Pyloric Stenosis Flashcards
Pyloric stenosis is the most common cause of non-bilious vomiting in children. What is the incidence of pyloric stenosis?
1 - 4 per 100,000
2 - 40 per 100,000
3 - 400 per 100,000
4 - 4000 per 100,000
1 - 4 per 100,000
It is the result of hypertrophy of the pylorus muscles of the stomach leading to gastric outlet obstruction.
Pyloric stenosis is the most common cause of non-bilious vomiting in children. Is this more common in boys of girls?
- boys
4:1 for boys
Babies are most likely to present with pyloric stenosis, but do they present immediately?
- no
Can be normal at birth, or present with symptoms
Babies are most likely to present with pyloric stenosis. When do they begin to develop increasingly frequent and forceful vomiting typically?
1 - at birth
2 - 4-7 days
3 - 2-8 weeks
4 - 12-16 months
3 - 2-8 weeks
Most common in the 3rd week of life
Which of the following are risk factors for developing pyloric stenosis?
1 - male gender
2 - firstborn born child
3 - family history
4 - maternal smoking
5 - bottle feeding
6 - preterm birth
7 - ethnicity (Caucasian and Hispanic)
8 - erythromycin
9 - all of the above
8 - all of the above
Use of erythromycin in first 2 weeks of life has been associated
In pyloric stenosis, increasingly forceful and ultimately projectile non-bilious vomiting is the most common presentation. Does this occur after every meal of just some feeds?
- occurs following every feed
Babies are typically very irritable and hungry due to lack of feeding
Haematemesis can occur in babies with pyloric stenosis. What % of cases does this typically occur in?
1 - 100%
2 - 75%
3 - 30%
4 - 10%
4 - 10%
Reflux oesophagitis resulting from gastric outlet obstruction
Do babies with pyloric stenosis typically gain weight in a healthy manner?
- no
They cannot keep food down, so cannot gain weight
Parents often advised to try lots of different formulas
Babies with pyloric stenosis can often be dehydrated and have electrolyte imbalance due to vomiting and inability to keep food and fluids down. Which 2 of the following electrolyte imbalances is most likely?
1 - hypokalaemia
2 - hyponatraemia
3 - hypochloremia
4 - hypomagnesemia
1 - hypokalaemia
3 - hypochloremia
Babies with pyloric stenosis can often be dehydrated and have electrolyte imbalance due to vomiting and inability to keep food and fluids down. Which of the following does this lead to?
1 - metabolic alkalosis
2 - metabolic acidosis
3 - respiratory acidosis
4 - respiratory alkalosis
1 - metabolic alkalosis
Due to loss of HCL in the vomit
Babies with pyloric stenosis can often be dehydrated and have electrolyte imbalance due to vomiting and inability to keep food and fluids down. In severe dehydration, would we expect a babies fontanelles to be sunken or raised?
- sunken
Babies with pyloric stenosis can often be dehydrated and have electrolyte imbalance due to vomiting and inability to keep food and fluids down. Is there an increase or decrease in capillary refill time?
- decreased
> 2 seconds after holding for 5 seconds
Babies with pyloric stenosis can often be dehydrated and have electrolyte imbalance due to vomiting and inability to keep food and fluids down. Which of the following is NOT a sign of dehydration?
1 - sunken eyes
2 - dry mucous membranes
3 - poor skin turgor
4 - decreased tearing
5 - lethargy
6 - tachycardia
7 - increased urine output
7 - increased urine output
Typically this is decreased, and can lead to AKI
What is typically the method of diagnosing pyloric stenosis?
1 - endoscopy
2 - oesophageal pH test
3 - clinical diagnosis
4 - ABG
3 - clinical diagnosis
Typically presents as triad of:
- projectile vomiting
- visible peristalsis
- palpable pyloric mass
What imaging method is best to aid diagnosis of pyloric stenosis?
1 - chest X-ray
2 - ultrasound
3 - endoscopy
4 - barium swallow test
2 - ultrasound
Often described as a target sign
