Easy Points: Pediatrics - GIT

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Easy Points: Pediatrics - GIT
2013-12-11 09:57:19
Pedia GIT olfu2016
Pedia: GIT 4
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  1. Regional enteritis; Trasmural
    Crohn Disease
  2. Ssx: obstructive symptoms
    Systemic symptoms: fever, malaise, growth failure
    Crohn Dse
  3. Why growth failure for Crohn Dse?
  4. Dx: depends on finding typical clinical features of the disorder
    Crohn Dse
  5. Expected height for 1 yo
    75 cm
  6. Labs for Crohn Dse?
    CBC, ESR, Fecal calprotectin or lactoferring (elevated), Radiography (cobble stone appearance fistula)
  7. Radiographic indication of advanced Crohn Dse?
  8. Tx for Crohn Dse
    • Medical vs. surgical
    • Mesalamine
    • Sulfasalzine
    • Corticosteroid
    • Immunomodulators
    • Metronidazole in fistula
    • Nutritional
    • *Surgical therapy should be reserved for very specific indications
  9. Defined histologically by the presence of bands of fibrous tissue that link central and portal areas and form parenchymal nodules
  10. Type of cirrhosis after toxic injury
  11. Cirrhosis due to biliary issues
    Chronic biliary cirrhosis
  12. alternative or concomitant response to injury, caused by extrahepatic or intrahepatic obstruction to blood flow
  13. Liver edge can be felt up to 2 cm below the right costal margin
  14. liver span at 1 week of age
    4.5 - 5 cm
  15. liver span 12 yo boy
    7-8 cm
  16. liver span for girl at 12 yo
    6-6.5 cm
  17. Intense generalized itching often with skin excoriation can occur in patients with cholestasis
  18. Blotchy erythema in thenar and hypothenar area
    Spider angioma
  19. Marked elevation of serum cholesterol levels (to > .5 mg/dL)
  20. Only type of herpes that has DNA
  21. Parameters of protection for immunoglobulins
    6-9 months
  22. First milk tooth to erupt at what age?
    5-8 mos
  23. When do the first permanent teeth erupt?
    6-8 years
  24. What week do we see fetal swallowing?
    10 weeks
  25. Complication of lack of fetal swallowing
  26. Complication seen if fetus is not urinating
  27. Why should you burp a baby after feeding?
    Uncoordinated swallowing
  28. When does posterior fontanelle close?
    4 months
  29. When does anterior fontanelle close?
    2 yo
  30. Borders of the liver at birth
    1-2 cm below R subcostal
  31. Why is the liver enlarged at birth?
    Organ for hematopoiesis during fetal life
  32. Flouride requirement?
    5 ppm
  33. Color of teeth from porphyria
    reddish black
  34. Color of teeth from tetracycline
  35. Color of teeth from enthambutol
    Gray (permanent discoloration)
  36. Causes of late eruption of teeth
    hypothyrodism, hypoparathyroidism, congenital illness
  37. When should you correct a cleft lip or palate?
    8 months old (before child learns to talk)
  38. Condition which is secondary to weather or Vit B deficiency, or contact dermatitis. Difficult to take big bites and to swallow.
  39. Incidence for cleft lip
  40. Incidence for cleft palate
  41. Condition described by the following:
    Dryness of the lips, followed by scaling and cracking and accompanied by a characteristic burning sensation
  42. Condition caused by sensitivity to contact substances (from toys and foods) plus photosensitivity to the sun's rays.
  43. Condition aggravated by the alternation of wetting with the tongue and drying by the wind, especially in cold weather.occurs in association with fever
  44. Gastroesophageal reflux due to incompetence of LES
  45. Treatment for Chalasia
    PPI, fundoplication
  46. Condition described as the following:
    Manifestations at birth are maternal history ofpolyhydramnios, inability to insert catheter innose/mouth to stomach, excessive oral secretions
    Tracheoesophageal fistula
  47. How to diagnose tracheoesophageal fistula
  48. Treatment for tracheoesophageal fistula
    OGT and surgery
  49. Herniation of the stomach through the esophageal hiatus
    Hiatal hernia
  50. Type of hernia in which the gastroesophageal junction slides into the thorax
    Sliding hernia
  51. Type of hernia in which portion of the stomach (usually the fundus) is insinuated next to the esophagus
    Paraesophageal hernia
  52. Pathophysiology of intestinal obstructions
    Obstruction --> intestinal dilatation --> decreased fluid absorption --> hypokalemia --> hypomotility --> nausea &vomiting
  53. Upper or lower GIT symptom?
    large-volume, frequent, bilious emesis
  54. Upper or lower GIT symptom?
    Pain-intermittent, localized relieved by vomiting
  55. Upper or lower GIT symptom?
    Minimal abdominal distention
  56. Upper or lower GIT symptom?
    Hypochloremic Metabolic alkalosis
  57. Upper or lower GIT symptom?
    Progressive emesis
  58. Upper or lower GIT symptom?
    Pain- Diffused
  59. Upper or lower GIT symptom?
    Marked abdominal distention
  60. Upper or lower GIT symptom?
    Metabolic acidosis
  61. Condition which describes the following:
    Seen as early as 1 week to 5 months Manifestation: Presents vomiting --> hypokalemia --> metabolic acidosis. Palpable mass at 2cm above and to the R of the umbilicus.
