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Flashcards in Common Medical Problems Deck (63)
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1

When should infants double their birth weight?

By 4 months

2

When should infants weight be tripled?

By 1 year

3

Abdominal Disorders of Pediatric Patients

Pyloric stenosis
Necrotizing enterocolitis
Other disease of bowel obstruction
GERD
Colic

4

Clinical Presentation of Pyloric Stenosis

3-5 weeks
"Projectile" nonblious vomiting
Infant immediately hungry
Dehydrated
Jaundiced

5

PE in Pyloric Stenosis

Check hydration status
Check for jaundice
Palpate abdomen for "olive"

6

Evaluation of Pyloric Stenosis

Labs
Ultrasound

7

Treatment of Pyloric Stenosis

Pyloramyotamy

8

Why is it important to inquire about forcefully a baby is vomiting?

Differentiate between normal spit-up and pyloric stenosis

9

What is the term commonly used to describe forceful vomiting?

Projectile

10

What is in a baby's differential with projectile vomiting?

Infection
Pyloric stenosis

11

What is the significance of a baby's weight when presenting with pyloric stenosis?

Above/at/below birth weight

12

Why is the color of a baby's emesis important?

Helps to determine if there is a bowel obstruction

13

How can you determine a baby's hydration status?

Palpate the fontanelles

14

What are the 2 categories of vomiting in a baby?

Bilious
Non-bilious

15

Examples of Bilious Vomiting

Malrotation
Volvulus
Hirschsprung disease
Incarcerated hernia
Intussusception
Intestinal atresia

16

Examples of Non-Bilious Vomiting

GERD
Cow/soy milk protein intolerance
Pyloric stenosis
Gastritis

17

Differential Diagnosis of Abdominal Pain in Newborns

GERD
Necrotizing colitis
Volvulus

18

Differential Diagnosis of Abdominal Pain in Infancy to 2 years

Intussesception
Meckel's diverticulum
Bacterial enteritis

19

Warning signs of underlying pathology in GERD

BIlious vomiting
GI bleeding
Forceful vomiting
Prolonged constipation
Dirrhea
Abdominal distension
HSM
Bulging fontanelle
Seizures
Micro/macrocephaly
Hyper/hypotonia
Stigmata of genetic disease
Chronic infections
Fever
Pneumonia
Lethargy
Failure to thrive

20

If GERD warning signs are absent and infant has these symptoms, a workup can be considered.

Poor weight gain
Irritability
Feeding refusal
Gross blood in stool

21

Workup of GERD

Esophageal pH monitoring
Endoscopy

22

GERD Treatment Options

Lifestyle changes
Positioning therapy
Pharmacotherapy

23

Lifestyle Changes for the Treatment of GERD

Avoid tobacco smoke
Smaller feedings
Remove all cow's milk

24

Positioning Therapy for the Treatment of GERD

Keep infant upright 10-20 minutes after a feed

25

Indications for Pharmacotherapy in GERD

Mild esophagitis
Significant symptoms when conservative measures have failed
3-6 months therapy with repeat esophagoscope
PPI preferred

26

How to Diagnosis Colic?

Rule of Threes
>3 hours/day crying
>3 days/week
Lasts >3 weeks
Infant

27

Associated Characteristics of Colic

Paroxysmal
More often in evening
Qualitatively different than normal crying
Hypertoina
Inconsolability
Normal when not colicky
First few weeks unremarkable

28

Colic Soothing Maneuvers

Pacifier
Car/stroller ride
Place them in front carrier
Rock them
Change scenery
Infant swing
Warm bath
Rub abdomen
Provide white noise
CD of heartbeats
Sing to baby
Quiet time in crib 5-10 minutes

29

Colic Treatment Suggestions

Elemental formula for one week
Hypoallergenic diet for mom
Probiotic
Support the parents

30

How to asses a baby's level of hydration?

Mucus membranes
Lethargic
Skin turger
Fontanelles