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GI > Peds GI Disorders > Flashcards

Peds GI Disorders Flashcards

1
Q

Time pattern of functional abdominal pain?

A

<5 min

Time pattern: upon awakening or bedtime but decreased during activities never awakes

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2
Q

Location of functional abdominal pain?

A

Closer to umbilicus the more likely functional

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3
Q

Red flag of abdominal pain?

A

Positive occult blood (+ve)

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4
Q

Urgent condition- pyloric stenosis: s/s?

A

projectile vomiting immediately after eating

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5
Q

Urgent condition- pyloric stenosis: PE findings?

A

olive-shaped mass on abdominal palpation.

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6
Q

Urgent condition- pyloric stenosis: diagnostic test?

A

barium swallow-string sign

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7
Q

Urgent condition- pyloric stenosis: occurs at what age range?

A

4-6 wks

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8
Q

What is midgut malrotation?

A

a congenital anatomical anomaly that results from an abnormal rotation of the gut as it returns to the abdominal cavity during embryogenesis

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9
Q

What is midgut malrotation s/sx?

A

abdominal pain, weight loss, melena, chronic pancreatitis = failure to thrive

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10
Q

What is volvulus?

A

bowel twisting on itself

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11
Q

MC location of volvulus?

A

sigmoid volvulus

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12
Q

Diagnostic finding of volvulus on imaging?

A

bent inner tube or “coffee bean sign”

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13
Q

Treatment for volvulus?

A

emergent decompression (sigmoid of colonic placement of rectal tube drainage.

reoccurrence is common-may require elective colectomy.

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14
Q

What is Meckels diverticulum?

A

remnants of omphalomesenteric duct

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15
Q

What is the rule of 2s for meckles diverticulum?

A

2% population

2ft proximal to ileocecal valve

2” in length

2 yrs of age

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16
Q

Presentation of Meckels diverticulum?

A

Painless rectal bleeding - d/t too much acid production

Obstructive signs

Epigastric pain

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17
Q

When is a meckel scan considered positive?

A

positive when the diverticulum contains associated ectropic gastric mucosa that is capable of uptake of the tracer

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18
Q

What is intussusception?

A

One segment of intestine “telescopes” inside of another, causing an intestinal obstruction (blockage)

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19
Q

MC location of intussusception?

A

Ileocolic

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20
Q

Intussusception usually follows what?

A

a viral infection

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21
Q

S/Sx of intussusception?

A

currant jelly stool - intestinal bleeding and edema

intermittent sudden and severe cramping pain alternates with periods of increasing lethargy

vomiting

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22
Q

Diagnostic finding of intussusception?

A

palpable mass = sausage mass

barium enema

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23
Q

Pathophysiology of appendicitis?

A

obstructed lumen (fecolith) —> bactria proliferate —> inflammation —> local irritation —> rupture —> peritonitis —> abscess

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24
Q

Appendicitis Triad?

A

RLQ pain
Fever
Anorexia

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25
Q

Appendicitis PE?

A

Guarding

Rovsing sign

McBurneys point tenderness

Psoas Sign

Obturator sign

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26
Q

Appendicitis tx?

A

Nothing PO

IV fluids, pre-op antibiotics, pain control, anti-emetic

Appendectomy

Post-op antibiotics if gangrenous or ruptured (7-10 days)

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27
Q

What is biliary atresia?

A

Bile flow usually present at birth but the decreases d/t inflammation and fibrosis

Tx: kasai procedure —> liver transplant

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28
Q

S/Sx of biliary atresia?

A

Appear normal at birth then jaundice, darkened urine, and paling of stool

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29
Q

What is Gastroesophageal reflux?

A

non-forceful movement of gastric contents to esophagus-mouth-nose.

30
Q

When does Gastroesophageal reflux resolve for pediatric patients?

A

9-12 mos

31
Q

What are some increased risks for GERD in peds pts?

A

Sandifer syndrome

neurologic impairment

Obesity

Lung disease (CF)

Esophageal atresia

Prematurity

32
Q

GERD diagnostic study?

A

24hr esophageal pH monitoring (gold standard)

Barium UGI

33
Q

GERD management in peds pts?

A

Increase caloric density

Thickening feeds with rice cereal

Positioning

2wk trial of casein hydrolysate or amino acid formula

34
Q

GERD management for children/adolescents?

