Vomiting in children and infants Flashcards
what are three possible causes of vomiting in the pediatric population?
gastroenteritis - activation, distension, irritation of GI tract mediated by serotonin
meningitis - meningeal inflammation and increased intracranial pressure
what are 5 warning signs of vomiting that require medical investigation?
bilious emesis GI bleeding failure to thrive forceful or projectile vomitus emesis beginning after 6 months of age
what is GERD?
passage of gastric contents into the esophagus (a normal physiologic process in infants)
projectile vomiting in infants is indicative of what condition?
pyloric stenosis
what are the vomit centers of the brain?
vomiting or emetic center - reticular formation of the medulla
chemoreceptor trigger zone - area postrema of floor of 4th ventricle
what are the signs of acute gastroenteritis?
history of ill contacts fever abdominal pain diarrhea nausea / vomiting acute onset
what is a common cause of meningitis in the late summer / fall?
enterovirus
how can GERD cause apnea?
airway protection reflex from laryngospasm
what is sandifer syndrome?
reflux into esophagus and resulting seizure-like motion in infants
when should GERD be worked up?
if significant complications arise - ALTE (acute life threatening event), FTT (failure to thrive) or uncertain diagnosis
what is the initial diagnostic study for GERD in an infant? what is the purpose?
fluoroscopic examination using barium to opacify the upper GI tract
anatomical abnormalities
what is the purpose of an esophageal pH probe?
measures frequency and duration of acidic esophageal reflux episodes
what test measures frequency and duration of acidic esophageal reflux episodes?
esophageal pH probe
what are lifestyle modifications for treatment of GERD in infants?
increase caloric density
decrease volume of feedings
thicken feedings
use formula with rice starch or carob bean gum
what drug can be used as a diagnostic test in a neurologically normal child or adolescent with classic symptoms of GERD?
PPI
