Patho 620 > Alterations in Digestive Function in Children > Flashcards

Alterations in Digestive Function in Children Flashcards

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1
Q

Main causes of Cleft lip/palate:

A

-maternal deficiency of B vitamins (B6, folic acid, b12)
-alcohol
-smoking
-diabetes
-steroids/statins
-gene mutations

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2
Q

Both Cleft lip and cleft palate are anomalies of the first what?

A

First brachial arch

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3
Q

Cleft treatment:

A

-surgical correction around 3-6 months
-special bottle for feeding

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4
Q

What is Esophageal Atresia?

A

Where the esophagus ends in a blind pouch

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5
Q

What is Tracheoeophageal fistula?

A

Abnormal connection between the trachea and the esophagus

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6
Q

Symptoms of esophageal atresia:

A

-drooling
-choking
-swallowing difficulties
-respiratory distress
-inability to pass OG tube

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7
Q

Esophageal fistula symptoms:

A

-recurrent aspiration
-pneumonia
-atelectasis

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8
Q

Risk factors for Pyloric Stenosis:

A

-increased gastrin secretion by the mother
-overproduction of gastric secretions in the infant
-exogenous administration of prostaglandin E
-family history

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9
Q

Pyloric stenosis symptoms:

A

-projectile vomiting after feeding
-weight loss
-fluid and electrolyte imbalances
-malnutrition
-dehydration

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10
Q

Pyloric stenosis treatment:

A

Pyloromyotomy (muscles of the pylorus are split and separated)

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11
Q

Pyloric stenosis is associated with

  1. Muscle hyperplasia
  2. Diarrhea
  3. Anorexia
  4. Increased maternal cholecystokinin
A
  1. Muscle hyperplasia
    (the circular muscle of the pylorus is grossly enlarged because of an increase in cell size and an increase in cell number which obstructs the pyloric opening
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12
Q

Malrotation:

A

-colon remains in the upper right quadrant; an abnormal membrane may press on and obstruct the duodenum
-malrotated intestine can easily twist as a result of a poor connection (twisting is volvulus)

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13
Q

Malrotation symptoms:

A

-bile vomit
-dehydration and electrolyte imbalance
-fever
-pain
-bloody stools

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14
Q

Malrotation treatment:

A

-Reduction of volvulus: surgery
-Necrotic bowel: resected
-Primary anastomosis (put back to normal or back together if infant had ostomy)
-Enterostomy

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15
Q

What is the most common congenital malformation of the GI tract in children?

A

Meckel Diverticulum

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16
Q

What is Meckel Diverticulum?

A

Outpouching of all layers of the small intestinal wall (usually in the ileum)

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17
Q

What are the “Rules of Two”?

A

-occurs in about 2% of the population
-2% develop complications before 2 years of life
-located within 2 feet of the ileocecal valve
-averages 2 inches in length

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18
Q

Meckel Diverticulum symptoms:

A

-usually asymptomatic
-painless rectal bleeding

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19
Q

Meckel Diverticulum treatment:

A

Surgery

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20
Q

What is the most common cause of colon obstruction?

A

Hirschsprung Disease

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21
Q

What is Hirschsprung Disease?

A

-obstruction of colon

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22
Q

Hirschsprung disease symptoms:

A

-delayed passage of meconium
-poor feeding
-poor weight gain
-abdominal distension

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23
Q

What is a meconium ileus?

A

An abnormal sticky meconium that causes intestinal obstruction

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24
Q

GERD treatment:

A

-thickened feedings
-small or frequent feedings, prolonged feeding duration, slower flow rate of feeding
-frequent burping or position changes
-medications
-If no improvement: antireflux surgery (gastropexy and fundoplication)

