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GI Issues & Disorders Flashcards

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1
Q

Gastroenteritis
Definition: a nonspecific term applied to a syndrom of -1- nausea, -2-, and -3- as the result of an acute irritation/inflammation of the gastric mucosa; children attending day care are at increased risk

A
  1. severe, acute
  2. vomiting
  3. diarrhea
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2
Q 
Gastroenteritis Causes/Incidence
-1- cause the majority of cases and are especially active during the winter
> -2-
> -3-
> -4-
A
  1. Viruses
  2. Rota (immunized)
  3. Noro (cruise)
  4. Adeno (autumn)
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3
Q 
Gastroenteritis Causes/Incidence
Bacterial
> -1- (odorous stool)
> -2- (mild loose stools); most -3-
> -4-
> -5- (fever spikes, bloody stools, febrile seizures)
A
  1. campylobacter
  2. E. coli
  3. common bacterial cause of diarrhea
  4. salmonella
  5. shigella
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4
Q 
Gastroenteritis Causes/Incidence
Viral
Bacterial
-1-
-2- contents (-3-)
-4- stress
A
  1. parasites
  2. inorganic food
  3. PICA
  4. emotional
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5
Q

Gastroenteritis S/S
> -1-
> -2-
> -3-/decreased -4-

A
  1. Vomiting
  2. Watery diarrhea
  3. dehydration/decreased
  4. urine output
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6
Q

Gastroenteritis S/S

  • 1- (fever when septic)
  • 2- and/or -3-
A
  1. General “sick” feeling/affect
  2. cramping abdominal pain
  3. abdominal distention
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7
Q 
Ax of Dehydration
> Moderate
>> HR -1-
> Severe
>> HR -2-
>> -3- prolonged (-4-)
A
  1. increased
  2. severe, decreased
  3. cap refill
  4. > 3sec
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8
Q

Ax of Dehydration

Moderate to severe: Urine -1- or -2-

A
  1. <1mL/kg/hour

2. <6 wet diapers/day

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9
Q

Gastroenteritis - Dx Tests/Findings
> None indicated unless symptoms persist for -1- or -2- is present
> -3- may be -4- w/ -5- infections

A
  1. > 72 hours
  2. bloody stool
  3. stool guaiac
  4. positive
  5. bacterial
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10
Q

Gastroenteritis - Dx Tests/Findings
> stool for -1-
> -2-
> stool for -3-

A
  1. WBCs
  2. stool culture
  3. ova & parasites
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11
Q

Gastroenteritis - Mgmt
Daycare exclusion: rotavirus, -1-, and -2-; only -1- & -2- require -3- prior to -4-
> Frequent -5- is often all that is needed

A
  1. e. coli
  2. shigella
  3. two negative stool cultures
  4. return to daycare
  5. supportive therapy
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12
Q

Gastroenteritis - Mgmt
> -1- should continue
> -2- with -3-

A
  1. Breastfeeding/formula
  2. oral rehydration therapy
  3. Pedia-, Infa-, Naturalyte, and Rehydrate
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13
Q

Gastroenteritis - Mgmt

|»_space; -1-, soda, and -2- are -3- due to -4- and -5-

A
  1. apple juice
  2. sports drinks
  3. not appropriate
  4. significant carb concentration
  5. limited E- concentrations
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14
Q

Gastroenteritis - Mgmt

A regular -1- after the patient is rehydrated (or -2-)

A
  1. diet gradually resumes

2. BRAT for diarrhea

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15
Q

Gastroenteritis - Mgmt
-1- should be used -2-
> may -3-
> -4- in patients with fever and/or -5-

A
  1. anti-motility drugs
  2. judiciously
  3. prolong illness –> perforation
  4. Shouldn’t be used
  5. bloody stools
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16
Q

Gastroenteritis - Mgmt
-1- therapy
> since most cases are -2- -1- are generally not indicated
> therapy is -3-
> Long term (for any reason): Include -4-, helps return -5- to -6-

A
  1. Antibiotic(s)
  2. caused by viruses
  3. based on the offending organism
  4. L. acidophilus
  5. gastric pH down
  6. physiologic/antiseptic levels
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17
Q

GERD

Definition: common condition in which -1- into the -2- from the stomach through the -3-

