Ch. 329.1 - Hypertrophic Pyloric Stenosis Flashcards Preview

Nelson - The Digestive System > Ch. 329.1 - Hypertrophic Pyloric Stenosis > Flashcards

Flashcards in Ch. 329.1 - Hypertrophic Pyloric Stenosis Deck (23):
1

T/F Hypertrophic pyloric stenosis (HPS) is rare in Asians and more common in whites

T

2

HPS: Gender

M, especially firstborns

3

T/F: Offsprings of a mother and to a lesser extent the father who had pyloric stenosis are at higher risk for pyloric stenosis

T

4

Incidence of pyloric stenosis is increased with infants with what blood groups

B and O

5

Syndromes associated with pyloric stenosis

1) Eosinophilic gastroenteritis 2) Apert syndrome 3) Zellweger syndrome 4) Trisomy 18 5) Smith-Lemli-Opitz syndrome 6) Cornelia de Lange syndrome

6

Use of this drug is associated with risk of pyloric stenosis

Erythromycin, especially if given with 1st 2 weeks of life

7

Higher risk of pyloric stenosis is seen in female infants of mothers treated with ___ during pregnancy and breastfeeding

Macrolide antibiotics

8

Reduced levels of this substance is implicated in the pathogenesis of pyloric stenosis

Nitric oxide

9

Initial symptom of pyloric stenosis

Nonbilious vomiting, which may or may not be projectile initially but is usually progressive, occurring immediately after feeding

10

Vomiting in infants with pyloric stenosis usually starts at what age

3 weeks of age, but can develop as early as a week and as late as 5th month

11

Acid base abnormality seen in patients with pyloric stenosis with persistent vomiting

Hypochloremic metabolic alkalosis

12

MC clinical association of pyloric stenosis

Hyperbilirubinemia aka icteropyloric syndrome

13

T/F In icteropyloric syndrome, unconjugated hyperbilirubinemia is more common than conjugated

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14

T/F Hyperbilirubinemia in icteropyloric syndrome usually resolves with surgical correction

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15

Characteristics of the pyloric mass

Firm, movable, approx 2 cm in length, olive-shaped, hard, best palpated from the left side, and located above and to the right of the umbilicus in the midepigastrium beneath the liver's edge

16

The pyloric "olive" is easiest palpated when

After an episode of vomiting

17

Diagnostic tool that confirms the diagnosis of pyloric stenosis in majority of cases

UTZ, sensitivity of approx 95%

18

Contrast studies of pyloric stenosis shows

1) String sign or an elongated pyloric channel; 2) shoulder sign or bulge of pyloric muscle into the antrum; 3) double tract sign or parallel streaks of barium seen in the narrowed channel

19

Preoperative treatment of pyloric stenosis is directed toward

Correcting fluid, acid-base, and electrolyte imbalance

20

Surgical procedure of choice for pyloric stenosis

Pyloromyotomy (Ramstedt procedure)

21

Successful management modality of infants with persistent vomiting secondary to incomplete pyloromyotomy

Endoscopic balloon dilation

22

Advisable mode of management for patients with pyloric stenosis who are not good surgical candidates

Nasoduodenal feedings

23

Pyloric muscle relaxant used in patients with pyloric stenosis when surgical treatment is not available

Atropine sulfate