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Child Health 2020 > Year 4 GI > Flashcards

Year 4 GI Flashcards

1
Q

viral causes of gastroenteritis

A

norovirus
adenovirus
rotavirus

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2
Q

bacterial causes of gastroenteritis

A

e. coli
c. diff
campylobacter
salmonella
cryptosporidium

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3
Q

management of gastroenteritis

A

trial of oral rehydration with dioralyte
ondansetron
advise loose stools can continue for a couple of weeks

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4
Q

define diarrhoea

A

> 3 stools a day

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5
Q

which conditions can have malabsorption?

A 
Coeliac's
Crohn's
CF
food allergies
lactose intolerance
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6
Q

what is toddler’s diarrhoea?

A

benign condition due to colonic immaturity

tends to improve around age 5-6

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7
Q

presentation of toddler’s diarrhoea

A

up to 10 stools a day
no abdo symptoms
thriving child

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8
Q

management of toddler’s diarrhoea

A

reduce excessive fruit juice
increase fat
keep fibre normal
may need loperamide for toilet training

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9
Q

what symptoms must be present for a diagnosis of constipation?

A

present for1 month
<3 defecations per week
one episode per week faecal incontinence
history of excessive retentions, painful/ hard movements and obstruction to toilet

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10
Q

RF for constipation

A 
low fibre
low fluid
excessive dairy
lack of exercise
obesity
problems with toilet training
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11
Q

diagnosis for constipation

A 
AXR
rectal biopsy (Hirschsprung's)
TFTs
calcium
allergy testing
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12
Q

management of constipation

A

softeners e.g. laxido, movicol

may need stimulants e.g. docusate or senna

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13
Q

what is infant dyschezia?

A

problems learning to defacate with poor coordination of straining on stool and opening of external anal sphincter

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14
Q

presentation of infant dyschezia

A

babies appear in pain when trying to pass stool and settle once it is passed

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15
Q

what is Hirschsprung’s

A

nerves do not form correctly in the colon

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16
Q

presentation of Hirschsprung’s

A

explosive passage of stool following examination
delayed passage of meconium
acute bowel obstruction
complex constipation

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17
Q

diagnosis of Hirschsprung’s

A

rectal biopsy

AXR

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18
Q

management of Hirschsprung’s

A

excision or bypass of ganglionic intestine (interval colsotomy)

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19
Q

management of GORD

A 
thicken feeds e.g. gaviscon or carobel
PPIs/H2RA
domperidone
assess for overfeeding, CMPA
nissen fundoplication
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20
Q

complications of GORD

A

pulmonary aspiration

oesophageal stricture

21
Q

presentation of pyloric stenosis

A

projectle vomiting
dehydration
3-8 weeks
olive mass

22
Q

blood gas result in pyloric stenosis

A

hyperchloraemic hypokalaemic metabolic alkalosis

23
Q

diagnosis of pyloric stenosis

A

USS

24
Q

management of pyloric stenosis

A

NBM, rehydration, NG tube

pyloromotomy (Ramstedt’s operation)

25
Q

diagnosis of Coeliac’s

A

TTG x10 and anti-EMA antibodies
endoscopy with duodenal biopsy
iron, ferritin, CRP, FBC, stool cultures, calprotectin

26
Q

associations with Coeliac disease

A 
T1DM
AI thyroid disease
juvenile chronic arthritis
Down's
Turner's
William's
27
Q

complications of Coeliac disease

A 
OP
anaemia
short stature
delayed puberty
female infertility
intestinal malignancies (small bowel lymphoma)
28
Q

what score is used in paediatric Crohn’s disease?

A

wPCDAI score (weighted paediatric Crohn’s activity index)

29
Q

MILD UC

A 
distal colon only
<3 stools/day
little blood
no fever
no weight loss
30
Q

MODERATE UC

A 
3-5 stools/day
bloody
abdo pain/cramp
low grade fever
mild anaemia
weight loss
31
Q

SEVERE UC

A 
>5 stools a day
frank blood
fever
anaemia
leucoytosis
hypoalbuminaemia
pain
risk of toxic megacolon
perforation
32
Q

complications of UC

A

long-term risk of colon cancer

33
Q

extra-intestinal manifestations of UC

A 
growth failure
arthropathy
episcleritis
skin (erythema nodosum/ pyoderma gangrenosum)
AI liver disease (PSC)
34
Q

typical histology of UC

A

polymorph nuclear leukocytes near base of crypts
crypt abscesses
no granulomas

35
Q

management of UC

A

steroids to induce remission
maintenance= mesalazine, azathioprine + infliximab/ adalimumab
colectomy

36
Q

what is toxic megacolon?

A

transverse colon diameter >5cm on AXR

37
Q

management of toxic megacolon?

A

drip and suck

IV antibiotics with early surgical review

38
Q

what is hypernatraemic dehydration?

A

sodium level very high due to difficult breast feeding or profuse watery diarrhoea
babies are drowsy

39
Q

presentation of abdominal migraine?

A

abdominal pain
headache
pallor

40
Q

management of abdominal migraine

A

same as for migraine

prevention with pizotifen (withdraw slowly as associated with depression, anxiety, poor sleep and tremor)

41
Q

UTI presentation

A

fever
vomiting
irritability
abdominal pain

42
Q

diagnosis of UTI

A

clean catch urine for dipstick

can do USS, MAg3 and DMSA scan

43
Q

structural renal abnormalities

A 
renal agenesis
horseshoe kidney
pelvic kidney
duplex system (bifid, duplication)
hypospadias
undescended testes (9 months send for surgical exploration)
posterior urethral valves
44
Q

what is biliary atresia?

A

gall bladder ducts are either small or absent causing bile to not be secreted so bilirubin is not broken down

45
Q

presentation of biliary atresia?

A

prolonged jaundice (>2 weeks)
pale stools
dark urine
hepatosplenomegaly

46
Q

diagnosis of biliary atresia

A 
raised ALP
raised bilirubin
USS
radioisotope scan
liver biopsy
47
Q

management of biliary atresia

A 
Kasai procedure (hepatoportoenterostomy)
or liver transplant
48
Q

what does a ribbon stool indicate?

A

anal stenosis

Child Health 2020 (22 decks)

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