A
  1. gastric contents pass
  2. esophagus
  3. lower esophageal sphincter
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18
Q

GERD - classes

-1-: -2- episodic vomiting

A
  1. physiologic

2. infrequent

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19
Q

GERD - classes

-1-: painless, -2- with -3-

A
  1. Functional
  2. Effortless vomiting
  3. no physical sequelae
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20
Q

GERD - classes

-1-: -2- with alteration in physical funciotning such as -3- and -4-

A
  1. pathologic
  2. frequent vomiting
  3. FTT
  4. asp. pna
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21
Q 
GERD - S/S
-1-
-2-, wheezing
-3-
Other (less common): -4-, -5-, -6-, pharyngitis
A
  1. weight loss
  2. choking, coughing
  3. heartburn
  4. otitis media
  5. dental erosion
  6. sore throat
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22
Q

GERD - Labs/Dx

Diagnosis is usually made from … findings

A

history and phys exam

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23
Q 
GERD - MGMT - feeding habits
> -1- feedings
> -2- feeding
> continue -3-
> Avoid -4-
A
  1. Small, frequent
  2. burp frequently during
  3. breastfeeding
  4. formula changes
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24
Q

GERD - MGMT

-1- or use -2-: one tablespoon of -3- per ounce of formula

A
  1. weighted formula
  2. anti-reflux formula
  3. rice cereal
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25
GERD - MGMT Medications > -1- to inhibit -2- (e.g., -3-); best for mild or intermittent symptoms: may cause gynecomastia
1. Histamine H2-receptor antagonists 2. histaminic acid secretion 3. famotidine (pepcid AC)
26
GERD - MGMT Medications > -1- to block -2- caused by histamine, acetylcholine, or gastrin (e.g., -3-): may cause -4-
1. PPIs 2. gastric acid secretion 3. lansoparazole (prevacid), pantoprazole (protonix) 4. permanent gynecomastia
27
``` GERD - MGMT > Frequent follow-ups to -1-; parent education > Consider -2- specialist for >> -3-, -4-, and/or >> -5- ```
1. montior growth parameters 2. referral to GI 3. FTT 4. Growth delay 5. refractory to two meds
28
``` Constipation Def: a -1- in toddlers, children, and adolescents S/S > -2- > -3- > -4- Labs/Dx > Dx is usually mad efrom -5-, but sometimes -6- findings ```
1. common problem 2. decreased appetite 3. abdominal pain 4. painful stooling 5. history & physical 6. KUB
29
Constipation - Mgmt Consider -1- and/or -2- Refer to a pediatirician or -3-
1. stool softeners 2. high fiber foods 3. peds GI
30
Pyloric Stenosis | Def: obstruction resulting from -1- of the -2-, occurring in 1:500 infants
1. thickening of the circular muscle | 2. pylorus (stomach-duodenal sphincter)
31
``` Pyloric Stenosis General > -1-; may be -2- > -3- more often affected > Most common in -4- > -5- presentation ```
1. cause is unknown 2. familial predisposition 3. Males 4. Caucasians 5. breastfeeding delays
32
``` Pyloric Stenosis S/S > Presentaiotn is usually from -1- > -2- after eating > -3- > Eventually -4- > -5- after vomiting (rare) ```
1. 3 weeks to 4 months of age 2. projectile, non-bilious vomiting 3. hungry after vomiting 4. becomes dehydrated 5. palpable mass (grape sign)
33
``` Pyloric Stenosis Labs/Dx > abdominal -1- > -2- if -1- is not diagnostic commonly shows -3- Mgmt > -4-; prognosis excellent, (-5-) ```
1. ultrasound 2. Upper GI 3. "string sign" (narrow pyloric canal) 4. surgical referral 5. 12-hour recovery
34
Intussuception | Def: -1- of one part of the -2-
1. Telescoping | 2. intestine into another adjacent segment
35
Intussuception General > -1- but may be due to -2- > Other prposed causes include -3- and -4-
1. cause is unknown 2. adenovirus 3. celiac 4. CF
36
