Pediatric Gastrointestinal Problems - Harden Flashcards Preview

GI Week 6 - WLB > Pediatric Gastrointestinal Problems - Harden > Flashcards

Flashcards in Pediatric Gastrointestinal Problems - Harden Deck (20)
Loading flashcards...
1
Q

What type of infections may cause vomiting?

A

Any systemic infections!

  • Viral gastroenteritis (rotavirus and norwalk)
  • Bacterial enterocolitis/sepsis
  • Hepatitis
  • Food poisoning
  • Staphylococcus aureus, Clostridium perfringens, Salmonella
  • Pelvic Inflammatory Disease
  • Peritonitis
  • Pharyngitis
  • Pneumonia
  • Otitis Media
  • Tonsillitis
  • Urinary Tract Infection
2
Q

What cause of vomiting should you NEVER miss in children?

A

DKA!

(and Pregnancy in adolescants)

3
Q

What are the clinical symptoms of DKA?

A
  • Polyuria
  • Polydipsia
  • Weight loss
  • Dehydration
  • Kussmaul respirations
  • Acetone Breath
  • Altered mentation
  • Profound fatigue, irritability
  • Hyperglycemia
  • Metabolic acidosis
4
Q

When does pyloric stenosis present?

A
  • First 2 months of life
    • Usually 2-4 weeks
  • 1/500 infants
  • Male:Female 4:1
5
Q

What imaging study is used to diagnose Pyloric Stenosis?

A

Ultrasound

6
Q

What predisposing pathology may lead to intussusception?

A
  • Infection
    • inflammation creates lead point for intestines to catch and telescope on itself
    • ⇒ red/black currant jelly stool
7
Q

What pediatric GI condition typically follows the “Rules of 2’s”?

A

Meckel’s Diverticulum

  • 2 years
  • 2% population
  • 2 types of tissue
  • 2 inches in size
  • 2 ft from ileocecal valve
8
Q

What is 70-80% of acute diarrhea in North America caused by?

A

Viral gastroenteritis

9
Q

What are the complications of diarrhea in pediatrics?

A
  • Complications
    • Dehydration
    • Electrolyte and acid-base disturbance
    • Bacteremia and sepsis
    • Malnutrition (chronic)
10
Q

What are the most common causes of bacterial and viral related diarrhea?

A
  • Viral
    • Rotavirus
    • Norovirus
  • Bacteria
    • Campylobacter
11
Q

What clinical features are ATYPICAL in viral gastroenteritis?

A
  • History:
    • Fever
    • Abdominal pain
    • Blood or mucus in stool
    • Bilious/projectile vomiting
    • >7 days
    • INCREASED urine output
    • Altered consciousness
    • International travel
    • Exposures to foods, unsafe water, farm animals, reptiles
  • Physical Exam:
    • Moderate to severe dehydration (children >2)
    • Bulging fontanelle
    • Hyponatremia with hyperkalemia
    • Respiratory abnormalities
    • Abdominal distension/focal tenderness/mass
    • petechiae
12
Q

How do you evaluate dehydration in kids?

A
  • Percentage of weight lost is an objective measure
    • No dehydration
    • Mild dehydration (3-5%)
    • Moderate dehydration (6-9%)
    • Severe dehydration (10+%)
  • Delayed Capillary Refill (>2 sec)
    • Capillary Refill time can be affected by ambient temperature
  • Urinary output and specific gravity
  • Pulse (high)
  • Blood pressure (low)
  • Mucous membranes (dry, parched)
  • Fontanelles (sunken)
  • Skin turgor (tented)
13
Q

Do Serum electrolytes studies in pediatric patients indicate dehydration?

A

NO!

They are usually normal since most episodes of dehydration caused by diarrhea are isonatremic.

14
Q

When should pediatric patients with diarrhea be treated with IV fluids?

A
  • Children who are severely dehydrated and in a state of shock or near shock require IV fluids
  • Children who are moderately dehydrated and cannot retain oral liquids because of persistent vomiting also should receive IV fluids.
15
Q

What do you treat a pediatric patient with severe dehydration (>10% dehydrated based on weight)?

A

20 mL per kg of Normal Saline (NS) or Normal Saline with %5 dextrose (D5NS) during a one-hour period

16
Q

What should you not use in the treatment of diarrhea in a pediatric patient?

A

Anti-diarrheals

17
Q

When does Colic crying in infants occur?

A
  • Can be anytime, but usually in evening
  • Starts at 3 weeks, peaks at 6 weeks
18
Q

What is the #1 cause of a surgical abdomen in children?

A

Acute Appendicitis

19
Q

What is Encopresis?

A

small amounts of stool leak out during the day

20
Q
A