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Peds - GI system
test 2
Question | Answer |
---|---|
Gi disorders can result from: | congenital defect; acquired disease; infection; injury; motility issues; inflammation; malabsorption. |
Colic | incessant crying for >3 hours/day, > 3 days a week, for >3 weeks. starts before 3mo old. not sure of the cause. |
what can be done to help Colic? | change to soy formula. check mother's diet (she make need to change it). rocking. swaddling. mylicon drops (can help with gas). |
REST | Regulation. Entertainment. Structure. Touch. |
Cleft Lip | incomplete coming together of the maxillary and nasal tissues. multifactorial. multiple congenital anomaly syndromes. may/may not have cleft palate as well. unilateral or bilateral. incomplete or complete. |
Cleft Lip: When does repair happen? | ~10 weeks to 6 months of age. at least 10lbs. Hgb 10. |
Cleft Palate | incomplete coming together of the palatae. may be incomplete (soft palate only) or complete (hard and soft palate). unilateral or bilateral. multifactorial. |
Cleft Palate: when does repair happen? | 6-18 months |
GERD | transient relaxation of the esophageal sphincter which allows stomach acids to come up into the esophagus. |
GERD baby | not happy, poor weight gain, passive regurgitation, arching/pulling away with feedings. |
GERD old child | aspiration pneumonia. usually developmentally delayed. will need surgery. |
Laproscopic Nissen Fundoplication | top part of the stomach is wrapped around the intra-abdominal esophagus. |
pyloric stenosis | thickening of the muscle of the pylorus. food is not able to leave the stomach. |
pyloric stenosi: common sx | projectile vomiting. palpable olive-like mass mid-epigastrium. weight loss. dehydration. |
pyloric stenosis: Dx | hx & abdominal ultrasound |
pyloric stenosis: Tx | stabilize (not rush to surgery right away. child will be very sick). pyloromyotomy (slicing the pyloric muscle). |
Appendicitis | inflammation of the appendix. acute obstruction of the lumen of the appendix. increased pressure in the appendix (bacteria/pus). ischemia, cell death, eventual rupture of appendix. |
Appendicitis: what does this child look like? | generalized abd pain. colicy, crampy, nausea, vomiting. may be mis-dx as gastroenteritis. focal pain in RLQ at McBurney's point. rebound tenderness. mid temp 100.5-102. elevated WBC, + ultrasound, - pregnancy test. |
appendicitis: surgery | laproscopic appendectomy |
Appendicitis: Tx (not ruptured) | take out the appendix, go home. |
Appendicitis: Tx (rupture discovered in OR). | JUST reuptured. penrose drain so all the crud can drain out. let surgeon change first dressing so they can see the drainage. |
Appendicitis: Tx (rupture discovered before OR). | surgery will be delayed. NPO. triple abx (IV then oral). possible TBP & lipids. surgery in weeks to 2 months. |
intussesception | telescoping of intestine into adjacent distal intestine. mesentary (blood supply) is pulled through the bowel. compression/obstruction of lymph & blood flow. pressure builds. eventually arterial blood flow stops. ischemia, perforation, peritonitis. |
Intussesception: what does it look like? | screeming in pain alternating with periods of calm. currant-jelly stools. sausage-like mass RLQ. absent bowel sounds RLQ. may resolve without intervention. |
Intussescaption: Dx | ultrasound. water-soluble contrast enema (treatment as well). may need surgery to manually reduce telescoping. end-to-end anastomosis of dead bowel. |
Hirshprung's Disease | AKA congenital aganglionosis of the colon. part of the nerve fibers (ganglion) of the colon responsible for peristalsis are absent. extent of missing ganglion varies. dx by rectal biopsy. |
Hirshprung's Disease: newborn | no meconium. may be very sick. rectal biopsy. surgical repair or temporary colostomy w/ end-to-end anastomosis when older. |