Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paedriatrics > Upper and lower GI > Flashcards

Upper and lower GI Flashcards

1
Q

What are the different types of vomiting?

A

Vomiting with retching
Projectile vomiting
Bilious vomiting
Effortless vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the three phases of vomiting with retching?

A

Pre-ejection phase
Ejection phase
Post-ejection phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the signs of the pre-ejection phase of vomiting with retching?

A

Pallor
Nausea
Tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the parts of the ejection phase of vomiting with retching?

A

Retch

Vomit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can stimulate the vomiting centre of the brain?

A 
Enteric pathogens
Intestinal inflammation
Metabolic derangement
Infection
Head injury
Visual stimuli
Middle ear stimuli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q 
CS:
6wk boy, 3wk Hx vomiting after every feed, bottle fed 6oz 3hrly, vomitus: large volume, milky/curdy, mostly projectile
Irritable/crying
Not gaining weight adequately
O/E: slightly dehydrated

What are the differential diagnoses?

A

Gastro-oesophageal reflux
Overfeeding
Pyloric stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is an olive tumour?

A

Olive-shaped mass in abdomen in upper left quadrant of epigastric region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a visible sign of pyloric stenosis?

A

Visible gastric peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is an olive tumour indicative of?

A

Pyloric stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the vomiting like with pyloric stenosis?

A

Projectile non bilious vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the management of pyloric stenosis?

A 
Fluid resuscitation (for dehydration)
Refer to surgeons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the surgery for pyloric stenosis?

A

Ramstedts pyloromyotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What age does pyloric stenosis usually present?

A

4-12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Does pyloric stenosis usually present in boys or girls more?

A

Boys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the characteristic electrolyte disturbance of pyloric stenosis?

A

Metabolic alkalosis (↑ pH)
Hypochloraemia (↓Cl)
Hypokalaemia (↓K)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the signs of physical signs pyloric stenosis?

A

Projectile non-bilious vomiting
Weight loss
Dehydration +/- shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is bilious vomiting usually due to unless proven otherwise?

A

Intestinal obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the main causes of bilious vomiting?

A 
Intestinal atresia
Malrotation +/- volvulus
Intussusuception
Ileus
Crohn's disease with strictures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a volvulus?

A

When a loop of intestine twists around itself and the mesentery that supports it, resulting in a bowel obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is ileus?

A

Lack of movement somewhere in the intestines that leads to a buildup and potential blockage of food material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is intussusception?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the investigations for bilious vomiting?

A 
Abdominal XR
Contrast meal
Surgical opinion (exploratory laparotomy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is effortless vomiting usually due to?

A

Gastro-oesophageal reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the cases when gastro-oesophageal reflux may not spontaneously resolve?

A

Cerebral palsy
Progressive neuro problems
Oesophageal atresia +/- TOF operated
Generalised GI motility problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the presenting symptoms of reflux?

A 
Vomiting
Haematemesis
Feeding problems
Failure to thrive
Apnoea
Cough
Wheeze
Chest infections
Sandifer's syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Sandifer’s syndrome?

A

Neurological: involves spasmodic torsional dystonia with arching of the back and rigid opisthotonic posturing, mainly involving the neck, back, and upper extremities, associated with symptomatic gastroesophageal reflux, esophagitis, or the presence of hiatal hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the medical assessment for reflex?

A 
History and exam
Video fluroscopy
Barium swallow
pH study
Oesophageal impedance monitoring
Upper GI endoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What problems can be identified on barium swallow?

A 
Dysmotility
Hiatus hernia
Reflux
Gastric emptying
Strictures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the problems with barium swallow?

A

Aspiration

Inadequate contrast taken

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the positive points of videofluroscopy and barium meal?

A

May detect aspiration

Defines anatomy well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the negative points of videofluroscopy and barium meal?

A

May miss reflux

Radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the positive points of pH study?

A

Detects acid reflux missed by barium

33
Q

What are the negative points of pH study?

A

Only detects acid reflux

May be unpleasant for child

34
Q

What are the positive points of endoscopy?

A

Best test for oesophagitis

Can be combined with pH+ impedance study

35
Q

What are the negative points of endoscopy?

A

Needs anaesthetic

36
Q

What are the positive points of trial feeding?

A

Most physiological test

May be best discriminator if child needs surgery

37
Q

What are the negative points of trial feeding?

A

NG tube required

Needs 2-3 days in hospital

38
Q

What is the treatment for gastro-oesophageal reflux?

A

Feeding advice
Nutritional support
Medical treatment
Surgery

39
Q

What is the feeding advice for gastro-oesophageal reflux?

A

Thickeners for liquids
Appropriateness of foods: texture/amount
Behavioural programme: oral stimulation/removal of aversive stimuli
Feeding position

40
Q

What nutritional support can be given to babies with gastro-oesophageal reflux?

A

Calorie supplements
Exclusion diet (milk free)
NG tube
Gastrostomy

41
Q

What medical treatment can be given for gastro-oesophageal reflux?

