Mucho vomito
Vomito...mucho mucho vomito
Donde estan mis vitaminas?
Little Baby, Little Bowel Troubles
Bad Gluten...Bad
100
You have a 5 week-old infant presenting with projectile vomiting. You palpate the stomach and feel an "olive-shaped mass."
Described the acid-base disturbance you expect to find on labs. Specifically tied to abnormality in which electrolyte?
Hypochloremic metabolic alkalosis
Also, with hypokalemia
100
What are the two most common etiologies of gastroparesis?
Idiopathic
Diabetic
100
Vitamin B12 deficiency can result from resection of what part of the small bowel?
Terminal Ileum
100
A 1-day old child comes in to the ED with complaint of billious emesis. Child looks dehydrated on exam.
Describe the finding you would expect to see on XR:
Double Bubble finding
Associated with duodenal atresia
100
Celiac disease is a systemic inflammatory reaction triggered by what protein?
Gluten
200
Which pulmonary disorder can predispose patients to develop a hiatal hernia?
COPD
Can increase intraabdominal pressure
200
Which nerve can be injured following surgery than can lead to delayed gastric emptying?
Vagal Nerve
200
Neonates can be deficient in this vitamin due to a lack of gut bacteria.
Vitamin K
200
What is the most common cause of lower GI bleeding in children?
Meckel's diverticulum
200
What is this rash called?
Dermatitis herpetiformis
300
Which gender is more likely to have pyloric stenosis?
At what rate?
Male
5:1
300
What is the gold standard for diagnosis of a patient with gastroparesis?
Gastric Emptying Scintigraphy of a solid meal
300
What are the two types of Beriberi?
And deficiency of what nutrient is responsible for this disease?
Dry Beriberi
- Symmetrical peripheral neuropathy (motor and sensory) mostly distal extremities
Wet Beriberi
- CHF, high output heart failure, cardiomegaly, peripheral edema, tachycardia, DOE/PND/orthopnea
- Can include neuropathy seen in Dry Beriberi
Thiamine deficiency
300
Meckel's Diverticulum results from incomplete involution of what embryonic structure?
Vitelline Duct
300
A severe complication of this celiac disease that can be triggered by surgery or infection resulting in severe dehydration and electrolyte abnormalities is known as?
Celiac Crisis
400
You order an ultrasound on a 5-week infant presenting with projectile vomiting. What part of the stomach are you looking at? Thickening of this structure greater than ______ indicates the diagnosis?
Pylorus
> 3mm
The main diagnostic criterion is a measurement of more than 3 mm in thickness of the muscular layer of pylorus
400
A condition characterized by the repetitive, effortless regurgitation of recently ingested food into the mouth followed by re-chewing and re-swallowing or expectorating of food.
Rumination Syndrome
400
What is the most common systemic complication and extraintestinal manifestation of inflammatory bowel disease
Anemia
Largely due to iron-deficiency
400
Name 5 rules within the Rule of 2's considering Meckel's Diverticulum
•2% of population
•2 ft from ileocecal valve
2 inches long
2% become symptomatic
2 years of age (45%)
2x more common in boys
2 types of epithelium (gastric/pancreatic)
400
What is the primary screening test done for celiac disease?
IgA anti-tTG antibodies
500
You order an abdominal XR on a 4 week-old with projectile vomiting. You see this finding. What is this finding called?
Caterpillar Sign
Characteristic caterpillar sign (gastric contractions against hypertrophied pylorus)
On these imaging modalities in a patient with pyloric stenosis, the stomach appears distended, air-filled and with wave-like contours, resembling the appearance of a caterpillar 1,2. This sign is produced when the gastric hyperperistaltic waves come to an abrupt stop at the pylorus
500
A patient with gastroparesis has failed outpatient management several times with different medication regimens and frequently returns to ED with recurrent vomiting and abdominal pain.
What is a surgical treatment these patients can undergo if they fail medical management?
Gastric electrical stimulation (GES)
has shown to relieve symptoms, mainly vomiting frequency and the need for nutrition supplementation. In patients with refractory symptoms even after trial of the medications. GES is approved for diabetic and idiopathic gastroparesis patients as a humanitarian exemption device.
Diabetic patients respond more effectively than other groups of gastroparesis patients. Implantation of GES stimulator needs surgical procedure either via laparotomy or laparoscopic approach.
500
In a person who has had their ileum removed, they are at risk of developing what painful non-GI pathology? Why?
Kidney stones.
Largely due to electrolyte and water loss. Not due to an excess build-up of oxalate.
500
What are the 3 views on x-ray you will need to diagnose a a newborn with duodenal atresia?
AP, Lateral, and Cross-table views
500
Infection with _________ virus predisposes children to development of celiac disease.
Rotavirus