``` Intussuception General > Most common cause of bowel obstruction in children -1- >> Peak incidence: -2- > more common in -3- ```
1. 3 mo - 6 years of age 2. 9 mo - 3 years 3. males
37
``` Intussuception S/S > -1- develops -2- > High-pitched, -3- caused by abdominal pain > -4- vomiting ```
1. previously healthy infant 2. acute colicky pain 3. sudden, loud crying 4. bilious vs non-bilious
38
Intussuception S/S > -1- in -2- > -3-: late presentation
1. sausage-shaped mass 2. RUQ 3. Currant jelly stool
39
``` Intussuception Labs/Dx Options > -1- > -2- > -3- > -4- ```
1. US 2. X-ray 3. CT 4. Enema (contrast or air)
40
``` Intussuception Mgmt > Refer to a pediatirican or -1- > fluid or -2- > -3- > may be -4- ```
1. Peds GI 2. air enema 3. surgery 4. fatal if not treated urgently
41
``` Hirschprung's Disease Def: birth defect in which -1- at the end of the child's bowel, causing -2- > Causes/Incidence >> May present in -3- or in -4- >> More common in -5- ```
1. nerves fail to grow/cells are missing 2. blockages in the bowel 3. infancy 4. older children 5. males than females
42
``` Hirschprung's Disease S/S > -1- > progressive -2- > failure -3- > -4- & -5- ```
1. bilious vomiting 2. abdominal distension 3. to pass meconium 4. empty rectum 5. tight anal sphincter
43
Hirschprung's Disease S/S > -1- > -2-
1. FTT | 2. malnutrition
44
``` Hirschprung's Disease Labs/Dx > abdominal -1- > -2- > -3-: -4- ```
1. X-ray 2. barium enema 3. rectal/colon biopsy 4. gold standard
45
Hirschprung's Disease Mgmt > Referral;...
...requires surgery
46
Volvulus Def: -1- of the GI tract, leading to bowel obstruction > Causes/Incidence >> May be first -2- disease in children
1. torsion | 2. sign of hirschprung
47
``` Volvulus S/S > Insidious, -1- > -2- > -3- > -4- ```
1. progressive abdominal pain 2. constipation 3. abdominal distension 4. N/V
48
Volvulus Labs/Dx -1- Plain abdominal -2-, CT scan and/or Upper GI series
1. CBC & BMP | 2. radiography
49
``` Volvulus Tx/Mgmt > referral to pediatrician and/or -1- > -2- may be used > -3- is the definitive -4- ```
1. peds GI 2. endoscopic detorsion 3. Surgery 4. intervention
50
Celiac Disease | Def: -1- to -2-, a protein found in wheat, barley, and rye; results in an inflammatory response & GI S/S
1. Immune reaction | 2. gluten consumption
51
Celiac Disease Causes/Incidence > -1- > -2- are more affected than -3- > May first appear in -4-
1. genetic disorder 2. females 3. males 4. infants
52
Celiac Disease S/S GI (findings often -1-) > -2- (primary finding; stools may be -3-, light tan, -4-)
1. suggestive of malabsorption 2. diarrhea 3. greasy 4. foul smelling
53
``` Celiac Disease S/S GI > -1- > -2- > -3- ```
1. flatus 2. weight loss 3. stomach pain
54
``` Celiac Disease S/S Extraintestinal > -1- > -2- > -3- (e.g., -4-, paresthesias, ataxia) > -5- ```
1. anemia 2. bleeding diathesis 3. neuro findings 4. Sz, motor weakness 5. amenorrhea
55
``` Celiac Disease Labs/Dx > Referral to pediatrician (-1- via GI endoscopy) > -2- > BMP & CBC for -3- ```
1. gold standard: intestinal biopsy 2. Ab testing: tTG-IgA (eat gluten 2 weeks before) 3. malabsorption & anemia
56
``` Celiac Disease Mgmt > Per pediatrician & -1- > -2- > Daily -3- for newly diagnosed patients > -4- used for refractory patients > Comorbid with -5-, immediate -6- ```
1. peds GI 2. gluten-free (trigger-free) diet 3. multivitamin 4. corticosteroids 5. T1D or hypothyroidism 6. GI referral
57
``` Ulcerative Colitis Def: -1- condition that affects the GI tract; most commonly affects the -2- > Incidence >> First pediatric peak onset in -3- >> More common in -4- in pediatric cases ```
1. Idiopathic, inflammatory 2. small bowel & colon 3. adolescence 4. males than females
58
UC S/S - 1- in children and adolescents - 2- - 3- or periumbilical -4- by -5-
1. Possible growth delay 2. prolonged diarrhea 3. RLQ 4. pain relieved 5. defecation
