Cause of GERD
- transient relaxation of Lower esophageal sphincter -> gastric acid reflux -> esophageal mucosal injury
In Barrett’s esophagus: what is occurring to the cells in the esophagus
- squamous -> columnar
Nonbilious vomiting/regurgitation projectile emesis after feeding is consistent with what condition
- pyloric stenosis
How is pyloric stenosis diagnosed
- US: showed thickening of pylorus
95% of cases of pyloric stenosis present in what age group
- 3-12 weeks of life
- will feel “olive-shaped” nontender mobile hard pylorus
What is Gilbert’s syndrome
- hereditary condition with reduced activity of UGT enzyme
- see an increase in indirect bilirubin
Jaundice presents when biliruben levels reach what level
- > 2.5 mg/dL
Why does hemolytic anemia result in jaundice
- massive RBC lysis -> an increase in indirect biliruben -> overwhelms liver’s ability to conjugate it
An increase in what enzymes signals biliary obstruction or intrahepatic cholestasis
- ALP and GGT
Dark urine seen in jaundice is due to an increase in
- direct biliruben
Acholic stools in suggests what
- biliary obstruction
- obstruction prevents bile from getting into the intestine to be excreted causing the normal dark color of stool
Transmission of Hepatitis A and E
- fecal-oral
Which hepatitis can become chronic
- HCV and HBV
What is intussusception
- intestinal segment invaginates “telescopes” into adjoining intestinal lumen -> bowel obstruction
What is the classic triad of intussusception
- vomiting
- abdominal pain
- passage of “current jelly stools” per rectum
How is intussusception diagnosed
- Barium contrast enema (often diagnostic and therapeutic)
How is lactose intolerance diagnosed
- hydrogen breath test
- hydrogen is produced by undirected lactose being fermented by colonic bacteria
Rovsing sign
- RLQ pain with LLQ palpation
McBurney’s point tenderness
- point 1/3 distance from anterior superior iliac spine and navel
Where do direct hernias protrude into ? Name the borders
- Hesselbach’s triangle
- Rectus abdominus, inferior epigastric vessels, and Inguinal ligament
Infants may be born with an umbilical hernia. Management?
- usually resolves by 2 yr of age
- may need to be repaired if still present in children > 5 y.o.
Most common cause of Vitamin C deficiency
- diet lacking in raw citrus and green vegetables
Scurvy is a disease that results from deficiency in
vit C
What is Rickets? What is it caused by?
- softening of the bones leading to bowed legs
- Vit D deficiency in children