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25
Intussusception symptoms:
-abdominal pain -sausage shaped mass in the abdomen -irritability (colicky) and flexing of knees -vomiting -"currant jelly" stools (Dark and gelatinous stools)
26
Intussusception treatment:
-enema reduction
27
If enema reduction is not successful in a patient with Intussusception what can that mean?
-not successful: needs surgery -surgery not successful or patient left untreated: fatal
28
An infant arrives to the eR with a diagnosis of intussusception. Which data will the nurse typically find during the assessment?
Currant-jelly stools
29
Cystic Fibrosis is a dysfunction of which specific protein?
CFTR protein
30
What is the classic triad in Cystic Fibrosis?
1. deficiency of pancreatic enzyme 2. overproduction of mucus in the respiratory tract 3. abnormally elevated sodium and chloride concentrations
31
Cystic Fibrosis symptoms:
-growth failure -glucose intolerance -chronic lung infections
32
Cystic Fibrosis evaluation protocol:
-72 hour fecal fat measurements to determine the extent of pancreatic function
33
Cystic Fibrosis treatment:
-PERT -high-cal, high-protein diets with frequent snacks and vitamin supps -growth hormone -enteral supplements
34
What is Celiac Disease?
An autoimmune disease of the small intestine villous epithelium when the cereal, protein gluten is ingested
35
When a person loses villous epithelium in the intestinal tract and gluten protein acts as a toxin this occurs in what disease?
Celiac Disease
36
Celiac Disease symptoms:
-diarrhea, meconium ileus (early signs) -pale, bulky, greasy, foul smelling stools -failure to thrive -malabsorption symptoms: rickets, bleeding, anemia -dehydration -magnesium and calcium malabsorption
37
What is Dermatitis Herpetiformis?
Itchy blister formation on elbows, knees, shoulders, middle line of back/buttocks
38
Celiac Disease evaluation:
-serologic antiendomysial and antitransglutaminase IgA antibodies and human leukocyte antigen (HLA)-type DQ2 or DQ8 to confirm diagnosis -duodenal biopsy detects the classic mucosal changes
39
Celiac Disease treatment:
-Immediately and permanently initiate gluten-free diet -lactose (milk sugar) intolerance is presume because of damage to the villi -take fat-soluble vitamins, iron, folic acid
40
What is the pathophysiologic process that occurs in a person with gluten-sensitive enteropathy?
T cell-mediated autoimmune injury to the intestinal epithelial cells
41
What does Dwashiorkor mean?
-Severe deficiency of protein
42
What is a main cause of Kwashiorkor?
Infants between 1-4 years of age who have just been weaned from breast milk to a high-starch, protein-deficient diet
43
What does Marasmus mean?
A deficiency of all nutrients
44
Symptoms of Marasmus:
-fatty liver and hepatomegaly -muscle wasting -diarrhea -infection -low hemoglobin level
45
Symtoms of Kwashiorkor:
-generalized edema -hypopigmented hair -distended abdomen -hepatomegaly -normal weight for age due to edema
46
Treatment for Kwashiorkor and Marasmus:
-food and other nutrients -breast-feeding -antibiotics
47
Failure to Thrive means what?
-inadequate nutrition for optimal growth and development -deceleration in weight gain, a low weight/height ratio, low BMI
48
Failure to Thrive symptoms:
-delayed growth -dry/cracked skin -poorly developed muscles -swollen abdomen with malabsorption -diarrhea -reduced energy level
49
What is the Failure to Thrive eval?
When the child falls below the third percentile on the growth curve or shows stagnation in length or width
50
Failure to Thrive treatment:
-nutrition -management of psychosocial symtoms
51
What is Necrotizing Enterocolitis (NEC)?
-Ischemic, inflammatory condition that causes bowel necrosis and perforation -
52
What is the most common GI emergency in newborns?
NEC
53
Why do we believe NEC happens?
Thought to be from reduced mucosal blood flow and immature mucosal barrier -ischemia leads to inflammation and necrosis of the intestinal segments and possible perforation -bacteria invade the mucosa
54
NEC symptoms:
-feeding intolerance -abdominal distention -bloody stools -sepsis -low platelet count -bradycardia -apnea -elevated WBC
55
NEC treatment:
-pause feeding (esp. formula) -repogle (gastric suction) -maintenance of fluid and electrolytes -antibiotics -surgery
56
What is the leading cause of severe diarrhea in infants and young children?
Rotavirus
57
Diarrhea treatment:
-rehydration with fluids and electrolytes -maintenance of nutrition -antibiotics -IV solutions
58
Newborn Jaundice diagnostic results:
-serum bilirubin values that increase greater than 5 mg/dL per day -persistent jaundice -conjugated bilirubin values greater than 2 mg/dL
59
What is Biliary Atresia?
Rare congenital malformation, characterized by the absence or obstruction of the extrahepatic bile duct -inflammation, fibrosis, loss of epithelial cells and obstruction of the bile canaliculi
60
Biliary Atresia treatment:
-surgical drainage and correction -Kasai portoenterostomy -liver transplant
61
What is it called when there is fibrotic scarring of the liver occurs in response to inflammation and tissue damage?
Cirrhosis
62
Intrahepatic portal hypertension is associated with what?
Cirrhosis
63
What disease causes toxic levels of copper to accumulate in the liver, brain, kidneys and corneas?
Wilson Disease
64
What gene is associated with Wilson Disease?
The loss of ATP7B gene located on chromosome 13
65
Wilson Disease symptoms:
-neuromuscular abnormalities -tremors -dysarthria (indistinct speech) -dystonia -Kayser-Fleischer rings -cirrhosis
66
Wilson Disease treatment:
-decrease dietary copper intake -increase renal excretion of copper -Chelation therapy -liver transplantation
67
Severe acute malnutrition is a state of starvation associated with food shortages. Severe deficiency of all nutrients is also known as...
Marasmus
68
The major pathophysiologic characteristic of gluten sensitivity is an autoimmune injury to the what?
Intestinal epithelial cells
69
Patho 620
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