Upper GI Flashcards
What are the different types of vomiting in children?
Vomiting with retching
Projectile vomiting
Bilious vomiting
Effortless vomiting
What might stimulate the brains vomiting centre in a child?
Enteric pathogens
Intestinal inflammation
Infection
Head injury
What could the causes of projectile vomiting after feeding?
GORD
Pyloric stenosis
Overfeeding
What are the clinical features of pyloric stenosis in children?
1 - Projectile non-bilious vomiting
2 - Weight loss
3 - Dehydration
What would be the metabolic disturbances in pyloric stenosis?
Metabolic alkalosis
Hypochloraemia
Hypokalaemia
What type of vomiting should always ring alarm bells and what is its most likely cause?
Bilious vomiting - intestinal obstruction
What are the causes of intestinal obstruction in children?
Intestinal atresia (newborns only)
Malrotation +- volvulus
Intussusception
How should bilious vomiting be investigated?
1 - Abdominal x-ray
What is the most likely cause of effortless vomiting?
Gastro-oesophageal reflux
How common is GORD in children and what is the likely course for it to take?
Very common in infants
Normally resolves itself
What are the different types of childhood diarrhoea?
Osmotic
Secretory
Motility
Inflammatory
What is osmotic diarrhoea?
Movement of water into bowel to equilibrate osmotic gradient
What is secretory diarrhoea?
Intestinal fluid secretion driven by Cl- secretion
What are the organisms most likely to be causing secretory diarrhoea?
Cholera
E.coli
What is motility diarrhoea?
Classic toddlers diarrhoea
What is inflammatory diarrhoea?
Malabsorption due to intestinal damage
What are the key differences between osmotic and secretory diarrhoea?
Osmotic:
- Small stool volumes
- Diarrhoea stops with fasting
Secretory:
- Large stool volumes
- Diarrhoea continues with fasting
What are the casuses of fat malabsorption in children?
Pancreatic disease
Hepatobiliary disease
What is the most likely cause of fat malabsorption due to pancreatic disease?
Cystic fibrosis
What are some of the features of coeliac disease in children?
Bloating
Failure to thrive
Diarrhoea or constipation
Dermatitis herpatiformis
Which auto antibodies are associated with coeliac disease?
Anti-tissue transglutaminase
What is the gold standard for diagnosing coeliac disease?
Dueodenal biopsy
What are the genetic markers of coeliac disease?
HLA DQ2
DQ8
How much weight should a child be gaining throughout the first 12 months of life?
0-3 months 200g
3-6 months 150g
6-9 months 100g
9-12 months 75-50g
What are the benefits of breast milk?
1 - Nutritionally best
2 - Improves cognitive development
3 - Reduces infection
For how long should an infant receive milk exclusively for?
4-6 months
Reduced levels of which enzyme cause a lactose intolerance?
Lactase
What is weaning?
Transition from milk to a mixed diet
When does weaning begin?
6 months