59
UC S/S - 1- - 2- - 3- (colon involvement)
1. low-grade fever 2. weight loss 3. bloody stool
60
UC Labs/Dx > -1- establishes -2- > -3- can differentiate between -4-
1. Colonoscopy 2. diagnosis 3. serologic testing 4. Crohn's & UC
61
UC Tx/Mgmt - 1- disease: -2- therapy - 3- disease: -4-
1. Mild 2. mesalamine, abx, nutritional (fiber) 3. Severe 4. corticosteroids, methotrexate
62
UC Tx/Mgmt | If all other therapies fail, -1- or -2- may be needed
1. biologics (e.g., infliximab) | 2. surgery
63
``` IBS Def: -1- that include -2- > Causes/General >> -3- >> Greater incidence among -4- ```
1. Group of symptoms 2. ABD pain, diarrhea, constipation, or a combo of the three 3. Stress theory 4. females
64
``` IBS S/S > -1- > -2- > -3- > -1- may be relieved by defecation > *-4-* ```
1. Abdominal pain/cramping 2. diarrhea 3. constipation 4. rectal tenesmus common (specific to IBS)
65
IBS Dx - 1- - 2- - 3-
1. CBC 2. UA & culture 3. Stool sample
66
IBS Dx -1- test abdominal -2- -3-
1. lactose breath hydrogen (lactose intolerance) 2. x-ray & US 3. endoscopy/colonoscopy
67
IBS Mgmt -1- -2- Stool -3-
1. symptomatic treatment 2. dietary fiber supplementaion 3. softeners for constipation
68
``` Malabsorption Syndrome Def: Refers to a(n) -1- in which the small intestine is unable to -2- > Causes >> -3- disease >> -4- disease >> -5- ```
1. group of disorders 2. absorb adequate nutrients 3. Celiac's 4. Crohn's 5. CF
69
Malabsorption Syndrome - S/S -1- -2- Bulky, foul stool (-3-)
1. FTT 2. severe, chronic diarrhea 3. steatorrhea
70
Malabsorption Syndrome - S/S - 1- - 2- - 3- abdomen
1. Vomiting 2. ABD pain 3. protuberant
71
``` Malabsorption Syndrome - S/S Assoc. w/ Vitamin deficiency/malabsorption > -1- > -2- > -3- abnormalities > -4- > -5- ```
1. pallor 2. fatigue 3. hair and dermatological 4. cheilosis 5. peripheral neuropathy
72
``` Malabsorption Syndrome > Labs/Dx >> StooL: -1-, hemocult, and ova/parasite exam >> -2- > DDx >> -3- >> -4- disease >> -5- disease ```
1. culture 2. bone age 3. CF 4. Hepatic 5. Inflammatory bowel
73
``` Malabsorption Syndrome - Mgmt > Dietary modificaionts: >> -1- wheat, oats, rye, barley >> CF: -2-; fat soluble vitamins (-3-) >> Treat -4- ```
1. celiac disease: no 2. pancreatic enzyme replacement 3. A, D, E, K 4. persistent enteric infections
74
Neuroblastoma Def: -1- type of -2- of the -3-; most commonly found in the -4-, but can spread to other parts of the body > Causes/Incidence >> Most common before th age -5-
1. rare 2. cancerous tumor 3. neuroblasts 4. adrenal gland 5. of 5 years
75
Neuroblastoma S/S | -1- where -2-
1. Lump, pain | 2. tumor is growing (e.g., neck, chest, abdomen, pelvis)
76
``` Neuroblastoma Labs/Dx > CT/-1- > -2- > -3- or biopsy > -4- > -5- (VMA, HVA test) ```
1. MRI 2. PET 3. bone marrow aspirate 4. Tissue biopsy 5. urine catecholamines
77
``` Neuroblastoma Mgmt > Referral to pediatric -1- > -2- > -3- > Prognosis: -4- ```
1. oncologist & surgeon 2. Surgery 3. Chemotherapy 4. starkly dependent on timing of Dx
78
Hepatitis Def: a(n) -1- of the -2- with -3- > General Comments >> Most common types in pediatrics: -4-
1. inflammation 2. liver 3. resultant liver dysfunction 4. A, B, & C
79
Hep A An enteral virus, transmitted via the -1- > contaminated -2- > -3- manifest -4- infection
1. oral-fecal route 2. food, especially shellfish (e.g., raw oysters, clams, and mussels) 3. S/S 4. 2-6 weeks after
80
Hep B A blood-borne virus present in -1- secretions, and -2- > May be transmitted via blood & blood products, sexual activity, and -3- > Incubation: -4-
1. saliva, semen, vaginal 2. all bodily fluids 3. mother to fetus (vertically) 4. 6 weeks to 6 months
81
Hep C > Traditionally associated with -1- > Today, most cases are related to -2- > Incubation: -3-