    Pyloric stenosis
  62. Obstruction caused by something in the lumen, such as a foreign body
  63. Obstruction caused by something pressing the intestinal tube
  64. Portion of the GIT with most common umbilical hernia
  65. Manifestation of hiatal hernia
    Feeding problems (regurgitation), vomiting, Dehydration
  66. Classic symptoms of obstruction
    nausea, vomiting, abdominal distention & obstipation.
  67. Lab test which is helpful in identifying pyloric stenosis, malrotation, and volvulus or intussusceptionin differentiating pyloric stenosis from other causes of proximal obstruction
  68. Condition which can be described by the following:
    Non billous vomiting
    Symptoms seen ay 1 week to 5 months
    metabolic acidosis due to fluid, Cl and H2 loss
    Pyloric stenosis
  69. Name the condition of this PE:
    palpable mass w/c is firm and movable 2 cm above and R of umbilicus
    Pyloric stenosis
  70. Tx for pyloric stenosis
    Ramstedt pyloromyotomy
  71. Name the condition:
    failure to recanalize the lumen after the solid phase of intestinal development in the 4th and 5th wk of gestation
    Duodenal atresia
  72. Condition described as the following:
    intact membrane obstructing the lumen,a short fibrous cord connecting two blind duodenal pouches,
    Duodenal atresia
  73. Condition that can be due to extrinsic obstruction: Ladd bands in patients with malrotation
    Duodenal atresia
  74. Condition with the following:
    bilious vomiting without abdominal distention
    Double bubble sign- due to distended fluid filled stomach and proximal duodenum
    Duodenal atresia
  75. Management of duoedenal atresia
    decompression evaluate other anomalies duodenoduodenostomy, place gastrostomy tube or transanastomotic jejunal tube until feeding is resumes
  76. Condition attributed to intrauterine vascularaccidents leading to ischemic necrosis of the sterile bowel and resorption of the affected segments
    Jejunal and ileal atresia and obstruction
  77. Anomalies associated with duodenal atresia
    • Malrotation 20%
    • Esophageal obstruction- 10-20%
    • CHD -10-15%
    • Anorectal and renal anomalies-5%
  78. Which type of jejunal/ileal obstruction?
    Mucosal obstruction caused by an intraluminal membrane with intact bowel wall and mesentery.
    Type 1
  79. Which type of jejunal/ileal obstruction?
    Blind ends are separated by a fibrous cord.
    Type II
  80. Which type of jejunal/ileal obstruction?
    Blind ends are separated by a V-shaped mesenteric defect.
    Type IIIa
  81. Which type of jejunal/ileal obstruction?
    Type IIIb
  82. Which type of jejunal/ileal obstruction?
    Multiple atresias.
    Type IV
  83. Ssx of which condition?
    abdominal distention
    bile stained emesis or gastric aspirate75% fail to pass meconium 20-30% - jaundice
    Jejunal/ileal obstruction
  84. Name the condition:
    abdominal x ray- many fluid filled levels or peritoneal calcifications
    Jejunal/ileal obstruction
  85. Treatment for jejunal/ileal obstruction
    • adequate fluid and electrolyte balance
    • End to end anastomisis
  86. How long do you wait for the meconium and urine from a newborn infant?
    48 hours
  87. incomplete rotation of the intestine during fetal development.