A

Limit high-fat content, caffeine, spicy foods, chocolate

Avoid tobacco and alcohol

35
Q

Taking a esophageal biopsy you may see what?

A

Eosinophils

36
Q

What causes non-ulcer dyspepsia?

A

acid-irritation of the stomach mucosa –> dyspepsia (upper abdominal pain) —> bloating, nausea (no vomiting)

37
Q

Gastric ulcer pain worsens with?

A

Eating

38
Q

Duodenal ulcer pain worsens when?

A

After eating, often at night

39
Q

Peptic ulcer disease S/Sx?

A

Weight loss

Bleeding

Perforation

40
Q

What is peptic ulcer disease?

A

Imbalance of acid secretion and mucosal defense —> stomach or duodenal mucosal breakdown/ulcer

41
Q

What are some causes of peptic ulcer disease?

A

NSAIDs, H. pylori, stress, crohns disase

42
Q

What is the H. pylori test?

A

Stool antigen test

43
Q

MCC of constipation is?

A

Functional (idiopathic)

44
Q

Associated sxs of constipation in peds?

A

Pain

Stool holding

Bleeding

Leakage

45
Q

What is encopresis?

A

Involuntary stool leakage around fecal impaction

46
Q

What is Hirschsprung’s disease?

A

Ganglion cells fail to migrate into distal colon —> spasm and narrowing of affected section —> proximal dilation

47
Q

Clinical S/Sx of Hirschsprung’s disease?

A

delayed stooling as newborn then recurrent constipation.

48
Q

Diagnosis of Hirschsprung’s disease?

A

Rectal suction biopsy

49
Q

Tx of Hirschsprung’s disease?

A

pull-through procedure (surgery)

50
Q

Increased risk for celiac disease for children?

A

Type 1 DM and 1st-degree relative w/ celiac disease

51
Q

Location of Ulcerative Colitis?

A

Colon

52
Q

Location of Crohns Disease?

A

Anywhere from mouth to anus

53
Q

Clinical manifestations of UC in peds?

A

cramping, diarrhea, rectal bleeding, chronic sxs

primary sclerosing cholangitis, uveitis, pyoderma gangrenosum

54
Q

Clinical manifestations of Crohns disease in peds?

A

oral aphthous ulcers, arthritis, erythema nodosum, clubbing, episcleritis, gallstones, renal stones

55
Q

Clinical manifestation IBD?

A

Toxic megacolon = systemic tox + colitis (massively dilated).

Fever, tachy, hypotension, dehydration, anemia, increased WBC, fecal protein loss- can be life-threatening.

56
Q

IBD specific antibody tests?

A

ANCA - more common in UC

ASCA - more common in CD

57
Q

Acute gastroenteritis MC virus?

A

Rotavirus

58
Q

Acute gastroenteritis 3 MC bacteria?

A

Shigella, salmonella, e.coli

59
Q

Acute gastroenteritis (AGE) 2 MC Parasites?

A

Giardia, Entamoeba histolytica

60
Q

Acute gastroenteritis (AGE) S/Sx?

A

sever dehydration

lethargic

tachy

sunken eyes

cold extremities

poor skin turgor

61
Q

Acute gastroenteritis (AGE) inpatient tx?

A

Admit for IV hydration (bolus, then 2x maintenance) until able to tolerate po

62
Q

Acute gastroenteritis (AGE) outpatient tx?

A

Oral rehydration fluids w/ glucose and electrolytes in small amounts

63
Q

S/Sx of Shigella?

A

Dysentery (blood, mucus, and foul-smelling diarrhea)

64
Q

Some strains of Shigella produce?

A

Shiga toxin

65
Q

When do you treat non-typhoid Salmonella?

A

Tx if < 3 mos old or sepsis, bacteremia

66
Q

Diagnostics for parasites?

A

Stool antigen test and ova and parasites x3

67
Q

Tx for parasites?

A

Metronidazole and albendazole

68
Q

Chronic diarrhea is defined as how many weeks?

A

> 2 wks

69
Q

What are S/Sxs of Ascariasis worm infection?

A

abdominal pain and possible cough

70
Q

Tx for Ascariasis worm infection and pinworm infection?

A

Mebendazole

71
Q

What are S/Sxs of pinworm infection?

A

Nighttime perianal itching and restlessness

GI (16 decks)

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