1. blood transfusion 2. IV drug use 3. 4-12 weeks
82
``` Hepatitis S/S > -1-: -2- > -3- > HA > aversion to -3- and -4- ```
1. Pre-icteric 2. fatigue, malaise 3. anorexia, N/V 3. second-hand smoke 4. alcohol odors
83
Hepatitis S/S > -1-, -2-, clay colored stool, -3- > Young children with hepatitis (esp. A) tend to be -4- or have only -5- including -6-.
1. Icteric (yellow sclera): weight loss 2. jaundice (rarely < 6 yo), pruritis (from elevated LFTs), RUQ pain 3. dark urine 4. asymptomatic 5. mild flu-like symptoms 6. fever, nausea, and anorexia
84
Hepatitis S/S > -1- > -2- > -3- over -4- area
1. hepatosplenomegaly 2. diffuse abdominal pain 3. tenderness 4. the liver
85
Hepatitis Labs/Dx > -1- > -2- > -3-
1. US 2. CBC 3. UA: proteinuria, bilirubinemia
86
Hepatitis Labs/Dx > Elevated -1- and -2- > Lactate dehydrogenase, -3-, alk phos, & PT may be normal or slightly elevated
1. AST 2. ALT (500 - 2,000 IU/L) 3. bilirubin
87
``` Hepatitis Labs/Dx Serology tests > Active Hep A: Anti-HAV, -1- > Recovered Hep A: Anti-HAV, -2- > Active & Chronic Hep B: HBsAg, Anti-HBc, -1- > Recovered Hep B: Anti-HBc, -3- > Acute Hep C: -4- > Chronic Hep C: Anti-HCV, HCV RNA ```
1. IgM (IMmediate, active) 2. IgG (Gone, recovered) 3. Anti-HBsAg 4. same as chronic (Anti-HCV, HCV RNA)
88
Hepatitis Mgmt > Referral to a peds -1- > -2-
1. GI | 2. supportive care (no specific therapy is available)
89
Appendicitis S/S > Begins with -1- pain > After several hours, the -2- RLQ of the abdomen
1. vague, colicky umbilical | 2. pain shifts to
90
Appendicitis S/S > McBurney's -1-: 1/3 the distance from the anterior -2- to the -3- > Rovsing's sign: -4- when pressure is applied to the -5-
1. point tenderness (palpate, along with Rovsing's) 2. superior iliac spine 3. umbilicus 4. RLQ pain 5. LLQ
91
Appendicitis S/S > Psoas sign: pain w/ -1- > Obturator sign: pain with internal rotation of the -2-
1. Rt thigh extension (manipulate, along with obturator) | 2. flexed right thigh
92
Appendicitis S/S > Pain -1- and localizes -2- > Nausea with -3- episodes of -4- > -5-
1. worsens 2. with cough 3. one to two 4. vomiting (more than this: other diagnosis) 5. Fever (low grade)
93
Appendicitis Labs/Dx > Elevated -1-: 10k - 20k/mcg > -2- > -3- or -4-
1. WBCs 2. Elevated ESR 3. US 4. CT is diagnostic
94
Appendicitis Mgmt > -1- tx w/ wound healing; prognosis is -2- > -3-
1. surgical 2. typically very good (full recovery in 24 hours) 3. pain mgmt
95
Foreign body ingestions -1- in children between the ages of -2- as well as in older children with -3-. -4- ingestions are more frequent in adolescents, adults, and in those with underlying -5-.
1. occur most commonly 2. 0.5-3 years 3. developmental delays 4. Intentional 5. behavioral/mental health diagnoses
96
Interventions for ingestions are based on the -1- ingested, time since ingestion, -2- of the object, and -3-. Any foreign body lodged -4- is considered an emergency due to the risk of -5-.
1. object or objects 2. anatomic location 3. presenting symptoms 4. in the esophagus 5. perforation and sepsis
97
Button battery ingestions have the -1- for serious injury. Lodged -2-, a button battery can result in burns and -3- to tissues within two to three hours of ingestion. An ingested button battery lodged -2- is therefore the -4- for endoscopic removal.
1. greatest potential 2. in the esophagus 3. liquefaction necrosis 4. most emergent indication
98
A single -1- which reaches the stomach carries a lower risk, but -2- is an extremely important factor as there may have been adequate exposure within the esophagus to cause -3-. An algorithm for management of a -1- has been published at www.poison.org.
1. ingested button battery/button battery ingestion 2. time since ingestion 3. severe tissue injury
99
