SECRETS GI - Small Intestine

Question 1

projectile vomiting in newborn ddx

Answer 1

hypertrophic pyloric stenosis

TE fistula

esophageal atresia
duodenal atresia
annular pancreas

gastroenteritis

Question 2

acid base disorder in prolonged vomiting

Answer 2

hypochloremic metabolic alkalosis

Question 3

firm palpable olive like mass in epigastric region

Answer 3

hypertrophic pyloric stenosis

Question 4

dumping syndrome

Answer 4

dysfunctional pyloric sphincter

too fast GI motility –> diarrhea

Question 5

TE fistula sx

Answer 5

coughing and cyanosis with 1st feeding

Question 6

Duodenal atresia sx

Answer 6

1st day of life
double bubble sign on xray
bilious vomiting
assoc with down syndrome

Question 7

hypertrophic pyloric stenosis sx

Answer 7

nonbilious projectile vomiting

3-4 weeks

Question 8

esophageal atresia sx

Answer 8

coughing, cyanosis during first feedings

Question 9

annular pancreas

Answer 9

duodenal obstruction

projectile vomiting within first few days

Question 10

celiac pathology

Answer 10

villous atrophy
lymphocytic infiltration of lamina propria
hyperplastic crypts

Question 11

celiac disease

Answer 11

hypersensitivity to gliadin in gluten

Question 12

celiac assoc anemia

Answer 12

iron deficiency (microcytic)
folate deficiency (megaloblastic)

more severe = B12

Question 13

celiac location

Answer 13

prox small bowel

duodenum, jejunum

Question 14

whipple’s disease

Answer 14

torphyrema whipelli

men >40

lipid vacuolation with infilcration of PAS-positive macrophages with small bacilli

Question 15

tropical sprue

Answer 15

does not respond to gluten free diet
affects entire small intestine

tx broad spectrum antibiotics

Question 16

small bowel obstruction bowel sounds

Answer 16

high-pitched tinkling sound

Question 17

small bowel obstruction sx

Answer 17

colicky abdominal pain, abdominal distention, vomiting, constipation

inability to pass gas

Question 18

small bowel obstruction cause

Answer 18

surgical adhesions