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I & E 2 > Peds GI > Flashcards

Peds GI Flashcards

1
Q

Pyloric stenosis- Eti

A
  • Narrowing outlet of stomach- fails to relax after meal
  • Unknown cause
  • 3:1000
  • M>F
  • Fam hx
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2
Q

Pyloric stenosis- Sx

A
  • 2-4 wks of age
  • Post-prandial distension, visible peristaltic wave
  • Olive like mass
  • Regurgitation, nonbilious vomiting, projectile
  • Hungry
  • severe dehydration, lytes imbalance, oliguria
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3
Q

Pyloric stenosis- Dx

A
  • Upper GI with barium: sting sign

- US

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4
Q

Pyloric stenosis- Tx

A
  • Most common cause for surg
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5
Q

Intussusception- Eti

A
  • Telescoping of bowel into distal segment
  • Most common cause of intestinal obstruction in 1st 2 yrs
  • Idiopathic
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6
Q

Intussusception- Sx

A
  • Current jelly stool - 12 hrs
  • V/D
  • Severe cycles of pain, appear well between
  • Sausage shaped mass
  • Tender to palpation, distension
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7
Q

Intussusception- Dx

A
  • Saline/ contrast/ air enema

- 3% risk of recurrence

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8
Q

Intussusception- Tx

A
  • Enema to reduce

- Surgery if perforation, peritonitis, necrosis

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9
Q

Intussusception- Tx

A
  • Enema to reduce

- Surgery if perforation, peritonitis, necrosis

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10
Q

Meconium Ileus- Eti

A
  • Bowel obstruction from thickened meconium

- CF until proven otherwise

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11
Q

Meconium Ileus- Sx

A
  • Normal wt
  • Distended abd
  • Failure to pass meconium
  • Loops of thick, distended bowel on exam
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12
Q

Meconium Ileus- Dx

A
  • Abd film: Soap bubble in RLQ
  • Gold standard: Water soluble contrast enema
  • Sweat chloride for CF
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13
Q

Meconium Ileus- Tx

A
  • Enema
  • NG suction
  • IV fluids
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14
Q

Meconium Ileus- Tx

A
  • Enema
  • NG suction
  • IV fluids
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15
Q

Malrotation- Eto

A
  • Twisting of intestinal loop due to embryonic development

- Partial or complete obstruction

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16
Q

Volvulus- Eti

A

Complication of malrotation- 50% children

  • Sm bowel around mesenteric artery
  • Ischemia & necrosis
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17
Q

Malrotation/ Volvulus- Sx

A
  • Look well then ill quickly
  • Extreme pain
  • Hemodynamic deterioration
  • Bulging typanic mass
  • Frank blood per rectum
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18
Q

Malrotation/ Volvulus- Sx

A
  • Look well then ill quickly
  • Extreme pain
  • Hemodynamic deterioration
  • Bulging tympanic mass
  • Frank blood per rectum
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19
Q

Malrotation/ Volvulus- Dx

A
  • ABd xray: coffee bean sigmoid
  • Double bubble sign- dilated stomach & duodenum
  • UGI: corkscrew
  • Barium: birds beak
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20
Q

Malrotation/ Volvulus- Dx

A
  • ABd xray: coffee bean sigmoid
  • Double bubble sign- dilated stomach & duodenum
  • UGI: corkscrew
  • Barium: birds beak
21
Q

Malrotation/ Volvulus- Tx

A
  • Decompression
  • Abx
  • Surgery if ischemic
22
Q

Malrotation/ Volvulus- Tx

A
  • Decompression
  • Abx
  • Surgery if ischemic
23
Q

Hirschprungs- Eti

A
  • Failure of enteric NS to develop
  • Absence of ganglion in colon- absence of peristalsis
  • M>W
  • ## Down syndrome assoc
24
Q

