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9 Cards in this Set
- Front
- Back
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What % of infants have a normal physiologic reflux/vomiting of 1x/day?
GER |
50% of infants 0-3 mos
25% of infants 3-6 mos 5% of infants 10-12 mos *Formula infants tend to vomit more as they are overfed! |
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What is the peak age for vomiting and why?
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4 mos at 61%, decreases to 21% by 6-7 mos
Because salivary glands are kicking in, more drooling |
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Symptoms of GERD
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wt loss or poor weight gain
irritability frequent regurg, qfeeds heartburn or chest pain hematoemesis dysphagia feeding refusal apnea wheezing or stridor hoarseness cough abnormal neck posturing |
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Sandifer Syndrome (associated with GERD)
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various stiff, bizarre postures can observed, last 1-3 minutes
infant may become very quiet then fussiness associated with normal exam in older children, may be associated with mental impairment |
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Diagnostics for GERD
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Ba swallow/UGI
Milk Probe Endoscopy/biopsy H & P very important pH monitoring |
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GERD Treatment
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-usually resolves 18-20 mos
-positioning the baby after feeds, elevate head -smaller, more frequent feeds -may instruct family to thicken formula -take the time to teach |
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GERD Medications PPI
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-lessens intestinal gas
-decreases or neutralizes stomach acid -improve intestinal coordination -Omeprazole -Lanzoprazole -Protein Pump Inhibitor (PPI) |
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GERD Medications
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Antacids-be careful with metals, aluminum tox
Prokinetic therapy-Reglan-AAP says no Sulcrafate Macrolides-rare |
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GERD Medications H2-RAs
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Tagamet, Zantac, Famotidine
Start low |
