Peds GI Flashcards
What is the definition of pyloric stenosis
acquired condition d/t hypertrophy and speasm of the pyloric muscle, nonbilious “projectile vomiting”
PE of pyloric stenosis
firm “olive” in RUQ, wave-like contractions visible across upper abd
What age is pyloric stenosis common
3-12 weeks of age, 1st born white males
When is a string sign seen
barium swallow in pyloric stenosis
Treatment of pyloric stenosis
pyloromyotomy
what will esophageal atresia most offten occur with
tracheoesophageal fistula d/t defect in co-development
diagnosis of esophageal atresia
attempt of passage of NG tube with confirmatory CXR revealing blind pouch
What are the risks of GERD in infants
body position, large feedings, small stomach, immature lower esophageal sphicter
when is GERD pathologic
presence of sx after 18 mos
what medications are utilized in GERD in infants
H2 receptor antagonists, PPI
What is the presentation of GERD
rapid weight gain, Sadifer’s sign, frequent burping
Etiology of upper GI bleeding in neonate
swallowed maternal blood during delivery, AV malformation, peptic disease, coagulopathy, volvulus
Eitology of lower GI bleeding in neonate
allergic colitis, necrotizing enterocolitis, volvulus, anal fissure
Etiology of upper GI bleeding in infant/toddler
esophageal varices from liver disease, peptic disease, NSAIDs or steroids
Etiology of lower GI bleeding in infant/toddler
Intussusception, Meckel diverticulum, bacterial enteritis
Etiology of upper GI bleeding in older children
peptic disease, esophageal varices, NSAIDs or steroid use, Mallory-Weiss syndrome
Etiology of lower GI bleeding in younger children
IBD, bacterial enteritis, pseudomembranous colitis, juvenile polyp, meckel diverticulum, nodular lymphoid hyperplasia, hemolytic uremic syndrome
what is Hirschsprung disease
Motility defect due to failure of ganglion cells to migrate into distal bowel during fetal life; Presentation in newborn with failure to pass meconium in first 24 hours
when will a “double bubble” present
in duodenal atresia or dilated loops of bowel in distal intestinal obstruction
What is the presentation of Meckel Diverticulum
Fetal remnant of omphalomesenteric duct, results in outpouching of the distal ileum; May also be a lead point for intussusception or allow twisting of bowel around vascular supply
What is intussusception
Telescoping of segment of proximal bowel into distal bowel, often lead points; Sudden onset of crampy abdomenal pain, currant jelly stools; Age range 1-2 years old
What is meconium ileus
mc GI obstruction with cystic fibrosis, occurs d/t inspissated meconium
what is necrotizing enterocolitis
MC GI medical/surgical emergency in a neonate; poor feeding, feeding intolerance. delayed gastric emptying, abdominal distention, abdominal tenderness, or both, decreased bowel sounds, abdominal wall erythema (advanced stages), hematochezia
Treatment of necrotizing enterocolitis
IVF, NPO, ceompression of GI tract, antibiotics
What is the defect in CF
due to the effect of the gene on the regulation of epithelial chloride and sodium transport causing viscous mucus, malabsorption and respiratory infections
How to diagnose CF
sweat testing is Gold Standard
Treatment of CF
surgical correction of anomalies, replacement of pancreatic enzymes, increased caloric intake, vitamin replacement
when is abd pain chronic
> 3 mos; multiple episodes
what is functional abd pain
daily or near daily pain not associated with eating or bowel movements or loss of normal activity.
what is irritable bowel syndrome
pain begins with change in stool frequency or consistency, alternating diarrhea and constipation, relief of pain with bowel movement.
what is the definition of diarrhea
Excessive daily stool liquid volume (>10ml stool/kg body weight per day)
When is diarrhea considered chronic
> 2 weeks
What is secretory diarrhea defined as
secretion of fluid and electrolytes into the stool directly from the mucosa due to inflammation (inflammatory bowel disease or chemical stimulus), infection (cholera triggers secretory diarrhea due to endotoxin) or more rarely, hormones secreted by tumors (neuroblastoma)
What is osmotic diarrhea defined as
due to water pulled into the bowel lumen after malabsorption such as undigested lactose triggering osmotic effect after intestinal brush border disruption from AGE
what is the definition of constipation
2 or fewer stools per week or passage of hard, pellet-like stools for at least 2 weeks
What is the treatment of constipation
Positive reinforcement; scheduled toilet times, or stool-softeners
