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Paeds AM > Vomiting > Flashcards

Vomiting Flashcards

1
Q

What can cause non bilious vomitig in babies?

A

GORD

Pyloric stenosis

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2
Q

What is the presentation of GORD?

A

Very common

Effortless non bilious vomiting

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3
Q

When is GORD investigated?

A

If suspect of underlying cause

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4
Q

What is the first management of GORD?

A

Feeding advice- thickeners for liquids, feeding position

Nutritional support

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5
Q

What is the medical management of GORD?

A

Gaviscon
Prokinetic drugs
Acid suppressing- H2 receptor blockers, PPIs

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6
Q

What are the indications for surgery in GORD?

A

Failure of medical management
Failure to thrive
Aspiration
Oesophagitis

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7
Q

What is the surgery for GORD?

A

Nissen fundoplication

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8
Q

Who is pyloric stenosis seen in?

A

M>F

4-12 weeks

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9
Q

What os the presentation of pyloric stenosis?

A

Projectile non bilious vomiting
Weight loss
Visible gastric peristalsis
Dehydration and characteristic electrolyte imbalance

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10
Q

What is the electrolyte imbalance seen in pyloric stenosis?

A

Metabolic alkalosis
Hypochloraemia
Hypokalaemia

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11
Q

What investigations are done for pyloric stenosis?

A

US

Test feed

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12
Q

What is the management of pyloric stenosis?

A

Periumbilical pyloromyotomy

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13
Q

What can cause bilious vomiting in babies?

A 
Malrotation
Intususseption
Duodenal atresia
Jejunal atresia 
Meconium ileus
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14
Q

What is malrotation?

A

Congenital anomaly of hindgut

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15
Q

Who is malrotation seen in?

A

Babies

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16
Q

What is the presentation of malrotation?

A

Bilious vomiting

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17
Q

What is the investigation of malrotation?

A

Upper GI contrast study

US

18
Q

What is the management of malrotation?

A

Laparotomy

19
Q

What is a complication of malrotation?

A

Volvulus

20
Q

What is intususseption?

A

Section of intestine invaginated into joining intestinal lumen

21
Q

Where is intususseption often seen?

A

Proximal to or at level of ileocaecal valve

22
Q

Who is intususseption seen in?

A

6-18 months

23
Q

What is the presentation of intususseption?

A

Intermittent colic
Red currant jelly stool
Bilious vomiting

24
Q

What investigation os done for intususseption?

A

US- target sign

25
Q

What is the management of intususseption?

A

Pneumostatic air reduction- air enema

Laparotomy if unsuccessful

26
Q

What are the risk factors for necrotising enterocolitis?

A

Prematurity

Intercurrent illness

27
Q

What is the presentation of necrotising enterocolitis?

A

Usually second week of life
Abdo distension
Bilious vomiting
Bloody stools

28
Q

What is the investigation necrotising enterocolitis?

A

AXR- dilated bowel loops, pneumatosis, portal venous gas

29
Q

What is the management of necrotising enterocolitis?

A

Non perforated- conservative dn supportive

Perforated- laparotomy and resection

30
Q

What is a risk factor for duodenal atresia?

A

Down’s

31
Q

What is the presentation of duodenal atresia?

A

Few hours after birth

Bilious vomiting

32
Q

What is the investigation of duodenal atresia?

A

AXR- double bubble sign

33
Q

What is the management of duodenal atresia?

A

Duodenoduodenostomy

34
Q

What causes jejunal atresia?

A

Usually vascular insufficiency in utero

35
Q

What is the presentation of jujenal atresia?

A

First 24 hours

Bilious vomiting

36
Q

What is the investigation of jujenal atresia?

A

AXR- air fluid levels

37
Q

What is the management of jejunal atresia?

A

Laparotomy with primary resection and anastomosis

38
Q

What is meconium ileus?

A

Meconium becomes thick and congested in intestines and fails to pass

39
Q

What is meconium ileus a red flag for?

A

CF

40
Q

What is the presentation of meconium ileus?

A

Within first 48 hours
Bilious vomiting
Abdo distension

41
Q

What investigations are done for meconium ileus?

A

AXR- fluid levels

Investigate for CF

42
Q

What is the management of meconium ileus?

A

Surgical decompression

Paeds AM (28 decks)

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