Cylindrical batteries have been associated with less -1- complications than -2-, if ingested. There is limited -3- ingestion of cylindrical batteries and no -4- of this ingestion.
1. serious and fewer 2. button batteries 3. literature regarding 4. algorithm for management
100
Removal of single cylindrical batteries from the esophagus is typically done -1-. Once these batteries reach the stomach, -2- is appropriate. If multiple cylindrical batteries are ingested, -3- is typically recommended.
1. within 24 hours 2. observation for stooling 3. endoscopic removal
101
Injury from ingestion of -1- has been the topic of increased literature within the past decade; including -2- primarily based on expert opinion in 2012 provided by the -3-.
1. high-powered magnets 2. management guidelines 3. NASPGHAN (North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition) Endoscopy Committee
102
Ingestion of multiple -1- simultaneously, can result in -2- of the bowel wall and ischemia or -3- if the -1- attract -4-.
1. high-powered magnets/metallic objects 2. pressure necrosis 3. fistula 4. across tissues
103
Due to the possible severe GI injury, multiple magnet ingestion should be -1-, usually inpatient, with -2-. Consult with a -3- and pediatric surgeon is warranted. Ingestion of a single magnet is -4- it arrives in the stomach, with the majority passing -5-.
1. closely monitored 2. x-rays 3. pediatric gastroenterologist 4. usually benign after 5. without incident
104
A single magnet lodged -1- is treated as any blunt object and -2- within 24 hours if it does not pass into the -3-. Ingesting -4- is primarily done for purposes of -5- without detection.
1. in the esophagus 2. removed endoscopically 3. stomach 4. packets containing drugs 5. transporting illegal substances
105
Endoscopic removal of packets containing drugs -1- and is avoided due to -2- the package and causing exposure to -3- of drug. If bowel obstruction or -4-, immediate -5- is indicated.
1. is not indicated 2. risk of rupturing 3. potentially fatal amounts 4. perforation is suspected 5. surgical intervention
106
In -1- patients who have ingested packets containing drugs, use of -2- irrigation has been described. -3-, if present, are -4- until the packet is passed or surgically removed.
1. asymptomatic 2. laxatives and bowel 3. Toxidrome symptoms 4. treated
107
Giardia duodenalis (formerly Giardia lamblia and Giardia intestinalis) is a -1- found in -2-. It is the most -3- in the United States and is commonly -4-.
1. flagellate protozoan 2. contaminated water sources/food 3. common parasitic infection 4. transmitted in daycares
108
Symptoms of Giardia duodenalis infection typically range from -1- in children and can include abdominal cramps, flatulence, bloating, and -2-. The incubation period is -3-, and the duration of illness is typically -4-.
1. mild to moderate 2. watery/greasy foul-smelling stools (NO FEVER, NO N/V) 3. 1-3 weeks 4. prolonged
109
Some Giardia duodenalis infections are -1- while others may require -2-. Rotavirus presents with acute -3-. Watery diarrhea occurs -4- in children less than 5 years of age. The duration of illness is -5- with a short incubation period of 48 hours.
1. self-limited 2. antimicrobial treatment 3. fever and vomiting 4. 2-4 days later 5. 3-8 days
110
Rotavirus is a -1- that occurs more commonly in cooler months. Treatment is -2- with replacement of fluids and electrolytes. The advent of the -3- in 2006 has -4- of the disease dramatically.
1. self-limiting virus 2. supportive 3. rotavirus vaccine 4. decreased the burden
111
Infection with Shigella begins with -1-, abdominal cramping, and -2-. It is most common in children 6 months to 3 years of age, with an incubation period of 24-48 hours and a duration of illness of -3-. The majority of cases are -4- antimicrobial therapy with the mainstay of treatment being supportive correction of -5- imbalances.
