GI

Question 1

small left colon associations

Answer 1

maternal diabetes
maternal hypothyroidism
maternal toxemia
prematurity

Question 2

intestinal structures due to NEC most common location

Answer 2

left colon

Question 3

SIP risk factors

Answer 3

indomethacin
post-natal steroids
vasopressors
mechanical vent+ surf
maternal chorio

most common site is terminal ileum

Question 4

parts of digestion that are well developed in a newborn

Answer 4

salivary amylase and lingual lipase - mouth for starch and fat digestion

gastric lipase

disaccharidases in small intestine (besides lactase 36wks)

everything else decreased

Question 5

48 hrs of NPO causes

Answer 5

deceased villi length
decreased cell growth
increased apoptosis

Question 6

trophic feeds cause

Answer 6

increased blood flow
increased barrier defenses
increased hormone regulation
increase motility

Question 7

first sucking is present at

Answer 7

16 wks

Question 8

most common type of TEF

Answer 8

Esophageal atresia with distal fistula

Question 9

duodenal atresia has high rate of associated disorders they are -

Answer 9

trisomy 21
malroation
CHD
esophageal atresia
GU anomalies
annular pancreas

Question 10

duodenal atresia occurs by

Answer 10

failure of recannulization by 8-10 weeks

Question 11

jejunal-ileal atresia

Answer 11

due to ischemic injury- either by anatomic crushing or meds like cocaine

Question 12

associations with malrotation

Answer 12

CDH
abdominal wall defects
intestinal atresias
beck with-weidemann

Question 13

CHD worse outcome if

Answer 13

Right sided
Liver in the hernia
Need for Ecmo
Require requires a patch
FI02 need on postop d30

Question 14

Transition zone for hirschsprung

Answer 14

Rectodigmoid

Question 15

Small left colon transition zone

Answer 15

Splenic flexure

Question 16

Difference between Meconium plug and Meconium ileus

Answer 16

Meconium plug involves the colon and is due immaturity of the colon

Meconium plug involves the distal ileum and due to hyperviscous secretions causing obstruction

Question 17

Disorder of failure of the lateral cephalic folds to close

Answer 17

Pentology of Cantrell

Question 18

Pentalogy of Cantrell

Answer 18

Cleft sternum
Anterior midline diaphragmatic abnormality
Pericardial defect
Ectopic cordis
Upper abdominal omphalocele

Question 19

Failure of the lateral abdominal folds to close

Answer 19

Omphalocele

Question 20

Failure of the caudal and lateral folds to close

Answer 20

Cloacal or bladder extrophy

Question 21

Gastroschisis-
Happens on what side
With - umbilical cord
Associated with -

Answer 21

Right side
Intact umbilical cord
Associated intentional anomalies , all have malroation
Associated with IUGR

Question 22

OEIS complex

Answer 22

Omphalocele
Extrohpy of bladder
Imperforate anus
Spinal deformity

Question 23

Age of onset of nec byGA

26 wks
>31
Term

Answer 23

23 d
11d
3 d

Question 24

Short gut is better if

Answer 24

The ileum is intact, the ileocecal valve is intact to prevent bacteria overgrowth

Question 25

Short gut is worse if

Answer 25

Colon is resected No valve +- 25 cm take Valve intact but 40 cm taken

Question 26

Multiple hemangiomas or one single large rapidly, growing hemangioma like lesion can also have retroperitoneal or mediastinal vascular abnormalities leading to high output, cardiac failure, DIC and thrombocytopenia

Answer 26

Kasabach Merrit syndrome

Question 27

Five reasons why premise get NEC

Answer 27

Loose tight junctions Thin goblet cells Few pants cells Decreased IgA Increase inflammatory cytokines Altered TLR4 signaling

Question 28

String and Apple core signs

Answer 28

Pyloric stenosis

Question 29

First sucking present

Answer 29

16

Question 30

Normal gastric emptying at

Answer 30

32 wks

Question 31

How do neonates have normal carb digestion

Answer 31

Normal glucoamylase, glucosidases, disaccharideases Normal absorption from active transport Colonic salvage pathway

Question 32

Left sided free air and perinatal depression

Answer 32

Gastric perf

Question 33

What percent of Meconium ileus will have cf

Answer 33

90 But only 10% of cf get a Meconium ileus

Question 34

Hirchsprungs Affected relatives ? Timing

Answer 34

33% 8-10 wks neurocrest cell migration

Question 35

Corkscrew on upper gi Whirlpool on us

Answer 35

Malroation + volvulus

Question 36

Bell staging

Answer 36

1. Mild, suspected, AB, feeding intolerance. 2 a: mild minor, electrolyte abnormalities, pneumatosis on x-ray 2 b: + moderate lab changes , portal venous air 3a : severe , strong lab changes, peritonitis 3b: surgical

Question 37

Term risk factors for NEC

Answer 37

Cong heart disease IUGR Polycythemia Sepsis NAS

Question 38

Most common congenital abnormality of the G.I. track

Answer 38

Meckel diverticulum