see on X-Ray with jejunoileal/colonic congenital intestinal atresia?
dilated loops
air fluid levels
What test is used for confirmation of congenital intestinal atresia?
GI Contrast Study and Contrast Enema
What is the progression of treatment for congenital intestinal atresia
broad spectrum abx
withhold feeding, IV hydration
Surgery
A patient presents with:
Bilious/Yellow Vomit
Abdominal Pain
Hemodynamic Instability
Abd. Distension
Abd. Tenderness
What is this concerning for?
Midgut Malrotation
Why should you order an X-Ray for midgut malrotation?
r/o perforation
What is the test of choice to dx midgut malrotation, and what should you expect to find?
Upper GI Contrast Study:
Corkscrew Appearance
What surgical intervention is used in midgut malrotation to prevent ischemia and recurrence?
LADD procedure
A patient presents with the following:
Abdominal Pain Abdominal Mass Currant Jelly Stool Sausage shaped mass Sudden onset abd. pain
Intussusception
You suspect a patient has intussusception. What is the test of choice, and what should you expect to see?
Abdominal US: Target Sign/Coiled Spring Sign
What treatment for intussusception is also diagnostic?
Hydrostatic/Pneumatic Enema
What is the most common pediatric surgical emergency?
Appendicitis
A patient presents with:
Anorexia
Migrating pain from periumbilical to RLQ
Fever
Vomiting
Appendicitis
What physical exam tests should you expect to be positive with appendicitis?
Guarding
Rebound Tenderness
Obturator Sign
Iliopsoas Sign
What diagnostic imaging can be useful in appendicitis?
US
Low dose CT
What is the most common etiology of diarrhea?
viral (Norovirus, Rotavirus, Adenovirus)
Would the following indicate increased or decreased severity of diarrhea?
Fever Pain Blood in stool Recent Abx Dehydration Leukocytosis
Serious.. Red Flags
Is a stool culture needed for routine diarrhea?
no
What tests can be ordered for diarrhea with red flags?
CBC CMP Celiac Testing Urine Cx Stool Tests
Should you prescribe abx for bloody diarrhea in well-appearing children? Why or why not?
no, risk of HUS
What is the recommended tx for diarrhea?
hydration
Are antimotility agents recommended for tx of diarrhea?
no
A patient presents with the following:
Anemia
FTT
IgA Abs to TTG
Celiac
Celiac Disease
Allergic Enteropathy
Malapsorption
Functional Diarrhea
These are all causes of…
chronic diarrhea
UC or Chron?
Transmural Inflammation
Skip Lesions
Cobblestone Appearance
Mouth to Anus
Chron
UC or Chron?
Rectum to Colon
Mucosal layer
Diffuse/continuous erythema, friability, ulcer
UC
The following medications can be used for what condition?
Aminosalicylates
Immunomodulating/Biologic Agents
Steroids
IBD
Patients presenting with the following should be concerning for…
Diarrhea
Abd. Pain
Tenesmus
IBD
Which condition has the following characteristics:
2% of the population
2:1 m:f ratio
2% have complications
2ft. from ileocecal valve
Meckel’s Diverticulum
A patient presents with painless rectal bleeding. What is this concerning for and what test confirms?
Meckel’s Diverticulum
Technetium-99 Scan
What is the treatment of choice for Meckel’s Diverticulum?
Surgery
What condition can mimic Meckel’s Diverticulum?
Appendicitis
The following are causes of…
Anal stenosis Hypothyroidism Hypercalcemia Celiac Dz CF Fibrosis Hirschprung
Organic Constipation
The following are characteristics of…
Failure to pass meconium
FTT
Abd. Distension
Lumbosacral/Neuro involvement
Occult blood in stool
Organic Constipation
What is the preferred tx for constipation?
fluids, gradual increase of fiber intake
Decrease dairy
Juice (apple, pear)
What imaging should be ordered to r/o impaction in constipation?
X-Ray
This condition is characterized by:
Failure to pass meconium
Bilious Vomiting
Abd. Distension
(+) Squirt Sign
Hirschsprung Disease
This condition is an absence of ganglion cells that occurs < 6 weeks of age…
Hirschsprung Disease
What is the test gold standard for Hirschsprung disease? What is often used instead?
Rectal Biopsy
Contrast enema
What is the definitive Tx for Hirschsprung disease?
surgical resection of affected area
What is the definition of acute diarrhea?
3+ loose stools/day x 5 days or less
