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N201 > Peds Exam 3 Gastrointestinal System Outline > Flashcards

Peds Exam 3 Gastrointestinal System Outline Flashcards

1
Q

Paroxysmal abdominal pain or cramping

A

Colic

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2
Q

S/S Colic

A 
Cries
Pulls legs up
Red Faced 
Fist Clenched
3h@3x a week
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3
Q

Tx Colic

A

Anti-flatulent
Car babies, swings, colic carry
Feet to head
Move–>get air out

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4
Q

Passive transfer of gastric content s into esophagus;

A

Gastroesophageal Reflux (GERD)

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5
Q

GERD S/S

A 
Passive regurgitation/ emesis immediately 
less common( poor wt gain, gagging)
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6
Q

Sx GERD

A

Nissen Fundoplication

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7
Q

Projectile, sour smelling vomit
Visible peristalsis
–>hungry, dehydrated, FTT

A

Pyloric Stenosis

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8
Q

Na loss> H2O

A

Hypotonic Dehydration

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9
Q

Isotonic Dehydration

Turgor; feel & mucous membranes

A

Poor

Dry

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10
Q

Isotonic Dehydration

Pulse, behavior

A

Rapid, irritable to lethargic

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11
Q

Hypotonic Dehydration Skin

A

Very poor turgor, clammy, mucous membranes slightly moist, pulse very rapid

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12
Q

Hypotonic Dehydration Pulse

A

Very Rapid

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13
Q

Behavior-Hypotonic Dehydration

A

Lethargic to coma

Convulsions

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14
Q

Hypertonic Dehydration Skin

A

Fair, thickened, doughy, parched

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15
Q

Hypertonic Dehydration Pulse

A

Moderately Rapid

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16
Q

HR Dehydration

A

Hypotonic>Hypertonic>Isotonic

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17
Q

Tx Pyloric Stenosis

A 
Sx Pyloromyotomy (Fredet-Ramstedt procedure)
Pre-op: rehydrate Post-Op:Clear liquids
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18
Q

Telescoping of 1 portion of the intestine into another, may ->ischemia

A

Intussusception

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19
Q

Most common cause of intestinal obstruction (3mo-5yr)

A

Intussusception

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20
Q

Sausage shaped mass in URQ
(Ileoc. Valve=most common site)
WAVES of pain

A

Intussusception

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21
Q

Dx pyloric stenosis

A

U/s

Barium swallow

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22
Q

Dx evaluation intussusception

A

Barium enema (May be enough to fix-hydrostatic reduction)