  88. a remnant of the embryonic yolk sac, which is also referred to as the omphalomesenteric duct or vitelline duc
    Meckel's diverticulum
  89. Name the condition with currant jelly colored stool
    Meckel's diverticulum
  90. When does the midgut rotate counterclockwise and returns to the peritoneal cavity
    12 week
  91. Condition common esp among premies and usually resultsfrom the inability of an immature liver to conjugatebilirubin, leading to an elevated indirect component
  92. Congenital aganglionic megacolonmost common cause of lower intestinal obstruction in neonates
    Hirschprung's Dse
  93. Name the condition with the following pathophysiology:
    absence of ganglion cells in the bowel wall, extending proximally and continuouslyfrom the anus for a variable distance.The absence of neural innervation is a consequence of an arrest of neuroblastmigration from the proximal to distal bowel
    Hirschprung's dse
  94. Name the condition with the following clinical manifestation:
    delayed passage of meconium
    sepsis due to bacterial overgrowth from fecal stasis
    Currarino triad
    Hurschprung's disease
  95. Name the components of Curarino Triad
    • anorectal malformation
    • sectopic,anus, rectal stenosis
    • sacral bone anomalies
    • hypoplasia,poor segmentation; presacral massesanterior meningoceles, teratoma, cysts
  96. Name the condition:
    Rectal manometry and rectal suction biopsy no closer than 2 cm to the dentate lineradiography- transition zonebarium enema
    Hirschprung's dse
  97. Tx for Hirschprung's dse
    • temporary colostomy
    • definitive surgery:
    • Swenson
    • Duhamel- neorectum
    • Soave-Boley- endorectal pull through
  98. occurs when a portion of the alimentary tract is telescoped into an adjacent segmentMost common cause of obstruction in 3 mo and 5 yr of age
  99. Name the condition with the following s/sx:
    vomiting – early phase bile stained
    currant jelly stool
    sausage shape mass
    bloody mucus on rectal exam
  100. Treatment for intussesception
    radiologic hydrostatic reduction
  101. inflammation due to an imbalance between cytoprotective and cytotoxic factors in the stomach and duodenum
    Deep mucosal lesions that disrupt the muscularis mucosa of the gastric or duodenal wall
    Cause: multifactorial
    Peptic ulcer
  102. Name the condition:
    Ssx:epigastric pain alleviated by the ingestion of food
    Dx: Esophagogastroduodenoscopy
    Tx: Healing and elimination of cause
    Peptic ulcer
  103. Peptic ulcer near the lesser curvature
  104. peptic ulcer near the bulb
  105. primary or secondary peptic ulcer?
    H. pylori
  106. primary or secondary peptic ulcer?
  107. primary or secondary peptic ulcer?
    Drugs (NSAIDs)
  108. primary or secondary peptic ulcer?
  109. Crohn disease and ulcerative colitis Crohn-idiopathic, chronic inflammatory disorder of the bowel Risk factors: Genetic-environment
    Inflammatory bowel disease
  110. Idiopathic chronic inflammatory disorderinvolve the colon
    Proctitis- rectum
    Pancolitis- entire colon
    Chronic ulcerative colitis
  111. S/sx for which condition:
    blood in the stool, tenesmus,urgency, cramping abdominal pain, nocturnal bowel movements are common
    Chronic ulcerative colitis
  112. Treatment for chronic ulcerative colitis
    Sulfasalazine- 50-75 mg/kgl24 hr (divided into two to four doses)5-aminosalicylate- (mesalamine, 50-T0mglkglday)Hydrocortisone enemas
  113. Regional enteritis
    Ssx:Obstructive symptoms
    Systemic symptoms: fever, malaise, growth failure
    Crohn Disease
  114. Dx for this disorder:
    depends on finding typicalclinical features of the disorder
    Chronically ill
    Crohn dse
  115. Lab tests and findings for which condition:
    Fecal calprotectin or lactoferrin
    cobble stone appearance, fistula
    Crohn dse
  116. Treatment for which condition:
    Medical vs. surgical
    mesalamine (50-70 mglkglday, maximum 3-4 g)
    corticosteroids (prednisone 1-2 mglkglday, maximum 40-60 mg).
    metronidazole in fistula
    Crohn dse
  117. defined histologically by the presence of bands of fibrous tissue that link central and portal areas and form parenchymal nodules
  118. type of cirrhosis after acute or chronic hepatitis
  119. type of cirrhosis after toxic injury
  120. type of cirrhosis after chronic biliary obstruction
    biliary cirrhosis
  121. an alternative or concomitant response to injury
    caused by extrahepatic or intrahepatic obstruction to bile flow
  122. liver edge can he felt up to 2 cm below the right costal margin
  123. liver span at 1 wk of age
    4.5-5.0 cm
  124. liver span for 12 yo boys
    7-8 cm
  125. liver span for 12 yo girls
  126. Intense generalized itching, often with skin excoriation,can occur in patients with cholestasis
  127. blotchy erythema in thenar and hypothenar area
    Spider angioma
  128. marked elevation of serum cholesterol levels (to >.500m g/dl)
  129. Only strand of hepatitis with DNA virology
  130. Diagnostic for which condition:
    Serology: anti-HAV (IgM)(+) during clinically apparent infection up to 4-months after infectionVirus is (+) in the stool for 2 weeks
    Hepatitis A