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Gastrointestinal > Vomiting and children > Flashcards

Vomiting and children Flashcards

1
Q

How do you define apnea in an infant?

A

greater than 20 seconds

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2
Q

What are the 5 warning signs of vomiting that require medical investigation?

A
  1. HSM
  2. Diarrhea
  3. Constipation
  4. Emesis after 6 mo
  5. Difficulty eating
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3
Q

What is GER?

A

Passage of gastric contents into the esophagus

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4
Q

What is regurgitation?

A

Spitting up is an effortless passage of gastric contents into the pharynx and mouth

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5
Q

What is rumination?

A

Voluntary, habitual, and effortless regurgitation of recently ingested food

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6
Q

How common is GER in infants?

A

very–about 50% in infants

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7
Q

By what age do most infants stop spitting up?

A

12 mo

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8
Q

Pea soup emesis = ?

A

Bilious emesis–worrisome for pyloric stenosis

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9
Q

What are the ssx of pyloric stenosis?

A

Projective vomiting

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10
Q

Emesis beginning after what age is concerning?

A

6 mo

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11
Q

Bulging fontanelle is concerning or not?

A

Is

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12
Q

What happens developmentally around 12 months that is relevant to children GI symptoms?

A

More vertical time

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13
Q

Where is the emetic center?

A

reticular formation the medulla

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14
Q

Where is the chemoreceptor trigger zone?

A

Floor of the 4th ventricle

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15
Q

What are the ssx of gastroenteritis?

A 
Fever
Abdo pain
diarrhea
n/v
h/o ill contacts
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16
Q

What are the viral causes of gastroenteritis?

A 
Rotavirus
Adenovirus
Norwalk
AStrovirus
Caliciviridae
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17
Q

What is the treatment for viral gastroenteritis?

A

Hydration

Fever control

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18
Q

What is the 5HT receptor antagonist that is used for nausea?

A

Ondansetron

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19
Q

What are the ssx of meningitis?

A 
Fever
Irritability
Lethargy
HA
emesis
Petechia
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20
Q

What is the viral cause of meningitis? When is this most common?

A

Enterovirus

Summer

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21
Q

What is the usual cause of meningitis

A

GBS

22
Q

What is the usual cause of meningitis 1-23 mo?

A

S. Pneumo

23
Q

What is the usual cause of meningitis 2-18 yrs?

A

N. Mening

24
Q

What is the usual cause of meningitis 19-59 yrs

A

S. pneumonia

25
Q

What is the usual cause of meningitis >60 yo?

A

S. Pneumonia

26
Q

Why does meningitis cause vomiting?

A

meningeal inflammation and ICP

27
Q

What is gastroesophageal reflux cause disease?

A

Passage of gastric contents into the esophagus

28
Q

What are the ssx of GERD in infants?

A

Persistent cough
Stridor
Wheezing
Apnea`

29
Q

What is the cause of stridor in emesis in children?

A

Protection of vocal cords

30
Q

What is sandifer syndrome?

A

Reflux in the esophagus causing szs like symptoms d/t pain (not actual szs)

31
Q

What should always be looked at when investigating GERD?

A

Growth charts

32
Q

When should work up be initiated for GERD?

A

If significant complications or ALTE

33
Q

What is the initial diagnostic study with GERD?

A

Ba swallow (upper GI series)

34
Q

What is the purpose of doing a Ba swallow?

A

Anatomic abnormalities

35
Q

Bird’s beak = ?

A

Achalasia

36
Q

What is an esophageal pH probe?

A

Measures the frequency of acidic esophageal reflux episode over a period of time

37
Q

What is the test for muscle/nerves problems in the GI tract?

A

Manometry

38
Q

What is a scintigraphy?

A

Nuclear med scan and watch it digest

39
Q

What is combined multiple intraluminal impedance and pH monitoring?

A

Measure fluids, air an solids in the esophagus along with pH changes

40
Q

What is the treatment for GERD in infants?

A
  • Increased caloric density
  • Thicken feedings with rice cereal
  • Use formula with rice starch
41
Q

What is the MOA of similac?

A

Thickening when hitting stomach acid

42
Q

What is the treatment for GERD in adolescence?

A

Avoid fatty/spicy/caffeine

Maintain healthy weight

43
Q

What are the meds that are useful for GERD?

A

Antacids

44
Q

Is a PPI indicated for GERD in children?

A

If neurologically intact, yes for 4 weeks

45
Q

What is the suffix that denotes a PPI?

A

-prazole

46
Q

How are PPIs administered?

A

Qd PO before meals

47
Q

What is the MOA of cimetidine, famotidine, ranitidine, and nizatidine?

A

H2 receptor blockers

48
Q

What is the MOA of metoclopramide?

A

opioid agonist

49
Q

What is a nissen fundoplication?

A

Cardia of the stomach is wrapped around the esophagus, to increase the tone of the esophageal sphincter

50
Q

What are the complications of untreated GERD in kiddos?

A

Asthma (?)
Dental caries
Aspiration pneumonia

Gastrointestinal (42 decks)

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