A

Feed thickener: Gaviscon
Prokinetic drugs
Acid suppressing drugs: H2 receptors blockers/PPI

42
Q

What are the indications for surgery in gastro-oesophageal reflux?

A

Failure of medical treatment

Persistent: failure to thrive, aspiration, oesophagitis

43
Q

What is Nissan fundoplication?

A

A surgical procedure that corrects GERD by creating an improved valve mechanism at the bottom of the oesophagus - it is meant to prevent the flow of acids upward

44
Q

For which group of patients might surgery be more complication for those with GOR?

A

Cerebral palsy

45
Q

What is the definition of chronic diarrhoea?

A

4 or more stools a day

>4 weeks

46
Q

What is the definition of acute diarrhoea?

A

4 or more stools a day

<1 week

47
Q

What is the definition of persistent diarrhoea?

A

4 or more stools a day

2-4 weeks

48
Q

What are the three main groups of causes of diarrhoea?

A

Motility disturbance
Active secretion (secretory)
Malabsorption of nutrients (osmotic)

49
Q

What conditions come under osmotic diarrhoea?

A

Food allergy
Coeliac disease
CF

50
Q

What is the management of osmotic diarrhoea?

A

Removal of causative agent

51
Q

What conditions come under secretory diarrhoea?

A

Acute infective diarrhoea

IBD

52
Q

What is secretory diarrhoea associated with?

A

Toxin production

53
Q

What conditions can cause motility diarrhoea?

A

Toddler’s diarrhoea
IBS
Congenital hyperthyroidism
Chronic intestinal pseudo-obstruction

54
Q

What is inflammatory diarrhoea?

A

Malabsorption due to intestinal damage

Accelerated transit time in response to inflammation

55
Q

Which type of diarrhoea has a larger volume: osmotic or secretory?

A

Secretory

56
Q

Which type of diarrhoea stops in response to fasting?

A

Osmotic

57
Q

Which diseases cause fat malabsorption and diarrhoea?

A 
Pancreatic disease (CF)
Hepatobiliary disease
58
Q

What are the signs and symptoms of coeliac disease?

A 
Abdominal bloatedness
Diarrhoea
Failure to thrive
Short stature
Constipation
Tiredness
Dermatitis herpatiformis
59
Q

What are the screening tests for coeliac disease?

A

Serological screens
Duodenal biopsy
Genetic testing

60
Q

What are the serological screens for coeliac disease?

A

Anti-tissue transglutaminase
Anti-endomysial
Anti-gliadin
IgA dependent test

61
Q

How would you diagnose children with coeliac disease with the ESPGHAN guidelines?

A

Symptomatic
Anti TTG >10 times upper limit of normal
Positive anti-endomysial antibodies
HLA DQ2, DQ8 positive

62
Q

What is the treatment for coeliac disease?

A

Gluten-free diet for life

63
Q

What questions should you ask about constipation?

A

How often?
How hard?
Is it painful?
Has there been a change?

64
Q

What type on the Bristol stool chart are constipated?

A

Type 1 & 2

65
Q

What are other signs/symptoms of constipation?

A 
Poor appetite
Irritable
Lack of energy
Abdominal pain/distention
Withholding or straining
Diarrhoea
66
Q

Why do children become constipated?

A 
Social:
- Poor diet, too many fluids/milk
- Potty training/school toilet
Physical
- Intercurrent illness
- Medication
FH
Psychological
Organic
67
Q

What diet measures can treat constipation?

A

Increase fibre, fruit, vegetables, fluids

Decrease milk

68
Q

What psychological factors can treat constipation?

A

Reduce aversive factors - height, cold, school

Reward good behaviour

69
Q

What are the different types of laxative that soften stool and stimulate defecation?

A

Osmotic laxatives - lactulose
Stimulant laxatives - senna, picolax
Isotonic laxatives - movicol

70
Q

What is the treatment of impaction?

A

Empty impacted rectum/colon
Maintain regular stool passage
Slow weaning off treatment

71
Q

What are more common presenting symptoms in UC than Crohn’s?

A

Diarrhoea and rectal bleeding

72
Q

What are symptoms of Crohn’s and UC?

A 
Diarrhoea
Rectal bleeding
Abdo pain
Fever
Weight loss
Growth failure
Arthritis
73
Q

What are more common presenting symptoms in Crohn’s than UC?

A

Weight loss

Growth failure

74
Q

What are the investigations for IBD?

A

FBC & ESR
Stool calprotectin
CRP

75
Q

What are you looking for the in FBC of someone with IBD?

A 
Anaemia
Thrombocytosis
Raised ESR
Raised CRP
Low albumin
Raised calprotectin
76
Q

What are imaging investigations for IBD?

A

MRI
Barium meal
Endoscopy

77
Q

What are the aims of treatment in IBD?

A

Induce and maintain remission
Correct nutritional deficiencies
Maintain normal growth and development

78
Q

What the methods of treatment for IBD?

A 
Medical:
- anti-inflammatory
- immuno-suppressive
-  biologicals
Nutritional:
- immune modulation
- nutritional supplementation
Surgical

Paedriatrics (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions