Phenobarbital MoA
Treat for hyperbili by conjugating bilirubin via UDPGT
Ursodiol MoA
increases hydrophilic bile acid pool so bilirubin can be secreted more readily
What things are there “more” of in cow’s milk than human milk?
Protein
All electrolyte: Na, Ca, K, Phos
Iron, Zinc
Why are whey proteins better digested?
they promote more rapid gastric emptying and remain in solution after acid precipitation to facilitate their digestion
What things are there less of in cow’s milk vs human milk?
immune system components: lactoferrin, lysozyme, secretory IgA, oligosaccharides (in HM they play a role in host defense)
whey
less carbohydrate concentration
What does the ileum absorb and what are the symptoms if it’s resected?
B12, bile salts/bile acids (steatorrhea/diarrhea, cholelithiasis)
What does the duodenum and jejunum absorb and what are the symptoms if it’s resected?
Folate, iron (anemia), calcium (osteopenia), main sites of amino acid, carb, calcium (osteopenia), vitamin and mineral deficiencies like zinc, fatty acids (decreased fat absorption - but ileum is the main part for bile acids), lactose (lactose deficiency)
What does the colon absorb and what are the symptoms if it’s resected?
Water and Na
watery diarrhea, electrolyte loss
What is function of ileocecal valve?
slow GI transit time, prevent reflux of colonic bacteria
Pathophysiology of omphalocele
failure of intestinal loops to return to cavity at 11 weeks or the somatic folds fail to complete formation of the abdominal wall by 18 weeks
what is gastroschisis associated with?
Younger mother, other associated GI conditions (vs. omphalocele is rare to have other intestinal anomalies)
Most common part of GI tract for SIP
terminal ileum
what is the pathophysiology of SIP?
skewed trophism (mucosal hyperplasia, submucosal thinning and smooth muscle necrosis) leading to bowel wall fragility and depletion of endothelial nitric oxide
Most common location for NEC
terminal ileum and proximal colon
What is the most commonly seen atresia?
ileal atresia
Common locations for ileal atresia?
distal ileum>proximal jejunum>distal jejunum>proximal ileum
Etiology of microcolon and associations in the mother
functional immaturity of ganglion cells.
assoc w maternal diabetes (most common), maternal hypothyroid, maternal mag exposure prolonged
What is the most common anatomic reason for a duodenal atresia
annular pancreas
Corkscrew proximal jejunum is…
malrotation
Etiology of omphalocele
Embryologic - if the intestinal loops fail to return to the abdominal cavity at 11 weeks or the somatic folds fail to complete formation of the abdominal wall by 18 weeks
most common location in GI tract of NEC
distal ileum and proximal colon (SIP is distal ileum)
do infants with SIP or NEC have less mortality and ND outcomes?
Both same
Most common places in intestine for a post NEC stricture?
Left colon (49
