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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
Q

Most common congenital malformation of gi tract

A

Meckel diverticulum
(Fistula)
Tx=Sx removal

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26
Q

S/s Meckel Diverticulum

A

Abd pain
Bloody stools
May be anemic

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27
Q

Dx Meckel diverticulum

A

Radionucleotide scintigraphy (Meckel Scan)

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28
Q

Abdominal pain, bloody stools, and occasionally anemic

A

Signs and symptoms of meckel diverticulum

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29
Q

Remnant of omphalomesenteric duct that Connects yolk sac w/ primitive midgut during fetal life fails to obliterate -> fistula

A

Mickel diverticulum

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30
Q

DX Mickel diverticulum

A

Radionucleotide scintigraphy

31
Q

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

A

Hirsprung disease

32
Q

Failure to pass meconium within 24 to 48H afterbirth, constipation/distention in the infant; constipation/impaction childhood

A

Clinical manifestation Hirsprung disease

33
Q

Childhood signs and symptoms Hirsprung disease

A

Constipation/impaction

<1 BM/ week; ribbon-like stool

34
Q

Hirsprung disease–>Post Op

A

NG tube until peristalsis/stool in colostomy; assess abdominal distention

35
Q

Preop Hirsprung disease

A

Daily enemas/ stool softeners ->BM
Bowel cleansing
Antibiotics
Nutritional status

36
Q

dx hirsprung disease

A

Anorectal manometry

Digital rectal exam, barium enema, rectal biopsy, HX

37
Q

Susceptible individuals cannot digest gliadin factin

A

Celiac disease

38
Q

Gluten consist of

A

Glutenin and gliadin

39
Q

Definitive diagnosis celiac disease

A

Jejunal biopsy

40
Q

Most common cause of vomiting in pediatrics

A

Gastroenteritis

41
Q

TX vomiting

A 
NPO (3-8H)
Ice chips, water/Popsicles in small amounts (clear liquids)
\+dry crackers/toast
Day2 – soft diet
Day3 - reg diet
42
Q

Definitive DX Hirschsprung’s disease

A

Barium enema (unprepped)

43
Q

Most common malignant neoplasm of of the kidney in children

A

Wilms tumor (nephroblastoma)

44
Q

Most common intestinal parasite in the US; children over five years, resolve spontaneously (4–6 W)

A

Guardiasis(Protozoa)

45
Q

TX: Guardiasis (protozoa)

A

Furoxone=drug of choice

$$$$$

46
Q

Dx guardiasis (protozoa)

A

Stool string test-attached string to capsule – swallow

47
Q

whelms tumor favors the

A

Left kidney

48
Q

Failure 1+ testes to descend

A

Cryptorchidism
More common in pre-terms
persist after 1y-refer to surgeon

49
Q

Abdominal cryptorchidism

A

Nonpalpable

50
Q

Acute glomerulonephritis typically follows:

A

Streptococcal upper respiratory or skin infection; clinically apparent 1–3 weeks after acute infection

51
Q

Initial S/S of acute Glomerulonephritis

A

Puffiness/dark colored urine

52
Q

Later as/S a cute glomerulonephritis

A

Moderate edema, pale, lethargic/irritable

Older children - HA, abd discomfort, dysuria

53
Q

Dx acute glomerulonephritis

A

UA-hematuria
⬇️ serum albumin/⬆️ASO (antiSTREPTOlysin)
CXR: ⬆️❤️& pulmonary congestion

54
Q

Acute edematous phase - glomerulonephritis

A

10-14d, listless, anorexic

Improvement=urine output

55
Q

Involuntary voiding of urine beyond age @ which vol. control is expected
(Symptom NOT disease)

A

Enuresis

Symptom NOT disease

56
Q

Hospitalize (acute glomerulonephritis) if…

A

Gross hematuria

HTN

57
Q

Complications of acute glomerulonephritis

A

HTN encephalopathy
Acute cardia decomp
Renal failure

58
Q

Hemolytic uremic Syndrome triad

A

Hemolytic anemia
thrombocytopenia
acute renal failure

59
Q

Lacks HexA for lipid metabolism->fatty deposits in the brain

A

Tay Sachs

Jews

60
Q

Exaggerated Marro
Cherry red macula
⬇️head control/severe hypotonia
Death by age 5 D/T cachexia

A

Tay-Sachs disease

Autosomal recessive

61
Q

Prognosis 2 yo tay-Sachs

A

Convulsion/blindness

62
Q

Avascular necrosis of femoral head

A

Coca plans/ perthes disease

63
Q

Four stages of perthes disease

A

Avascular
Fragmentation/revascularization
Reparative
Regenerative

64
Q

Slipped femoral capital epiphysis

A

Medical emergency
Slipping posteriorly and inferiorly
Widening growth plate/ slipped Epiphysis

65
Q

Therapeutic management slipped femoral capital epiphysis

A 
TX ASAP
Nonweightbearing on DX/bedrest
Prevent necrosis
May need surgical stabilization
30% develop in opposite hip
66
Q

Chronic inflammation of synovium & joint effusion in 1+ joint beginning before age 16y & last >6w

A

Juvenile rheumatoid arthritis

67
Q

DX juvenile rheumatoid arthritis

A

Exclusion/ESR

Laytex fixation test – not reliable

68
Q

Therapeutic management – juvenile rheumatoid arthritis

A

No cure! Preserve joint function/ROM
prevent physical joint deformation
Iridocyclitis or uveitis -> ophthalmologist

69
Q

Meds – juvenile rheumatoid arthritis

A

NSAIDs,SAaRDS, cytotoxic’s, corticoid steroids (most potent)
Give meds 1H before getting up
Attend school even if some pain

SX if synovitis

70
Q

Brushfield spots

A

Trisomy 21 – down syndrome

71
Q

Missing portion of chromosome number five

A

Cri-du-cat

72
Q 
We cut pitched cry (mew like)
Microcephaly 
Eyes far apart
FTT
Severe mental retardation
A

Cry-du-chat

73
Q

Males extra X chromosome(s)
Testosterone only for appearance
⬆️X⬆️impairment
Apparent at puberty

A

Klinefelter’s

74
Q

Only females
Absent X
Estrogen for 2ndary sex characteristics

N201 (21 decks)

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