Upper GI Flashcards by Jade Kiersten

4 types of vomiting

vomiting with retching
projectile vomiting
bilious vomiting
effortless vomiting

How well did you know this?

Not at all

Perfectly

phases of vomiting with retching

pre-ejection - pale, nausea
ejection - retch and vomit
post ejection

How well did you know this?

Not at all

Perfectly

Stimulation of vomiting centre

enteric pathogens 
intestinal inflammation 
infection 
head injury 
middle ear stimuli 
metabolic derangement

How well did you know this?

Not at all

Perfectly

What can you see and palpate on a test feed?

olive tumour

visible gastric peristalsis

How well did you know this?

Not at all

Perfectly

managing pyloric stenosis

fluid resuscitation

pyloromyotomy

How well did you know this?

Not at all

Perfectly

Typical presentation of pyloric stenosis

4-12 week old boy
projectile non bilious vomit
weight loss, dehydration

How well did you know this?

Not at all

Perfectly

typical electrolyte disturbance of pyloric stenosis

metabolic alkalosis
hypochloraemia
hypokalaemia

How well did you know this?

Not at all

Perfectly

investigating pyloric stenosis

test feed
USS
blood gas

How well did you know this?

Not at all

Perfectly

type of vomiting associated with GORD

effortless

How well did you know this?

Not at all

Perfectly

presenting symptoms of GORD

GI - vomit, haematemesis
Nutritional - FTT, feeding
resp = apnoea, cough, wheeze, chest infections
neurological - sandifers

How well did you know this?

Not at all

Perfectly

Investigating GORD

history and exam
video fluoroscopy - swallowing problems
barium study 
pH study 
oesophageal impedance
endoscopy

How well did you know this?

Not at all

Perfectly

Barium swallow can detect what?

dysmotility
reflux
gastric emptying
strictures

How well did you know this?

Not at all

Perfectly

4 broad treatments of reflux

feeding advice
nutritional support
medial
surgical;

How well did you know this?

Not at all

Perfectly

feeding advice - reflux

carobel - feed thickener
appropriateness of food
behaviour programme
feeding position

How well did you know this?

Not at all

Perfectly

nutritional support - reflux

calorie supplement
exclusion diet - milk free
NG tube
gastrostomy

How well did you know this?

Not at all

Perfectly

medical treatment - reflux

feed thickener - Gaviscon
prokinetic drugs
H2 receptor blockers
PPI

indications for surgery reflux

persistent FTT, aspiration, oesophagitis

surgery for reflux

fundoplication

Causes of bilious vomiting

INTESTINE OBSTRUCTION 
intestinal atresia 
malrotation/volvulus 
intussusception 
ileus 
crohns with strictures

Investigating bilious vomiting

abdominal x-ray
contrast meal
surgery

chronic diarrhoea

4 or more stools per day for 4 weeks

causes of diarrhoea

motility - toddlers, IBS
active secretion - cholera
malabsorption - CF, coleliac

Osmotic diarrhoea

malabsorption - enzyme, transporter defect

mechanism of lactulose

nocturnal defaecation

organic pathology

osmotic or secretory diarrhoea stop with fasting?

osmotic

Appearance of baby with coeliac

``` bloated stomach diarrhoea FTT/short constipation tired dermatitis herpatiformis ```

susceptible groups - coeliac

type 1 DM autoimmune thyroid disease downs HLA DQ8, DQ2

testing for coeliac

anti ttg and anti endomysial duodenal biopsy genetic testing

coeliac histology

total vilious atrophy crypt hyperplasia lymphocytes

Criteria for coeliac diagnosis with no biopsy

anti ttg >10 times normal limit anti endomysial ab +ve HLA Q2/8 positive

treatment for coeliac

strict gluten free diet