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Paediatrics > Upper and Lower GI Disorders > Flashcards

Upper and Lower GI Disorders Flashcards

1
Q

What is included in the pre-ejection phase of vomiting ?

A

Pallor
Nausea
Tachycardia

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2
Q

What is included in the ejection phase of vomiting?

A

Retch

Vomit

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3
Q

What is included in the post ejection phase of vomiting ?

A

Phase of weakness, shivering and lethargy.

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4
Q

What are some examples of stimulants to the vomiting centre?

A 
Enteric pathogens
Intestinal inflammation
Metabolic derangement
Infection
Head injury
Visual stimuli
Middle ear stimuli
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5
Q

What is the age bracket for pyloric stenosis?

A

Babies ~4-12 weeks

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6
Q

What are the signs and symptoms of pyloric stenosis?

A

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

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7
Q

What kind of electrolyte disturbance would you expect in pyloric stenosis?

A

Metabolic alkalossis (Increased Ph)
Hypochloraemia (Decreased Cl)
Hypokalaemia (Decreased K)

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8
Q

What is the common cause of Bilious Vomiting in the new born ?

A

Intestinal obstruction

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9
Q

What are the causes of intestinal obstruction in the new born/infants ?

A

Intestinal atresia (New borns only)
Malrotation
Ileus
Crohn’s disease with strictures

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10
Q

What investigations would you carry out to diagnose an intestinal obstruction ?

A

Abdo x-ray
Consider contrast meal
Surgical exploration

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11
Q

What is commonly diagnosed in a child who has effortless vomiting?

A

Gastro-oesophageal reflux

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12
Q

What is the treatment for a child who has effortless vomitting ?

A

Self-limiting and resolves spontaneously in the majority of cases.

Exceptions:
Cerebral palsy
Oesophageal atresia
Generalised GI motility problem

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13
Q

What is Sandifer’s syndrome ?

A

The association of gastro-oesophageal reflux disease with spastic terticollius and dystonic body movements.

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14
Q

What kind of medical assessments would you carry out if a child has gastro-osaephageal reflux ?

A

Radiological investigations i.e. Video fluroscopy
Barium swallow

pH study
Endoscopy

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15
Q

What type of conditions would be shown by a Barium Swallow ?

A 
Dysmotility
Hiatus hernia
Reflux
Gastric emptying
Strictures
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16
Q

What is the treatment for gastro-osaephageal reflux in children?

A

Feeding advice
Nutritional support
Medical treatment
Surgery

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17
Q

What would be the feeding advice given for children with gastro-oasophageal reflux ?

A

Thickeners for liquids
Appropriateness of foods (texture and amount)
Feeding position

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18
Q

What kind of nutritional support would be suggested for children who suffer from GOR ?

A

Calories supplements
Exclusion diet (milk free)
NG tube
Gastrostomy

19
Q

What would be the chosen medical treatment for those with GOR ?

A

Gaviscon
Prokinetic drugs
Acid suppressing drugs (H2 receptor blockers and PPIs)

20
Q

What are the indications for surgery in children with GOR ?

A

Failure to thrive
Aspiration
Oesophagitis

21
Q

Children with cerebral palsy are more likely to have what kind of symptoms after surgery ?

A

Complications of bloat, dumping and retching after surgery

22
Q

What is the surgical procedure which is suggested for GOR ?

A

Nissen Fundoplication

23
Q

What is the definition of chronic diarrhoea ?

A

4 or more stools per day.

For more than 4 weeks.

24
Q

<1 week of diarrhoea is defined as what ?

A

Acute diarrhoea

25
Q

2-4 weeks of diarrhoea is defined as what ?

A

Persistant diarrhoea

26
Q

What type of motility disturbance causes diarrhoea ?

A

Toddler diarrhoea

IBS

27
Q

What kind of active secretion disorders causes diarrhoea ?

A

Acute infective diarrhoea

IBS

28
Q

What kind of malabsorption conditions cause diarrhoea ?

A

Food allergies
Coeliac disease
CF

29
Q

Define osmotic diarrhoea

A

Movement of water into the bowel to equilibrate osmotic gradient.

30
Q

What is osmotic diarrhoea a feature of ?

A

Malabsorption (Enzymatic defect or transport defect)

31
Q

How is osmotic diarrhoea resolved ?

A

Clinical remission with removal of causative agent

32
Q

Define secretory diarrhoea

A

Intestinal fluid secretion predominantly driven by active Cl secretion via CFTR

33
Q

What is secretory diarrhoea commonly associated with ?

A

Toxin production from Vibrio cholerae and enterotoxigenic Escherichia coli

34
Q

Define motility diarrhoea

A

Classically called toddlers diarrhoea ?

35
Q

Causes of motility diarrhoea ?

A

IBS
Congenital hyperthyroidism
Chronic intestinal pseudo-obstruction

36
Q

Define inflammatory diarrhoea

A

Malabsorption due to intestinal damage, accelerated transit time in response to inflamation.

37
Q

What are the pancreatic causes of fat malabsorption ?

A

Diarrhoea due to lack of lipase and resultant steatorrhoea.

CF

38
Q

What are the hepatobilliary causes of of fat malabsorption ?

A

CLD

Cholestasis

39
Q

Define coeliac disease

A

Gluten sensitive eneteropathy

40
Q

What are the signs and symptoms of coeliac disease?

A 
Abdominal bloatedness
Diarrhoea
Failure to thrive
Short stature
Constipation
Tiredness
Dermatitis herpatiformis
41
Q

What are the screening tests for coeliac disease ?

A

Serological screens
Duodenal biopsy
Genetic testing

42
Q

What is the treatment for coeliac disease ?

A

Gluten-free diet for life
Gluten must not be removed prior to diagnosis as serological and histological features will resolve
In very young <2yrs, re-challenge and re-biopsy may be warranted

43
Q

What is the risk to children if coeliac is left untreated ?

A

Increased risk of rare small bowel lymphoma if untreated

Paediatrics (17 decks)

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