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41 Cards in this Set

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Presents with watery diarrhea, which can last for up to 7-10 days. It can be accompanied by 3-4 days of vomiting. Fever may be present
Causes a mild diarrhea in immunocompetent infants, but causes severe diarrhea in AIDS pts
When is treatment of Salmonella diarrhea indicated?
-only for < 3 mo of age
-toxic patient
-disseminated dz
-or if its S. typhi
What is the treatment for Shigella diarrhea?
Tri/Sulfa = Bactrim
What is Entamoeba treated with?
Obstipation = ?
absence of bowel movements
Constipation = ?
infrequent passage of hard, dry stools
What is the most common cause of constipation outside of infance?
Functional constipation = voluntary withholding
What should constipation in the neonate be considered until proven otherwise?
What is the treatment for functional constipation?
Initial cleaning out, & may involve dietary manipulation, stool softeners, & counseling
A newborn presents with bilious vomiting with every feed. Abdominal film reveals a double bubble
Duodenal Atresia
What is the association with Duodenal Atresia?
Trisomy 21
When does Duodenal Atresia usually present?
usually in the first day of life
-there may be a history of Polyhydramnios
A 4 month-old is admitted w/ episodes of apnea occurring 20-30 minutes after feeds. The mother states the baby has been spitting up since birth. She is at the 5th% for weight
GER = occurs when the lower esophageal sphincter pressure is reduced
What associated conditions is GER more common in?
pts with Developmental Delay & Cerebral Palsy
Patients presents with GER & opisthotonus ( condition, caused by a tetanic spasm of the back muscles, in which the trunk is arched forward while the head and lower limbs are bent backward)
Sandifer syndrome
How would you diagnose GER?
pH probe is the standard

Other imaging studies include technetium scanning & barium swallow
What is the treatment for GER?
Antireflux measures such as elevating the head of the bed & thickening of feeds.

Medical management = antacids, prokinetics, H2-receptor blockers, PPI's

Failure of medical management results in surgical correction w/ a Nissen Fundoplication
A 4 week old boy has nonbilious projectile vomiting. Exam is remarkable for a small mass palpated in the abdomen
Pyloric Stenosis
What is the gender ratio for Pyloric Stenosis?
Boys 4:1
What is the presentation of Pyloric Stenosis?
1. nonbilious projectile vomiting
2. usually AFTER 3 WEEKS of age
3. baby remains hungry after vomiting
4. olive may be palpated
5. peristaltic wave may be seen
What does the BMP show in Pyloric Stenosis?
Hypokalemic, Hypochloremic Metabolic Alkalosis
A 15 month-old child is seen for cramping, colicky abdominal pain of 12 h duration. He has had 2 episodes of vomiting & a fever. Exam is remarkable for a lethargic child; abdomen is tender to palpation. Leukocysotis is present. During examination, the patient passes a bloody stool with mucus
When do most intussusceptions occur?
6-24 months of age
What vaccine was associated with Intussusception?
Rotavirus vaccine
Acute onset of cramping, colicky abdominal pain. Pts may have vomiting. Pt may develop fever & become lethargic. Sausage-shaped mass may be palpated
What is the diagnostic test for Intussusception?
Barium enema or Air Enema
A 2 year old boy presents with a 1 wk history of painless rectal bleeding. Exam is unremarkable. Abdomen is soft & nontender. Rectal examination is unremarkable
Meckel Diverticulum
Most frequent congenital anomaly of the GI tract
Meckel Diverticulum
What are the rules of 2 with Meckel Diverticulum?
1. presents in about 2% of infants
2. peak incidence is by 2 years of age
3. contains 2 types of tissue
4. 2 cm in size
5. located 2 feet from ileocecal valve
Painless rectal bleeding
Meckel Diverticulum
What can be a complication of Meckel Diverticulum?

Inflammation mimicking appendicitis

Can perforate & cause peritonitis
What is the diagnostic test for Meckel Diverticulum?
Technetium scan for gastric mucosa in the bowel
An 8 year old is seen in the emergency department w/ persistent vomiting & mental status changes. On exam he is combative & has a seizure, becomes apneic, & requires intubation. Lab tests are remarkable for hypoglycemia & elevated ammonia. The pt had recently recovered from a viral URI
Reye Syndrome
Define Reye Syndrome
Encephalopathy with fatty degredaton of the liver
What is the etiology of Reye Syndrome?
Recent viral URI or Varicella with concomitant use of Aspirin
What is the presentation of Reye Syndrome?
-hx of recent viral URI
-after 5-7 days they then present w/ abrupt onset of protracted vomiting
-delerium, combative behavior, & stupor quickly ensue. can progress to seizures, coma, & death
-focal neurologic signs are absent
What are the lab tests like in Reye Syndrome?
Ammonia, Transaminases, CK, & LDH are markedly elevated