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43 Cards in this Set

  • Front
  • Back
Patient starts vomiting 6-8 hours after eating a meal. What is the most likely cause?
food poisoning caused by Staph aureus
How will vomiting differ whether an obstruction is above or below the ligament of Trietz?
• obstruction above the ligament of Trietz: non-bilious vomiting
• obstruction below the ligament of Trietz: bilious vomiting
What are complications of vomiting?
• dehydration
• enamel erosion
• esophagitis
• Mallory-Weiss tears
• metabolic alkalosis
What causes pyloric stenosis?
• hypertrophy of pyloric muscle
• causes gastric outlet obstruction
What are risk factors for pyloric stenosis?
• male (4:1)
• family history
What are signs & symptoms of pyloric stenosis?
• projectile non-bilious vomiting after feeding
• poor weight gain
• dehydration
• lethargy
• onset between 2-6 weeks
What are physical exam findings of pyloric stenosis?
• dehydration (possibly shock)
• "olive-like" mass in RUQ
What is the treatment for pyloric stenosis?
What is the most common cause of acute gastroenteritis in children?
Rotavirus normally occurs during what time of year?
winter and spring
Complicated cases of E. Coli 0157:H7 can cause what?
True/False: E. Coli 0157:H7 is treated with antiobiotics
The correct answer is: False
List bacterial causes of gastroenteritis
• Campylobacter
• Salmonella
• Shigella
• Yersinia
Of the 4 bacterial causes of gastroenteritis, which one do you not treat?
Salmonella (unless high risk or immunosuppressed)
What is the treatment for Campylobacter?
What is the treatment for Giardia?
What is the most serious complication of acute gastroenteritis?
What causes Toddlers diarrhea?
fruit juice excess
What is the most common form of carbohydrate intolerance?
lactose intolerance
How is dehydration classified?
• classified by total body water lost
• mild = 5%
• moderate = 10%
• severe = 15%
What is the recommended rehydration method for a child that is mildly dehydrated?
oral rehydration
What are signs and symptoms of dehydration?
• dry mucous membranes
• decreased urine output
• decreased skin turgor
• lethargy
• prolonged cap refill
• sunken eyes
• sunken fontanelle
• tachycardia
What is Hirschsprung's Disease?
congenital aganglionic megacolon
What are presenting signs and symptoms of Hirschprung's Disease?
• bowel obstruction
• chronic constipation
• failure to thrive
• hypoproteinemia
How is Hirschsprung's disease diagnosed?
surgical biopsy
What are complications of inguinal hernias?
• incarceration/strangulation
• signs of abdominal obstruction (ex. vomiting, constipation)
What is the most common cause of intestinal obstruction between 3 months-6 years?
How do patients with intussusception present?
• colicky abdominal pain (rhythmic)
• current jelly stools
• emesis early becoming bilious
• decreased stool, then blood passage
• increasing abdominal tenderness & distention
• possible abdominal mass in RUQ
• lethargy, shock (late sign)
How is intussussception diagnosed?
• ultrasound
• barium enema
What is the most common condition requiring emergency surgery in childen?
What is the classic presentation of appendicits?
• periumbilical pain that migrates to RLQ
• classic triad (pain, vomiting, fever)
What is the most common cause of testicular pain in children 12 years or older?
testicular torsion
How can patients with testicular torsion present clinically?
• acute unilateral pain
• absent cremastric reflex
• scrotal swelling
• vomiting
What is the most common cause of testicular pain in ages 2-11?
torsion of the appendix testis
How do patients with torsion of the appendix testis clinically present?
• pain
• erythema
• gradual onset
• 3-5 mm tender, palpable mass on the upper pole
How do you distinguish testicular torsion from torsion of the appendix testis?
ultrasound w/ doppler (flow scan)
What are causes of epididymitis?
• reflux of urine
• infection
What is the MCC of epididymitis in kids? in adults?
• kids: virus
• adults: gonorrhea or chlamydia
Most undescended testes descend by 3 months. At what point will you refer for surgical correction if the testis haven't descended?
at 6 months
What are complications of cryptorchism?
• associated hernia
• infertility
• malignancy
• torsion
What is treatment for cryptorchism?
What is a mid-gut volvulus?
• malrotation of the intestines
• twisting of vessels off the aorta cause decreased perfusion
• true surgical emergency
• diagnosis made by upper GI
When does malrotation of the gut most commonly present?
within the first two weeks of life