Pediatric Gi Disorders

Front 1

Describe the term "mega-colon"

Back 1

accumulation of fecal material in the intestine that is unable to pass

Front 2

Pathophysiology of Hirshprungs Disease

Back 2

absence of ganglionic cells in one or more portions of the intestine

Front 3

Why does fecal material accumulate in the intestine with Hirshprungs disease

Back 3

absence of peristalsis

Front 4

What 3 disorders are most commonly found in pt's with Downs Syndrome

Back 4

diabetes, hirshprungs, AV canal

Front 5

What is the leading cause of death in children with Hirshprungs

Back 5

entericolitis

Front 6

What is a major concern with enterocolitis

Back 6

perforation

Front 7

What disorder is synonymous with a tight anal sphincter that fails to relax

Back 7

hirshprungs

Front 8

4 s&s's of newborns suffering from hirshprungs

Back 8

1-failure to pass meconium w/in 24hrs
2-reluctant to ingest fluids
3-bile-stained vomitus
4-abdominal distention

Front 9

6 s&s's during infancy of pt's suffering from hirsphrungs

Back 9

1-failure to trhive
2-constipation
3-D/V
4-abdominal distention
5-fever
6-exhaustion

Front 10

A pt comes in complaining of constipation and ribbon-like bowels; upon assessment you you notice the child is poorly nourished and has a distended abdomen. What disorder are they likely suffering from and what else do you expect to find?

Back 10

hirshprungs; palpable fecal masses & visible peristalsis proximal to megacolon

Front 11

When performing a rectal exam on a pt with hirshprungs what do you expect to find

Back 11

tight internal sphincter & absence of stool

Front 12

What is an anorectal manometry

Back 12

insert a catheter beyond internal sphincter, inflate balloon; normal response is for anal sphincter to relax

Front 13

At what point can a child undergo surgical procedures for hirshprungs

Back 13

adequately nourished, 9kg

Front 14

What therapeutic measurement is used until an infant is ready to undergo surgery for hirshprungs

Back 14

temporary ostomy

Front 15

2 surgical procedures for hirshprungs

Back 15

immediate resection of intestine; resection of intestine after megacolon has shrunk in size

Front 16

Define enterocolitis

Back 16

inflammation of intestine & colon

Front 17

When assessing for enterocolitis what would we expect to find r/t VS's?

Back 17

increased HR, increased RR, decreased BP

Front 18

In children, which is typically the last VS to change

Back 18

BP

Front 19

When assessing the abdomen of a pt with enterocolitis what do we expect to find

Back 19

absence of bowel signs, distention and tenderness

Front 20

When assessing for enterocolitis what is it important that we check for r/t VS

Back 20

s&s's of shock

Front 21

A pt comes in with a fever and a possible diagnosis of enterocolitis; it is suspected that this pt's intestine has perforated. Should we administer a rectal temp?

Back 21

no

Front 22

At what point can we remove the NPO diet restriction from a post-op pt for enterocolitis

Back 22

presence of bowel sounds, passing of flatulence

Front 23

Is gastric emptying delayed with GERD?

Back 23

yes

Front 24

What is the most common cause of GERD

Back 24

underdeveloped esophagus

Front 25

What are the peak ages we see GERD in children

Back 25

1-4mos

Front 26

At what age in children does GERD tend to resolve

Back 26

6-12mos

Front 27

Describe Sandifer's Syndrome

Back 27

post-feed the infant or child turns head to one side to alleviate discomfort from GERD; often mistaken for seizure

Front 28

Is respiratory illness associated with GERD

Back 28

yes

Front 29

When is the only time it is recommended to add rice cereal when bottle-feeding

Back 29

infant with GERD

Front 30

NG tube and surgery are considerations for what pt's diagnosed with GERD

Back 30

failure to thrive, anatomical abnormalities, respiratory illness, non-responsive to medical therapy

Front 31

Complications of Nissan Fundoplication

Back 31

too tight; bowel obstruction, gas-bloat syndrome

Front 32

When should meds be administered for pt's diagnosed with GERD

Back 32

around feedings; 30 min prior

Front 33

What classifications of drugs are used for medical therapy r/t GERD

Back 33

antacids, proton pump inhibitors, prokinetics

Front 34

Commonly used drugs more medical therapy r/t GERD

Back 34

prilosec, prevacid, pepsid, tagamet, others

Front 35

What disorder is described as chronic inflammatory disease

Back 35

crohn's

Front 36

What disorder is Crohn's often misdiagnosed as

Back 36

appendicitis

Front 37

What "triggers" are commonly associated with Crohn's disease

Back 37

stress, viral&infectious agents, food allergies, increased intestinal permeability, immunological dysfunction

Front 38

What is erythema nosdosum and what disorder is it associated with

Back 38

large, painful nodules on the legs; crohn's

Front 39

s&s's of Crohn's disease

Back 39

abdominal pain, cramps, diarrhea, weight loss, poor growth, fever, anorexia, rectal bleeding, perianal discomfort&fissures, and fistulas through other loops of bowel

Front 40

Why might we find elevated levels WBC and ESR with Crohn's disease

Back 40

due to inflammatory response r/t dysfunctional immunology

Front 41

Uveitis and large jt arthritis are associated with what disorder, why?

Back 41

Crohn's disease

Front 42

When do we expect to find pANCA levels elevated?

Back 42

enterocolitis, not with Crohn's

Front 43

What lab data would we expect to see elevated in a pt with Crohn's disease r/t inflammation

Back 43

CBC, ESR, CRP

Front 44

What lab data would we expect to see elvated in a pt with Crohn's disease r/t nutritional status

Back 44

zinc, mg++, B12

Front 45

Will protein be in elevated or decreased levels in Crohn's

Back 45

elevated

Front 46

What do we expect to find in stool of pt's with Crohn's disease

Back 46

blood, leukocytes, infectious agents

Front 47

What drugs are commonly administered to treat Crohn's

Back 47

corticosteroids, aminosalicylates, immunodulators, antibiotics

Front 48

What function do aminosalicylates serve?

Back 48

anti-inflammatory

Front 49

What is important concerning a pt who is consistently taking corticosteroids

Back 49

adrenal gland works via negative feedback so it is not producing cortisol on it's own; important for surgery because will need to implement stress doses of corticosteroids

Front 50

What dos Zinc do r/t treating Crohn's disease

Back 50

helps remove free radicals from the body

Front 51

Signs of toxic megacolon

Back 51

fever, acute abdominal pain, abdominal distention

Front 52

Why are pt's with Crohn's disease at risk for enterocolitis

Back 52

inflammation + ulceration can lead to perforation

Front 53

Can you cure Crohn's disease

Back 53

no

Front 54

What is a long-term concern for pt's with Crohn's disease

Back 54

colon cancer

Front 55

Why should pt's with Crohn's disease receive frequent colonoscopies

Back 55

at risk for colon cancer