Mtb: Pediatrics 10, Gastroenterology

Front 1

on what day is jaundice considered pathological in neonatal life

Back 1

on the first day of life

Front 2

and what rate of rise is considered pathological for bilirubin?

Back 2

over 5 mg/dL/day

Front 3

what serum level of bili is pathologic?

Back 3

over 19.5 mg/dl

Front 4

what rate of rise is pathologic for DIRECT bili>

Back 4

over 2 mg/dL at any time

Front 5

how long can hyperbili persist before it's considered pathologic?

Back 5

it's pathologic after 2 weeks of persistence

Front 6

what is the most serious complication of hyperbilirubinemia?

Back 6

kerniceterus- the deposition of bilirubin in the basal ganglia

Front 7

presentation of kernicterus

Back 7

hypotonia, seizures, choreoathetosis, hearing loss

Front 8

what is the basic workup of jaundice in a newborn?

Back 8

you check direct/indirect bili

check the blood type of the infant and mother

analyze peripheral smear

check retic count for hemolysis

Front 9

what is the basic mgmt of nwborn jaundice?

Back 9

phototherapy or exchange transfusion if bilirubin rises over 20 to 25 mg/dL

Front 10

there is alot more about newborn jaundice

Back 10

on U World though

Front 11

newborn presenst with vomiting after the first feeding, choking, coughing and cyanosis

Back 11

esophageal atresia, TE fistula

Front 12

what is the most common complication of a TE fistula?

Back 12

aspiration pneumonia

Front 13

classic sign for a TE fistula

Back 13

the NGT curls up in a blind ending pouch

Front 14

dx test for a TE fistla

Back 14

chest X ray showing esophageal and gastric air bubbles, coiling of the NGT, CT or esophagram

Front 15

what is the treatment for TEF?

Back 15

2 stage surgical repair

in the meantime- manage with good anaerobic and GNR coverage for pneumonia and provide fluid resuscitation

Front 16

classic radiologic sign of pyloric stenosis

Back 16

the STRING sign. seen on upper Gi series with barium swallow

Front 17

when is the donut sign seen?

Back 17

intussusception

Front 18

what is the steeple sign?

Back 18

seen during croup

Front 19

what do we think is a major risk factor for pyloric stenosis?

Back 19

formula feeds

firstborn males

Front 20

when does pyloric stenosis present?

Back 20

after 3 to 4 weeks of life so it probably develops in that time period as well

Front 21

it can also present

Back 21

as late as 6 months of life

Front 22

what is a "succession splash?"

Back 22

just a random PE finding associated with pyloric stenosis. It's a sound of stomach contents splashing up against the pylorus

Front 23

hallmark symptom of HPS

Back 23

projectile non bilious vomiting

Front 24

what electrolyte abnormality would you expect with pyloric stenosis?

Back 24

hypokalemic, hypochloremic metabolic alkalosis

Front 25

then what hormone becomes a big problem and further complicates electrolyte losses?

Back 25

aldosterone

Front 26

best dx test for pyloric stenosis

Back 26

ultrasound

Front 27

what is the most accurate dx test for pyloric stenosis however?

Back 27

upper GI series

Front 28

what is the mushroom sign?

Back 28

it's a sign where the pylorus is up against the duodenum

Front 29

what is the railroad track sign?

Back 29

excess mucosa in the pyloric lumen resulting in 2 columns of barium

Front 30

what is the mgmt of pyloric stenosis?

Back 30

requires surgical myotomy

replace fluids and correct electrolytes

replace K+

NGT to decompress the bowel

Front 31

a condition marked by cyanotic episodes when feeding and then turning pink again with crying

Back 31

choanal atresia

Front 32

what causes choanal atresia

Back 32

these babies have an abnormal membrane between their nasal septum and pharyngeal space that keeps them from breathing through nose very well

Front 33

what syndrome is associated with choanal atresia?

Back 33

CHARGE syndrome

coloboma of the eye, CNS anomalies

Heart defects

Atresia of choanae

Retardation of growth/development

Genitourinary defects, hypoGonadism

Ear anomalies and/or deafness

Front 34

dx test for choanal atresia

Back 34

CT scan

Front 35

the tx for choanal atresia is

Back 35

surgical perforation of the membrane

Front 36

a congenital lack of innervation to the distal bowel

Back 36

Hirschsprung disease

Front 37

what plexus is missing in an HD patient?

Back 37

Auerbach's plexus

Front 38

What does this lack of innervation cause?

Back 38

contractures of the bowel muscle.

Front 39

boys or girls? what genetic condition?

Back 39

boys

Down syndrome commonly

Front 40

first sign of Hirschsprung disease

Back 40

failure to pass meconium in under 48 hours

Front 41

then this is followed by extreme

Back 41

constipation and large bowel obstruction

Front 42

on rectal exam, the baby cannot

Back 42

pass flatus

Front 43

what is the dx value of contrast enema with HIrschsprung?

Back 43

shows retention of contrast for more than 24 hours

Front 44

best dx test for Hirschsprung

Back 44

full thickness biopsy that reveals a lack of submucosal ganglionic cells

Front 45

treatment for Hirschsprung

Back 45

3 stage surgery