Gi Test 2: Martin Ped Gi Cases

Front 1

what congenital defect characterized by incomplete closure of the abdominal wall with protrusion of the viscera

Back 1

gastroschisis

Front 2

what GI disorder has intact peritoneal sac covering the viscera that protrudes outside the body?

Back 2

omaphocele

Front 3

What is the diff of gastroschisis and omaphocele?

Back 3

gastroschisis is loss of all layer of the abdominal wall and omaphocele still has the perioneal sac intact.

Front 4

slanted palpebral fissures and epicanthal folds, a flattened face, and a single simian crease on each of a newborn’s broad hands.

disease?

Back 4

Trisomy 21 (down)

Front 5

Which congenital GI disorders should you be aware of in a patient with Trisomy 21?

Back 5

duodenal atresia and hirschsprungs disease

Front 6

holoprosencephaly
Cleft lip (60-80%)
Flexed fingers with polydactyly
Low set malformed ears
Omphalocele

syndrome?

Back 6

trisomy 13; platau syndrome.

Front 7

Overlapping fingers
Short sternum
Rocker bottom feet
Microagnathia
Cardiac malformations
Omphalocele
Cleft lip/palate


syndrome?

Back 7

trisomy 18; edwards syndrome

Front 8

Absence of Meissner and Auerbach plexus in the bowel wall
and delayed passage of meconium. what is the disease?

what is the associated syndrome?

Back 8

hirschsprungs disease

trisomy 21

Front 9

what is billious emesis?

Back 9

bile stained vomit

Front 10

what is a common cause of billious emesis?

Back 10

Malrotation with volvulus of the intestines.

must be distal to the sphincter of oddi

Front 11

What is the double bubble sign on radiology a sign of?

Back 11

duodenal atresia (air is stuck and cannot get distal to the place of atresia).

Front 12

if someone brings a child to you and says the dad has multiple polyps in the colon and possible cancer since he was 20, what is your next step?

what is the possible disease?

Back 12

genetic testing for genetic defect in APC gene

Familial adenomatous polyposis (FAP)

Front 13

what is the diff in gardners syndrome and FAP?

Back 13

gardners syndrome also has osteomas where as FAP does not.

Front 14

You are evaluating a one month old full term infant who has persistent jaundice. The parents explain that his stools were green 2 weeks ago and now are pale gray. Exam findings are unremarkable, except for a liver that is now palpable 4cm below the costal margin when it wasn’t before. The infant’s total bilirubin is 6.1mg/dL and direct bilirubin is 4.2mg/dL. Liver function tests are elevated—Alanine amino transferase is 240U/L and aspartate amino transferase is 160U/L. A hepatobiliary iminodiacetic acid (HIDA) nuclear medicine scan demonstrates absence of excretion of tracer into the bowel.


what do you think is the disease?

Back 14

biliary atresia

Front 15

If a pt with biliary atresia is left alone, what may occur?

Back 15

liver cirrosis

Front 16

Lack of galactose-1-phosphate uridyl transferase

disease?

Back 16

galactosemia

Front 17

Hepatomegaly, cataracts (galcticol accumulation), mental retardation

accumulation of galactose-1-phosphate in the liver, eye lens, kidney, heart muscle, brain, and erythrocytes

disease?

Back 17

galactosemia

Front 18

what is the tx for galactosemia?

Back 18

cut out galactose from the diet.

Front 19

what type of milk is ok for a baby with galactosemia?

Back 19

soy milk

Front 20

has absent bilirubin UGT (uridine diphosphate-glucuronosyltransferase) activity. Disease?

Back 20

craigler najjar syndrome type I

Front 21

If someone goes jaundace under stress but no other time, what might they have?

Back 21

gilberts syndrome

Front 22

People with HSP are at increased risk of what bowel problem?

Back 22

intussuseption

Front 23

6 year old male is brought to the emergency room with colicky abdominal pain, tea colored urine, and a rash. On examination, you note edema of his ankles and the palpable rash seen on the next page.

Dx?

Back 23

HSP

Front 24

what Sx separates HSP and intussuseption?

Back 24

intussuseption has hematochezia and HSP does not.

Front 25

A 4 week old male infant has been vomiting all his feedings for the last 2 days. His mother reports decreased urine output but no fever. On physical exam, he is alert, irritable but consolable, and moderately dehydrated. When he is offered a bottle, he takes it eagerly and then vomits formula forcefully. Abdominal exam reveals a small mass in the epigastrum.

Dx

Back 25

pyloric stenosis

Front 26

what is a common electrolyte problem with someone who has been suffering from pyloric stenosis?

why?

Back 26

metabolic alkalosis

this is because of the loss of stomach acid.

Front 27

Baby feeds eagerly, immediately vomits, and is ready to eat again

Dx?

Back 27

pyloric stenosis

Front 28

A 2 month old infant is brought to your office with spitting and fussiness with feeds for 3 weeks. On exam he is a calm, smiling baby but his stool tests positive for blood. What is the likely cause?

Back 28

milk protein allergy

Front 29

what is the criteria used to dx colic?

Back 29

cry 3 hrs; 3x a week, for 3 weeks.

Front 30

Abdominal distension
Hematochezia
Feeding intolerance**
Lethargy or shock
kids look deathly sick

Back 30

Necrotizing entericolitis

Front 31

You follow an 18 month old male in your practice who has over a short time developed poor weight gain, diarrhea, flatulence and fatigue. On exam, he has a protuberant abdomen, thin arms and legs, and he is 2 standard deviations below the mean for height and weight. His weight gain was fine while his diet consisted of breast milk and rice cereal. He now eats with the family—a well balanced diet of meat, vegetables, grains and whole milk.

possible disease?

Back 31

celiac disease

Front 32

hypersensitivity to gluten and these patients cannot eat wheat, or closely related grains—oat, barley, rye

Back 32

celiac disease

Front 33

what is the tx for celiac disease?

Back 33

cut out wheat

Front 34

can someone with celiac disease eat corn or rice?

Back 34

yes