GI Emergencies

Question 1

What are the symptoms of children with GI emergencies?

Answer 1

• Pain
• Vomiting
• Bleeding

These symptoms indicate potential underlying issues requiring evaluation.

Question 2

Name the causes of GI emergencies.

Answer 2

• Gastroenteritis
• GERD
• Infection
• Over feeding
• Obstruction
• Poisoning

Understanding these causes helps in diagnosing and managing GI emergencies.

Question 3

In children with abdominal pain, what does an immobilized child indicate?

Answer 3

Peritoneal

This suggests a more serious underlying condition.

Question 4

In children with abdominal pain, what does a restless child indicate?

Answer 4

Obstructive lesion

Restlessness can be a sign of discomfort due to obstruction.

Question 5

Pain in children may radiate to the shoulder. True or False?

Answer 5

TRUE

Radiating pain can indicate referred pain from abdominal issues.

Question 6

Pain lasting 6 hours in a child requires what?

Answer 6

Surgical evaluation/treatment

Prolonged pain can indicate serious conditions needing immediate attention.

Question 7

What does bilious vomiting indicate in children?

Answer 7

Serious problem

Bilious vomiting often suggests an obstruction or other serious condition.

Question 8

What are the potential causes of LGI bleeding with pain in children?

Answer 8

• Volvulus
• Intussusception
• Complicated Meckel’s

These conditions may require urgent medical intervention.

Question 9

What are the potential causes of LGI bleeding without pain in children?

Answer 9

• Fissure
• Gastroenteritis
• Swallowed maternal blood
• Polyps
• Uncomplicated Meckel’s

These conditions may be less urgent but still require evaluation.

Question 10

What are the signs of appendicitis in children?

Answer 10

• Sudden pain that begins on the right side of the lower belly
• Sudden pain that begins around the belly button and often shifts to the lower right belly
• Pain that worsens with movement
• Nausea and vomiting
• Loss of appetite
• Low-grade fever that may rise as the illness worsens
• Constipation or diarrhea
• Belly bloating

Appendicitis can present atypically in young children.

Question 11

What is the most common sign of Meckel’s with abdominal pain?

Answer 11

Painless massive lower GI bleeding

This condition can lead to significant complications if not addressed.

Question 12

What are the characteristics of intussusception in children?

Answer 12

• Sudden onset severe pain
• May quickly subside
• ‘Currant jelly’ stools

Intussusception is a serious condition that requires prompt treatment.

Question 13

What is the most urgent GI emergency in infants and children?

Answer 13

Malrotation/Volvulus

This condition can lead to gangrene within hours if not treated.

Question 14

What are the clinical features of gastroenteritis?

Answer 14

• Anorexia
• Nausea
• Vomiting
• Diarrhea
• Colicky abdominal pain
• Fever

Gastroenteritis is a common cause of dehydration in children.

Question 15

What is the mortality rate of diarrheal disease in children worldwide?

Answer 15

2-3 million deaths annually

This highlights the importance of effective treatment and prevention strategies.

Question 16

What are the most useful signs for assessing dehydration?

Answer 16

• Kussmaul respirations
• Skin turgor
• Capillary refill time
• Mental status

These signs help determine the severity of dehydration.

Question 17

What are the classifications of dehydration severity?

Answer 17

• Mild (3-5%)
• Moderate (6-9%)
• Severe (>10%)

Each classification has specific clinical criteria.

Question 18

What is the preferred treatment for dehydration in children?

Answer 18

Enteral (po) rehydration

IV therapy is reserved for severe cases or when oral rehydration fails.

Question 19

What type of fluids should be avoided in IV rehydration?

Answer 19

Hypotonic IV fluids

These fluids have higher rates of adverse events, including fatal outcomes.

Question 20

What is the role of oral rehydration therapy (ORT)?

Answer 20

Promotes improvement in bowel mucosa

ORT is effective and associated with fewer major adverse events.

Question 21

What are the recommended oral rehydration solutions (Not Water)?

Answer 21

• WHO Endorsed Solutions
• Pedialyte
• Gatorade: Not recommended for younger than 2

Different solutions have varying compositions and recommendations.

Question 22

What are the genitourinary (GU) emergencies in males?

Answer 22

• Balanoposthitis: infection of the glans
• Phimosis: Infection of the foreskin
• Paraphimosis
• Epididymitis
• Testicular torsion
• Incarcerated hernia
• Orchitis

These conditions require prompt medical attention.

Question 23

True or False: Dehydration by itself is an indication for IV rehydration or hospitalization.

Answer 23

FALSE

Dehydration must be assessed in the context of severity and response to oral rehydration.