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80 Cards in this Set
- Front
- Back
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Neonatal hepatitis |
SGA or preterm Familial Giant cells on bx Favorable outcome |
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Normal liver edge |
2 cm below margin in newborn 1 cm below up to 1 year |
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Meckel's diverticulum |
Rule of 2s: 2 cm long, 2 yrs old, 2 ft from ileocecal valve, 2% of population, twice as likely in boys |
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test Hematemesis from mom or baby? |
Apt test. Positive = moms blood |
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Causes of acute abdominal pain |
Constipation, cyst-ovarian Adentitis, mesenteric Mono Pancreatitis
Hepatitis Infection (UTI) Trauma |
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Define Functional dyspepsia |
At least 2 months of upper abd or Periumbilical pain not relieved by pooping, at least once per week, w/o other explanation. |
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Periumbilical pain following viral gastro |
Gastroparesis |
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Dyspepsia treatment |
Smaller meals, eliminate nsaids, sodas, caffeine, spicy foods
Maybe h2 antagonist, PPI, or low dose antidepressants |
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Define IBS |
Duration >2 months, once per week. Pain improved with defecation, change in pattern. Stools with mucus, bloating or distention. |
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IBS tx |
Eliminate sorbital, fructose, gass foods (Brussels sprouts, broccoli, beans, Kim chi). |
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Triggers for abd migraines |
Caffeine, stress, smoked meats (nitrate foods) |
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When to test watery diarrhea? |
C of diarrhea. C diff and cholera |
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Optimal oral rehydration |
2% glucose and 90 mEq NaCl |
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How do you find WBCs in stool? |
Methylene blue |
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Viral vs bacterial diarrhea |
Viral: watery and large Bacterial: small and frequent with mucus or blood and higher fevers |
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EPEC |
Diarrhea <2 yrs old Poor sanitation Fever bad vomiting, non bloody |
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ETEC |
Mexico Severe diarrhea and cramping Can consider TMO-SMX, azithro, or cipro after several days. |
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EIEC |
dysentery presentation, afebrile, blood and mucus tinged stools, tenesmus |
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Tests for sugar malabsorption |
Positive reducing substances Positive hydrogen breath test |
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How long does transient lactase deficiency last? |
Up to 3-6 months |
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Cancer with diarrhea? |
Neuroblastoma secreting VIP |
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MCC of chronic diarrhea until 3 yrs |
Toddlers diarrhea from excess juice Gets looser throughout the day |
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Vomiting, no fever, labs |
Look for hypoglycemia, high ammonia, gap acidosis. Consider inborn error |
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Bilious vomiting newborn work up? |
KUB |
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Bilious vomit DOL 1 |
Duodenal atresia. Double bubble. No distal gas. |
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Newborn with bilious vomit, pain, distention, bloody stool. |
Term: malro Preterm: NEC |
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Decreased intestinal air and corkscrew appearance. Right sided distention. Ladd bands. |
Volvulus |
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Ondansetron MOA |
Serotonin receptor antagonist |
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Pyloric stenosis management |
Correct electrolytes first, then surgery |
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US findings in PS |
Length >14 mm Thickness >4 mm |
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Cyclic vomiting short and long term tx |
Short: IV hydration Long: propranolol, cyproheptadine, TCAs |
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Mucocele on floor of mouth |
Ranula. Excise |
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Mucocele on floor of mouth |
Ranula. Excise |
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Midline mass in mouth |
Ectopic thyroid. Don't excise. |
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Ectodermal hypoplasia |
Empty dental. No teeth Dx by biopsy. Lack of sweat pores. X linked |
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Hallermann Streiff syndrome |
Holler man stress. Small teeth. No endocrine probs. |
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Portal hypertension and tarry stools. |
Varices. Bright red stool and hematemesis also. |
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Most common TE fistula |
Blind upper esophageal pouch |
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Dangerous drug for PUD |
Misoprostol in pregnant teens |
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Vomiting after eating, pain that wakes kid up at night. |
