Upper GI

Question 1

What are the different types of vomiting in children?

Answer 1

Vomiting with retching

Projectile vomiting

Bilious vomiting

Effortless vomiting

Question 2

What might stimulate the brains vomiting centre in a child?

Answer 2

Enteric pathogens

Intestinal inflammation

Infection

Head injury

Question 3

What could the causes of projectile vomiting after feeding?

Answer 3

GORD

Pyloric stenosis

Overfeeding

Question 4

What are the clinical features of pyloric stenosis in children?

Answer 4

1 - Projectile non-bilious vomiting

2 - Weight loss

3 - Dehydration

Question 5

What would be the metabolic disturbances in pyloric stenosis?

Answer 5

Metabolic alkalosis

Hypochloraemia

Hypokalaemia

Question 6

What type of vomiting should always ring alarm bells and what is its most likely cause?

Answer 6

Bilious vomiting - intestinal obstruction

Question 7

What are the causes of intestinal obstruction in children?

Answer 7

Intestinal atresia (newborns only)

Malrotation +- volvulus

Intussusception

Question 8

How should bilious vomiting be investigated?

Answer 8

1 - Abdominal x-ray

Question 9

What is the most likely cause of effortless vomiting?

Answer 9

Gastro-oesophageal reflux

Question 10

How common is GORD in children and what is the likely course for it to take?

Answer 10

Very common in infants

Normally resolves itself

Question 11

What are the different types of childhood diarrhoea?

Answer 11

Osmotic

Secretory

Motility

Inflammatory

Question 12

What is osmotic diarrhoea?

Answer 12

Movement of water into bowel to equilibrate osmotic gradient

Question 13

What is secretory diarrhoea?

Answer 13

Intestinal fluid secretion driven by Cl- secretion

Question 14

What are the organisms most likely to be causing secretory diarrhoea?

Answer 14

Cholera

E.coli

Question 15

What is motility diarrhoea?

Answer 15

Classic toddlers diarrhoea

Question 16

What is inflammatory diarrhoea?

Answer 16

Malabsorption due to intestinal damage

Question 17

What are the key differences between osmotic and secretory diarrhoea?

Answer 17

Osmotic:

• Small stool volumes
• Diarrhoea stops with fasting

Secretory:

• Large stool volumes
• Diarrhoea continues with fasting

Question 18

What are the casuses of fat malabsorption in children?

Answer 18

Pancreatic disease

Hepatobiliary disease

Question 19

What is the most likely cause of fat malabsorption due to pancreatic disease?

Answer 19

Cystic fibrosis

Question 20

What are some of the features of coeliac disease in children?

Answer 20

Bloating

Failure to thrive

Diarrhoea or constipation

Dermatitis herpatiformis

Question 21

Which auto antibodies are associated with coeliac disease?

Answer 21

Anti-tissue transglutaminase

Question 22

What is the gold standard for diagnosing coeliac disease?

Answer 22

Dueodenal biopsy

Question 23

What are the genetic markers of coeliac disease?

Answer 23

HLA DQ2

DQ8

Question 24

How much weight should a child be gaining throughout the first 12 months of life?

Answer 24

0-3 months 200g

3-6 months 150g

6-9 months 100g

9-12 months 75-50g

Question 25

What are the benefits of breast milk?

Answer 25

1 - Nutritionally best

2 - Improves cognitive development

3 - Reduces infection

Question 26

For how long should an infant receive milk exclusively for?

Answer 26

4-6 months

Question 27

Reduced levels of which enzyme cause a lactose intolerance?

Answer 27

Lactase

Question 28

What is weaning?

Answer 28

Transition from milk to a mixed diet

Question 29

When does weaning begin?

Answer 29

6 months