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16 Cards in this Set
- Front
- Back
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What is the tx for reflux in infants less than 12 mos old?
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physiologic GER or "spitting up" is normal in infants. no tx necessary
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What is the most valuable tool for a functional dz workup in pediatric GI conditions?
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H&P
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What adverse effect does overzealous testing that is not indicated by H&P cause?
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feeds anxiety and /\ morbitidy of condition
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What is the most common cause of diarrhea in all age groups?
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AGE (acute gastroenteritis)
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How does pyloric stenosis present?
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vomiting, failure to thrive, delayed gastric emptying, elongated pyloric channel on XR. this is caused by a transient hypertrophy of the pyloris that is compounded by muscle spasm when the stomach empties.
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What are the metabolic consequences of pyloric stenosis?
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this only allows gastric contents to evacuated by (commonly projectile) emesis. there are no duodenal contents, so there is no bile in the vomit. this causes hypochloremia that impairs the kidney's ability to excrete bicarb and further causes metabolic alkalosis. secondary hyperaldosteronism develops due to hypovolemia and this causes Na retention, K excretion in the urine => hypokalemia.
the body tries to compensate per hyperventilation |
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How is constipation defined?
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2 or fewer stools per week or passage of pellet stool for 2 weeks.
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What is habit constipation?
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functional retention cuased by voluntary withholding of stool => encopresis (poopin yo pants)
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What's the DL on Hirschsprung dz?
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failure to develop normal ENS from the anus to no more than about 30 cm above the anus that causes a paralyzed section of bowel. look for aberrant acetylcholine esterase positive fibers in the lamina propria.
more importantly, if you have a baby that has not passed meconium in 48 hrs from delivery, abdominal distension and constipation, you better do a suction biopsy of the distally narrowed segment. happens more often in males. |
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What can be acquired by the birth canal or from the environment, is more common in breast fed babies and manifests as a easily visible white plaques that are difficult to remove?
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thrush from Candida albicans
tx with topical nystatin followed by oral fluconazole if tx failure |
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What is a Schatzki ring?
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narrowing of lower esophagus that can be seen on barium swallow and is associated with hiatal hernia. this will cause dysphagia and esophageal obstruction.
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What is the cause of allergic colitis?
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allergic rx to formula. usually a milk or soy protein intolerance. manifests as bloody mucous in stool with NO abdominal tenderness, distension, or vomiting. can cause severe anemia.
tx by restricting the mother's diet or switch to bottled hydrolyzed protein formula. |
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How is colic clinically defined?
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Wessel's rule of threes: > 3 hrs/day for > 3 days/wk for > 3 wks. tx with soothing techniques, possible dietary changes, will usually be self limiting
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Fever, diarrhea and a multitude of symptoms are commonly blamed by this natural occurence without scientific evidence.
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teething. just treat conservatively with teething toys first, then move to topical anesthetic, then to tylenol or ibuprofen is really really necessary.
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How is diarrhea defined?
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> 10 ml stool/kg/day usually caused by viruses
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What is "functional abdominal pain?"
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recurrent abdominal pain with multiple episodes over 3 mos that restricts some activity and is not associated with eating or defecation. often psychological.
similar to IBS, but does NOT involve bowel changes. low doses of anti-depressants have shown to be helpful. |