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23
Q

Tx intussusception

A

Hydrostatic reduction

Sx-manual reduction & resection of any non-viable intestine

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24
Q

Post op intussusception

A

Alert MD of normal stool- passage of stool=reduced intussusception

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25
Most common congenital malformation of gi tract
Meckel diverticulum (Fistula) Tx=Sx removal
26
S/s Meckel Diverticulum
Abd pain Bloody stools May be anemic
27
Dx Meckel diverticulum
Radionucleotide scintigraphy (Meckel Scan)
28
Abdominal pain, bloody stools, and occasionally anemic
Signs and symptoms of meckel diverticulum
29
Remnant of omphalomesenteric duct that Connects yolk sac w/ primitive midgut during fetal life fails to obliterate -> fistula
Mickel diverticulum
30
DX Mickel diverticulum
Radionucleotide scintigraphy
31
Absence of the ganglionic innervation to the muscle of the bow (typically lower portion of the sigmoid colon); d/t abnormal gene on chromosome 10
Hirsprung disease
32
Failure to pass meconium within 24 to 48H afterbirth, constipation/distention in the infant; constipation/impaction childhood
Clinical manifestation Hirsprung disease
33
Childhood signs and symptoms Hirsprung disease
Constipation/impaction | <1 BM/ week; ribbon-like stool
34
Hirsprung disease-->Post Op
NG tube until peristalsis/stool in colostomy; assess abdominal distention
35
Preop Hirsprung disease
Daily enemas/ stool softeners ->BM Bowel cleansing Antibiotics Nutritional status
36
dx hirsprung disease
Anorectal manometry | Digital rectal exam, barium enema, rectal biopsy, HX
37
Susceptible individuals cannot digest gliadin factin
Celiac disease
38
Gluten consist of
Glutenin and gliadin
39
Definitive diagnosis celiac disease
Jejunal biopsy
40
Most common cause of vomiting in pediatrics
Gastroenteritis
41
TX vomiting
``` NPO (3-8H) Ice chips, water/Popsicles in small amounts (clear liquids) +dry crackers/toast Day2 – soft diet Day3 - reg diet ```
42
Definitive DX Hirschsprung's disease
Barium enema (unprepped)
43
Most common malignant neoplasm of of the kidney in children
Wilms tumor (nephroblastoma)
44
Most common intestinal parasite in the US; children over five years, resolve spontaneously (4–6 W)
Guardiasis(Protozoa)
45
TX: Guardiasis (protozoa)
Furoxone=drug of choice | $$$$$
46
Dx guardiasis (protozoa)
Stool string test-attached string to capsule – swallow
47
whelms tumor favors the
Left kidney
48
Failure 1+ testes to descend
Cryptorchidism More common in pre-terms persist after 1y-refer to surgeon
49
Abdominal cryptorchidism
Nonpalpable
50
Acute glomerulonephritis typically follows:
Streptococcal upper respiratory or skin infection; clinically apparent 1–3 weeks after acute infection
51
Initial S/S of acute Glomerulonephritis
Puffiness/dark colored urine
52
Later as/S a cute glomerulonephritis
Moderate edema, pale, lethargic/irritable Older children - HA, abd discomfort, dysuria
53
Dx acute glomerulonephritis
UA-hematuria ⬇️ serum albumin/⬆️ASO (antiSTREPTOlysin) CXR: ⬆️❤️& pulmonary congestion
54
Acute edematous phase - glomerulonephritis
10-14d, listless, anorexic | Improvement=urine output
55
Involuntary voiding of urine beyond age @ which vol. control is expected (Symptom NOT disease)
Enuresis | Symptom NOT disease
56
Hospitalize (acute glomerulonephritis) if...
Gross hematuria | HTN
57
Complications of acute glomerulonephritis
HTN encephalopathy Acute cardia decomp Renal failure
58
Hemolytic uremic Syndrome triad
Hemolytic anemia thrombocytopenia acute renal failure
59
Lacks HexA for lipid metabolism->fatty deposits in the brain
Tay Sachs | Jews
60
Exaggerated Marro Cherry red macula ⬇️head control/severe hypotonia Death by age 5 D/T cachexia
Tay-Sachs disease | Autosomal recessive
61
Prognosis 2 yo tay-Sachs
Convulsion/blindness
62
Avascular necrosis of femoral head
Coca plans/ perthes disease
63
Four stages of perthes disease
Avascular Fragmentation/revascularization Reparative Regenerative
64
Slipped femoral capital epiphysis
Medical emergency Slipping posteriorly and inferiorly Widening growth plate/ slipped Epiphysis
65
Therapeutic management slipped femoral capital epiphysis
``` TX ASAP Nonweightbearing on DX/bedrest Prevent necrosis May need surgical stabilization 30% develop in opposite hip ```
66
Chronic inflammation of synovium & joint effusion in 1+ joint beginning before age 16y & last >6w
Juvenile rheumatoid arthritis
67
DX juvenile rheumatoid arthritis
Exclusion/ESR | Laytex fixation test – not reliable
68
Therapeutic management – juvenile rheumatoid arthritis
No cure! Preserve joint function/ROM prevent physical joint deformation Iridocyclitis or uveitis -> ophthalmologist
69
Meds – juvenile rheumatoid arthritis
NSAIDs,SAaRDS, cytotoxic's, corticoid steroids (most potent) Give meds 1H before getting up Attend school even if some pain SX if synovitis
70
Brushfield spots
Trisomy 21 – down syndrome
71
Missing portion of chromosome number five
Cri-du-cat
72
``` We cut pitched cry (mew like) Microcephaly Eyes far apart FTT Severe mental retardation ```
Cry-du-chat
73
Males extra X chromosome(s) Testosterone only for appearance ⬆️X⬆️impairment Apparent at puberty
Klinefelter's
74
Only females Absent X Estrogen for 2ndary sex characteristics
Turners

N201 (21 decks)

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