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31 Cards in this Set
- Front
- Back
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What is intussusception?
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Intestine telescoping upon itself (ileocolic is common)
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What are the symptoms of intussusception?
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6-12 months old
Sudden onset of severe intermittent abdominal pain Gradual progression to lethargy Bilious emesis Currant jelly stools** Sausage shaped mass in right side of colon |
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How is intussusception diagnosed and treated?
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Diagnosed by ultrasound, air contrast enema, CT
Treatment with air contrast enema or surgery |
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What is the etiology of hemolytic uremic syndrome (HUS)?
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Mostly in first 5 years of life
E. Coli 0157:H7 toxin |
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What are the symptoms of HUS?
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Develop 5-10 days after diarrhea starts
Microangiopathic hemolytic anemia Thrombocytopenia Acute renal failure |
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How is HUS treated?
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Antibiotics will WORSEN the condition
Treatment is supportive therapy |
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What is the etiology of pseudomembranous colitis?
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Rare
Overgrowth of C. difficile after or during antibiotic treatment |
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What are the symptoms of pseudomembranous colitis?
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Watery diarrhea
Low grade fever Leukocytosis May progress to toxic megacolon and shock |
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How is pseudomembranous colitis diagnosed and treated?
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Diagnosis: Isolation by culture for C. difficle
Treatment: Antibiotics like metronidazole and vancomycin, supportive care |
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T or F: Rates for C. difficile associated disease in children have been increasing over the last decade.
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True
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T or F: Asymptomatic carriage of C. difficile is uncommon in infants younger than 1 year
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False
It is common 25-33% of asymptomatic 0-36 month patients have stools positive for C. difficile |
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What are the 4 keys to diagnosing and treating C. difficile associated disease?
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Perform testing only on liquid stools
Make sure other etiologies of diarrhea have been ruled out Dont test infants younger than 1 year of age (unless they have Hirschsprung's) Don't perform tests for check for cure |
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What is the cause of appendicitis?
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Bacterial infection of the appendix
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What are the symptoms of appendicitis?
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Pain in lower right quadrant
Abdominal wall rigidity Migration of pain from umbilicus to lower right quadrant |
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How is appendicitis diagnosed and treated?
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Diagnosis: CT scan
Treatment: surgery, antibiotics if ruptured |
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What is toxic megacolon and what are some common causes?
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Rapid widening of the colon over 1-4 days
Causes: Infection (shigella) Pseudomembranous colitis Hirschsprung disease IBD |
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What are the symptoms of toxic megacolon?
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Distension
Abdominal pain Small volume stools with mucous Tachycardia Possible shock |
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How is toxic megacolon diagnosed and treated?
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Diagnosed: Physical exam, x-ray, CT
Treatment: decompression, surgery |
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What is the cause of congenital secretory diarrhea?
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Inborn errors of metabolism in which digestion, absorption, transport, etc. are abnormal
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What are the symptoms of congenital secretory diarrhea?
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Profuse watery diarrhea in the newborn period
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How is congenital secretory diarrhea diagnosed and treated?
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Diagnosed: Stool studies, genetic studies, newborn screens
Treatment: Condition specific, hydration and nutrition are key |
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What is the most common cause of diarrhea?
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Viruses, specifically norovirus
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What are some common extra intestinal causes of diarrhea?
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Otitis media
UTI Pneumonia |
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What is the difference between acute and chronic diarrhea?
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Acute: 5 days or less in duration
Chronic: greater than 1 month in duration |
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What are three important questions to ask a patient with diarrhea?
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Been peeing?
Been able to eat and drink? Blood in the stool? |
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What is the gold standard for assessing dehydration?
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Weight loss!
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T or F: If there is profuse blood in the stool, rule out life threatening conditions such as HUS, intussusception, pseudomembranous colitis, etc.
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True
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If a child has a fever but non-bloody diarrhea, what is the most likely cause?
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Virus
With blood diarrhea, think bacteria |
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What do you use to rehydrate a dehydrated patient?
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Must use isotonic fluid
Normal saline or lactated ringers |
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When should a person with diarrhea be in the hospital?
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Potentially life threatening cause of the diarrhea
Severe dehydration Lack of improvement with initial therapy Continued severe diarrhea Inability or refusal to drink |
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What are some causes of chronic diarrhea?
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Hirschsprung disease
Cystic fibrosis HIV IBD Serial enteric infections Encopresis |