Hirschprungs- Sx

A
  • Failure to pass meconium
  • Vomiting, abd distension, no feeding
  • Enterocolitis: fever, inflammation, diarrhea
  • Ischemia, perforation & sepsis
  • Fecal masses, peristalsis palpable
25
Q

Hirschprungs- Dx

A

Abd film: loops of distended bowel, retained stool

- Barium enema- narrowed, irregular

26
Q

Hirschprungs- Tx

A
  • Resection of aganglionic segment
27
Q

Inperforate anus- Eti

A
  • Infra or supralevator
  • Infra in girls, supra in boys
  • Abn anorectal termination
  • M>W
  • Tethered spinal cord, GI abn assoc with
28
Q

Inperforate anus- Sx

A
  • Bilous vomiting
  • ## Lack of anal opening
29
Q

Inperforate anus- Sx

A
  • Bilous vomiting

- Lack of anal opening

30
Q

Inperforate anus- Tx

A

Surgery

31
Q

Constipation- Eti

A
  • Peak during pre-school
  • 3-5% of visits
  • BMs change with age
  • Organic: dietary, structural, metabolic, skeletal or psych
32
Q

Constipation- Sx

A
  • Distended abd
  • Stool in distended rectum
  • Hemoccult testing
33
Q

Constipation- Dx

A

2 for 1 to 2 months:

  • 2 or fewer BM /week
  • 1 episode of incontinance
  • Hx of retention
  • Hx of painful or hard bowels
  • Presence of mass in recturm
  • Large diameter of stools obstruction toilet
34
Q

Constipation- Dx

A

2 for 1 to 2 months:

  • 2 or fewer BM /week
  • 1 episode of incontinance
  • Hx of retention
  • Hx of painful or hard bowels
  • Presence of mass in recturm
  • Large diameter of stools obstruction toilet
35
Q

Constipation- Tx

A
  • Remove impaction
  • Increase fiber/ liquids
  • Laxatives
36
Q

Anal fissure- Eti

A
  • Most common cause of rectal bleeding
37
Q

Anal fissure- Sx

A
  • Crying with defecation
  • BRBPR
  • See fissure
38
Q

Anal fissure- Tx

A
  • Tx underlying constipation

- Sitz baths

39
Q

Encopresis- Eti

A
  • Repeated passage of feces in inappropriate places
  • > 4 yrs, not related to med disorder
  • 1% school aged
  • Boy>girls
40
Q

Encopresis- Sx

A
  • Retentive most common- Constipation with overflow
  • Continuous- never gained control over bowel function
  • Discontinuous- hx of normal control, loss during stress
  • Toile phobia- frightening structure, fear of being swept down
41
Q

Encopresis- Sx

A
  • Retentive most common- Constipation with overflow
  • Continuous- never gained control over bowel function
  • Discontinuous- hx of normal control, loss during stress
  • Toile phobia- frightening structure, fear of being swept down
42
Q

Encopresis- Tx

A
  • Tx underlying cause
43
Q

Colic- Eti

A
  • 9-17%
  • Idiopathic
  • Benign/ self limited
  • 2 wks - 3 months
44
Q

Colic- Sx

A
  • Paroxysmal crying- in afternoon and evening
  • Minmal response to soothing
  • Cries for > 3 hrs/ day, >3days / week, > 3 weeks
45
Q

Colic- Tx

A
  • Parental support, reassurance

- Take breaks from baby

46
Q

Colic- Tx

A
  • Parental support, reassurance

- Take breaks from baby

47
Q

Normal Amt of crying

A
  • 2 hrs at 2 wks
  • 3 hrs at 6 wks
  • 1 hd by 3 months
48
Q

Normal Amt of crying

A
  • 2 hrs at 2 wks
  • 3 hrs at 6 wks
  • 1 hd by 3 months
49
Q

Recurrent abd pain- Eti

A
  • 1/ mo x 3 mo
  • Affects activities
  • 4-6 yrs of age
  • Organic v fxn, organic

I & E 2 (8 decks)

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