1. fever 2. diarrhea 3. 4-7 days 4. self-limiting/do not require 5. fluid and electrolyte
112
Abrupt onset of watery diarrhea, -1-, and abdominal cramping are the symptoms of Norovirus; the incubation period is -2-, and the duration can be 24-60 hours. Transmission of this virus is most common in -3-.
1. N/V 2. 12-48 hours 3. the cooler months
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Treatment of Norovirus is -1- to maintain -2- balance.
1. supportive | 2. fluid and electrolyte
114
Diseases causing fever, diarrhea, and abdominal pain in children can range from a -1- to more -2-. The initial presentation of a -3- also be considered. Most children with Crohn disease present with diarrhea, abdominal pain, and -4-. -5- including skin tags, fissures, fistulae, and abscesses may be present.
1. short-lived viral illness 2. urgent surgical conditions 3. chronic illness should 4. weight loss 5. Chronic perianal disease
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Recurrent -1- is also suggestive of Crohn disease. Poor appetite, fever, and -2- are also commonly noted at initial presentation. A child with -3- often presents with vomiting, diarrhea, decreased appetite, and occasionally low-grade fever. Enterocolitis is inflammation of the small and large intestines typically presenting with fever, -4-, and -5-.
1. aphthous stomatitis (differentiating sign, but not necessarily present) 2. iron deficiency anemia 3. acute gastroenteritis 4. abdominal distention 5. bloody stools
116
Symptoms of pseudomembranous colitis can start -1- days of -2- and include -3- in diarrheal stools, along with abdominal pain and fever.
1. after a couple 2. taking an antibiotic 3. blood or pus
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An -1- is the diagnostic study of choice for pyloric stenosis; it usually reveals an elongated thickened pylorus and a fluid-filled stomach. Although an -2- can be used to diagnose the cause of an infant's vomiting, this test involves an -3- that do not help diagnose pyloric stenosis. A -4- is conducted after an infant presents with certain gastrointestinal findings similar to pyloric stenosis, but this test is typically used to confirm gastroesophageal reflux disease. A -5- may be helpful in determining the nature and degree of symptoms, but are insufficient for definitively confirming pyloric stenosis.
1. abdominal ultrasound 2. upper gastrointestinal series 3. x-ray examination series 4. pH probe study 5. history and physical
118
Vomiting and choking are signs and symptoms of -1-. -2- usually presents with vomiting but not choking. There would also be a palpable mass visible after vomiting if the child had -2-. Vomiting is also a symptom of -3-, but, if the patient had this condition, he would have fever and other signs of illness. -4- presents with vomiting, but there would also be -5- in the vomit, as well as signs of jaundice and explosive bowel movements, among others.
1. GERD 2. Pyloric stenosis 3. meningitis 4. Hirschsprung's disease 5. bile
119
Findings of paleness, jelly-like stools, vomiting, inconsolable crying, abdominal distention, a sausage-shaped mass in the right upper quadrant, and blood in the baby's rectum are indicative of -1-, and -2- are the most definitive tools for confirming this diagnosis. -3- are most useful in diagnosing problems with the solid organs of the abdomen, such as the pancreas and liver. -4- and -5- are more advanced diagnostic tools and are not necessary for diagnosing -1-.
1. intussusception 2. barium enema radiography 3. Abdominal ultrasounds 4. Magnetic resonance imaging 5. computed tomography scans
PNCB CPNP-PC
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