Peptic ulcer dz. dx c upper GI endoscopy for h pylori and biopsy |
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H pylori tx |
PPI 2 abx: clarithro and (amox or flagyl) 7-14 days |
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Celiac screening and confirmation |
Anti tTG and anti endomesial IgA. Confirm with bx |
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Bowel resection complication |
Macrocytic anemia 2/2 B12 deficiency |
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IBS tx |
High fiber diet, emotional factors. Maybe amitryptyline |
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Causes of rectal prolapse |
CF, tenesmus, pertussis, parasites, constipation, meningomyelocele |
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Gardners syndrome |
Extra teeth, intestinal polyps and osteomas. AD. Surgical excision to tx. |
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Peutz-jeghers syndrome |
Mucosal pigmentation of lips and gums. Hundreds of colonic polyps. Tx c routine colonoscopies |
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Ulcerative colitis tx |
Flaygl for infant 5 ASA chronic first line. Second line: steroids. 6mercaptopurine, azathioprine, or mtx. Cyclosporine or tacro |
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Crohns buzz words |
Skip lesions, cobblestoning, transmural lesions, noncaseating granulomas Apthous ulcers Personal fistula |
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Crohns extraintestinal manifestations |
Pyoderma gangrenosum of foot Erythema nodosum nodules over shin Ankylosis spondylitis/sacroiliitis Uveitis Arthritis Liver disease Renal stones |
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Crampy abd pain and fever less severe than appendicitis |
Camp jejuni or yersinia |
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Crampy sudden, severe abd pain with emesis, better with stooling, progresses to lethargy. |
Intussusception, 3 mo to 6 yrs |
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Toxic 2 yr old with no fever or abd symptoms |
Intussusception |
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Intussusception after 6 yrs |
Rule out lymphosarcoma as a lead point |
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Newborn with Bilious emesis, poor PO, distention, periods of diarrhea. |
Hirschsprungs |
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Umbilical hernia, constipation |
Hypothyroidism |
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False + guaic |
Meat ingestion, horseradish, ferrous sulfate |
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False + guaic |
Meat ingestion, horseradish, ferrous sulfate |
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False - guaic |
Vitamin C ingestion, old or poorly stored card. |
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GI probs in T21 |
Meckels, pyloric stenosis, duodenal atresia, hirschsprungs. |
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2 yr old c painless lower GI bleed |
Meckels |
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Painless rectal bleeding in school age and no other sx |
Juvenile polyposis |
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Direct hyperbili work up |
Hepatobiliary scintigraphy |
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Med to stimulate bile secretion |
Phenobarbital |
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Biliary atresia onset, dx and tx |
Over 1 month, dx c US then HIDA scan. Tx c kasai before 2 months old. |
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Labs in cholestatic vs hepatocellular jaundice |
Cholestatic: high alk phos Hepatocellular: high SGPT |
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Neonatal jaundice with fever, RUQ pain and mass |
Choledochal cyst |
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Recent flu or varicella, now comatose, with high ammonia and LFTs. |
Reye's syndrome after aspirin If second episode: inborn error of metabolism |
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Wilson's disease tx |
D-penicillamine (can cause aplastic anemia) |
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Specific test for pancreatitis |
Abd us |
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Labs in pancreatitis |
High glucose, BUN/Cr, low Ca, anemia. Coagulopathy. |
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Hepatosplenomegaly, icteric, abd pain |
Cholelithiasis |
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Who needs to stay home with HAV? |
Workers in daycares and food service. For 1 week after sx onset |
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Chronic HBV complications |
Fulminant liver failure, hepatocellular cancer |
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Hep C complications |
Cancer and cirrhosis |
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Umbilical instrumentation |
Ports vein thrombosis |
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Splenomegy most sensitive indicator of what? |
Portal hypertension and varices Commonly associated with thrombocytopenia, anemia, and leukopenia |
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Hx of bowel obstruction or surgery. Neurological sx. Acidosis. |
D-lactic acid acidosis |
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Pancreatitis complications |
ARDS |
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Peutz jeghers syndrome |
Mucocutaneous freckling, family hx of polyposis, GI bkeedinn |
