Wk 6 GI Diseases Flashcards Preview

N320 Neo Peds Pathophysiology > Wk 6 GI Diseases > Flashcards

Flashcards in Wk 6 GI Diseases Deck (142)
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1

What is gastroesophageal reflux?

Intrusion of acids into the dilated esophagus resulting into the deterioration of the esophagus' epithileum & stimulation of the vomiting reflex.  

2

What is the etiology of gastroesophageal reflux?

Low cardiac sphincter pressure

Short cardiac sphincter

Transient/prolonged relaxation of LES

Poor coordination of esophageal motility

3

What are signs & symptoms of GERD?

Vomiting

Persistent cough

Crying w/ feeding

Choking/gagging with feeding

4

What medical problems can GERD lead to? 

Poor weight gain

Aspiration

Pneumonia

5

How do you diagnose GERD?

Clinical s/s often adequate to diagnose

Esophageal pH monitoring w/ a probe for 24 hrs

Endoscopy

6

What is the treatment for GERD? 

Usually resolves w/ age

Mild GERD = no treatment.

Upright positioning

Thickened feeds OR small frequent feeds w/ freq. burping 

Gastric acid blockers, metoclopramide (reglan),  & antacids

Surgery (gastropexy or fundoplication - recreates a valve by wrapping fundus of stomach around the esophagus)

 

7

What is esophageal atresia (EA)?

When the esophagus ends in a blind pouch & does not connect to the stomach

Can happen in conjunction w/ tracheoesophageal fistula

8

What is a tracheoesophageal fistula (TEF)?

An abnormal connection btwn the esohagus & the trachea

Can happen in conjunction with esophageal atresia

9

What is the etiology of esophageal atresia & tracheosophageal fistula?

An incomplete division of the oforegut into the respiratory & digestive portions at wk 4 of gestation.

 

10

Esophageal atresia & tracheoesophageal fistula can be an isolated defect or appear as part of what syndrome(s)?

VATER, VACTERL, & CHARGE

11

What does VATER syndrome/ VATERL syndrome stand for?

Anomalies of the following:

 Vertebrae

Anus 

Trachea

Esophagus 

Renal

Limb

12

What does CHARGE syndrome stand for?

CNS anomalies

Heart defects

Atresia of nasal passage/choana

Retardation of growth/dvlpment

Genital/urinary defects

Ear anomalies/deafness

13

What are prenatal s/s of esophageal atresia & tracheosophageal fistula?

polyhydramnios

no stomach bubble in US

14

What are postnatal s/s of esopheal atresia & tracheoesophageal fistula?

OG/NG tube does not pass

Excess salivation

Nonbilious vomiting

Feeding intolerance

Respiratory distress w/ feeds

Abdominal distention (TEF when abdomen fills w/ air)

Intermittent cyanosis

15

What is the treatment for esophageal atresia & tracheosophageal fistula?

Usu. diagnosed @ birth

Inability to pass NG/OG tube

prenatal US

16

What medical problems can esophageal atresia & tracheoesophageal fistula lead to?

recurrent aspiration

pneumonia

atelectasis

17

What is the treatment for esophageal atresia & tracheoesophageal fistula?

Surgery to restore esophageal continuity & eliminate fistula.

 

18

What is duodenal atresia?

The complete closure of the duodenum - causes an intrinsic obstruction

19

What is the etiology of duodenal atresia?

Failure of bow to recannulize in 2nd month of gestation.

20

What are prenatal s/s of duodenal atresia?

Polyhydramnios

Distended duodenum

21

What symptom is a medical emergency until proven otherwise?

Bilious emesis

22

What are postnatal s/s of duodenal atresia?

Bilious emesis - 1st 24 hrs of life

Abdominal distention of upper quadrants

KUB = double bubble (see pic showing air trapped in stomach & air trapped in proximal duodenum; separated by the pyloric sphincter - why looks like double bubble)

23

What is the treatment for duodenal atresia?

Decompression

Surgery

24

What disorders have a high rate of association w/ duodenal atresia?

Trisomy 21

CHD

Malrotation

Annular pancreas

EA

Genitourinary anomalies

25

What extrinsic causes could result in duodenal obstruction?

Malrotation/volvulus

Annular pancreas

Bowel duplications

Retroperitoneal tumors

26

What is an annular pancreas?

when the pancreas surrounds the second part of the duodenum causing constriction or blockage of the intestines.

27

What is the etiology of the annular pancreas?

when the ventral bud rotates counter-clockwise

28

What are the s/s of annular pancreas?

Polyhdramnios

Feeding intolerance

Low birth weight

29

What is the treatment for annular pancreas?

Surgical bypass of the blocked part of the duodenum

30

What is a malrotation?

When the intestines fail to rotate properly and affix improperly (the cecum ends up in the RUQ instead RLQ) & an abnormal membrane called the Ladd's band may obstruct the duodenum (see pic)

Leads to an increase likelihood of volvulus.