Williams- PEDS GI of Upper Tract Flashcards

1
Q

passage of esophageal contents into esophagus that happens in 2/3 healthy infants

A

gastric esophageal reflux (GER)

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2
Q

painful passage of gastric contents into esophagus + complications such as projectile emesis and hematemesis

A

GERD

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3
Q

children should double their weight by _____ months

A

3 months

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4
Q

children should triple their weight by _____ months

A

12 months

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5
Q

____ is normal

A

GER

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6
Q

____ in infants is not a problem of excessive acid production

A

GER

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7
Q

the ____ has the same pressure in infants as it does in adults (10-30 mmHg)

A

LES

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8
Q

how to test for reflux

A

observation
pH testing

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9
Q

what to not do when testing for reflux

A

do not do upper GI study

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10
Q

what does this show

A

swallowing (pH doesnt drop)

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11
Q

what does this show

A

acidic reflux event (pH drops)

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12
Q

drop in pH

A

acid reflux episode

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13
Q

no pH drop

A

nonacid reflux episode

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14
Q

upper GI study is _______ justified to diagnose GER or GERD in infants

A

NOT

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15
Q

______ imaging is useful in the evaluation of vomiting (due to obstruction)

A

upper GI

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16
Q

how do H2 receptor antagonists work

A

inhibit acid secretion from H/K ATPase by blocking histamine

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17
Q

histamine
gastrin
Ach

A

all cause acid production (H/K ATPase stimulation)

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18
Q

these drugs physically attach to and block H/K ATPase

A

PPIs

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19
Q

_____ blocks gastrin, histamine

A

somatostatin

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20
Q

does not block vagal stimulation

A

somatostatin

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21
Q

2 main H2 blockers used in peds

A

Famotidine
Nizatidine

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22
Q

this suppresses acid production from 12-24 hours

A

PPIs

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23
Q

PPI that can be given in first few weeks/months of life

A

Omeprazole

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24
Q

this drug has no benefit in reducing crying or fussing and can be tied to increase risk for infection (due to decrease in acid production)

A

PPIs

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25
Q

SE of this drug: necrotizing enterocolitis in preterm infants

A

PPIs

26
Q

this drug is a coating agent that is good if used short term

A

Sucralfate

27
Q

SE of this drug is bezoar formation

A

Sucralfate

28
Q

best position for babies to sleep in

A

supine

29
Q

FPIAP is aka

A

milk protein allergy/intolerance
milk allergy

30
Q

explain FPIAP (milk protein allergy)

A

GI tract has allergic response (IgA mediated) to milk proteins and antibodies created against specific protein and attacks; inflames GI mucosa—–> mucosal injury

31
Q

sx’s of this include:
hematochezia
fussiness
mucus in loose stools

A

milk protein allergy (FPIAP)

32
Q

blood in stool

A

hematochezia

33
Q

how to manage milk protein allergy

A

change diet (exclude cow milk from mothers diet if breast feeding or use formula that is hydrolyzed)

34
Q

formula that does not have protein intact any longer

A

elemental formula (AA based)

35
Q

gastric emptying faster for ____ than for ______

A

human milk than formula

36
Q

if you are to use formula, what kind speeds up gastric emptying

A

hydrolyzed/elemental

37
Q
A

trachealization seen in eosinophilic esophagitis

38
Q
A

eosinophilic esophagitis

39
Q

pt has a food allergy and also dysphagia or odynophagia

A

eosinophilic esophagitis

40
Q

eosinophilic esophagitis is ______mediated

A

IgA-mediated

41
Q

to Rx eosinophilic esophagitis

A

food elimination diets
PPIs
Dupixent

42
Q

IL-4, IL-13 blocker used to treat eosinophilic esophagitis

A

Dupixent

43
Q

to dx eosinophilic esophagitis

A

EGD

44
Q

responsible for 90% of cases of peptic ulcer formation

A

H. pylori

45
Q

triple therapy Rx of H. pylori

A

PPIs
Clarithromycin
Amoxicillin

46
Q

quadruple therapy of H. pylori

A

PPIs
tetracycline
metronidazole
bismuth

47
Q

congenital hypertrophy of pylorus muscle

A

pyloric stenosis

48
Q

palpable mass or “olive” noted on exam

A

pyloric stenosis

49
Q

infants will have PROJECTILE vomiting that will shoot across the room

A

pyloric stenosis

50
Q

to dx pyloric stenosis

A

ultrasound

51
Q

to Rx pyloric stenosis

A

surgery to cut hypertrophied muscle and open canal

52
Q

what makes up gluten

A

Gliadin + Glutanin (protein combo)

53
Q

gluten is found in

A

wheat, rye, barley

54
Q

explain celiac disease

A

body makes Ab’s that attack gluten and injure the villi in small intestine

55
Q

patient experiences sx’s to gluten but has negative lab findings

A

non-gluten celiac sensitivity

56
Q

pt has elevated specific Ab’s for this and dermatitis herpetiformis

A

pathognomonic for celiac disease

57
Q

to dx this:
upper endoscopy w/ atleast 6 biopsies in duodenum and atleast 2 from the bulb

A

celiac disease

58
Q

what must you always get when checking celiac specific antibodies

A

total IgA

59
Q

alleles that confer an increased risk for celiac disease

A

DQ2/DQ8

60
Q

to Rx celiac disease

A

gluten free diet

61
Q

intraepithelial lymphocytes in duodenum and damage to villi (think what)

A

celiac disease