Term
| what are respiratory signs of GERD (6) |
|
Definition
wheezing
asthma
pneumonia
aspiration
laryngospasm
apena |
|
|
Term
| what are esophagitis signs of gerd (9) |
|
Definition
irritability
colic
hiccups
anemia
hematesis
stricture
protein loosing enteropathy
melena
occlut blood loss |
|
|
Term
| what are the regurgitation signs of GERD (3) |
|
Definition
spitting
emesis
failure to thrive |
|
|
Term
| what are some non GI/respiratory signs of GERD (5) |
|
Definition
clubbing of digits
SidS
dystonic posturing
snedifer syndrome
seizure like episodes |
|
|
Term
| how is GERD evalulated (4) |
|
Definition
barium swallow and upper GI series
esophageal pH study
endoscopy
milk scintiscan |
|
|
Term
|
Definition
postural management
thickening of food
antacids
H2 agonists
prokinetics
fundoscoplication |
|
|
Term
| hypertric pyloric stenosis cause |
|
Definition
| muscle hypertrophies within first 3-4 weeks of life due to improperlly formed ganglion cells |
|
|
Term
| who gets pyloric stenosis |
|
Definition
mostly males
strong family history |
|
|
Term
| what are the signs of pyloric stenosis (7) |
|
Definition
gastric waves after earing
projectile vomiting
palpable mass (olive)
hypokalemia
hypochloremia
metabolic acidosis |
|
|
Term
| how is pyloric stenosis diangosed (2) |
|
Definition
dtring like pyloric channel on barium study
conformation: ultrasound/sonogram of pylorus |
|
|
Term
| how is pyloric stenosis treated |
|
Definition
pyloromyotomy
correct electrolytes first to avoid anasthesia complications |
|
|
Term
| what are the two types of constipation |
|
Definition
|
|
Term
| what are two common causes of functional constipation |
|
Definition
switched formula
holding poo |
|
|
Term
| who normally gets functional constipation |
|
Definition
|
|
Term
| why does holding poo cause constipation |
|
Definition
more time in rectum removes water making it hard and painful and then they hold more
stretch receptors get desensitized and increase time in rectum for future poo |
|
|
Term
| treatment for functional diarrhea (2) |
|
Definition
peristaltic stimulant
mineral oil (libricant) |
|
|
Term
| what causes orgaic constipation |
|
Definition
| hirschsprungs disease (anatomical abnormality since birth) |
|
|
Term
| why does hirschsprungs disease cause constipation |
|
Definition
| ganglion cells stop too soon so last 5 cm of rectum has no ganglion cells so it never relaxes after peristalsis |
|
|
Term
| 4 signs of hirschsprung's disease |
|
Definition
hard poo
baby cries
belly distended
always constipated |
|
|
Term
| how is hirschsprungs diagnosed (3) |
|
Definition
barium enema
analrectal manometer
rectal suction biopsy |
|
|
Term
| what does a barium enema show in hirschsprungs |
|
Definition
| large colon with narrowing (rat tail) |
|
|
Term
| how does a analrectal manometer work, how is hirschsprungs diagnosed from it |
|
Definition
two balloons inserted and air is put into proximal and the pressure should drop in distal
in hirschsprungs pressure does not drop in distal because there is no receptive relaxation |
|
|
Term
| what is the diagnostic test for hirschsprungs |
|
Definition
| rectal suction biopsy has no ganglion cells |
|
|
Term
| how is hirschsprungs treated |
|
Definition
| divergent colospony and pull through |
|
|
Term
| what are 6 general questions or observations to see if a kid isnt faking abdominal pain |
|
Definition
weight loss
noctournal pain
emesis
regular school attendance
easy going kid
stable home |
|
|
Term
| what are three physical exam findings that say kid isnt faking abdominal pain |
|
Definition
clubbing
perianal skin tags
abdominal masses |
|
|
Term
| what are 5 lab findings that say kid isnt faking abdominal pain |
|
Definition
decreased albumin or lipase
increased ESR or anemia
occult blood in stool |
|
|
Term
| what are 4 cases of upper GI hemorrhage |
|
Definition
esophageal varices
gastric ulcers
gastritis
duodenal ulcer |
|
|
Term
| what are 7 causes of lower GI hemorrhage |
|
Definition
colonic polyps
anal fissure
intussecuption
mekel's diverticulum
ulcerative colitis
regional enteritis
hemorrhoids |
|
|
Term
|
Definition
| juvenile, benign, inflammatory polyps |
|
|
Term
| what causes anal fissure, what are two signs |
|
Definition
due to long term constipation
bleeding after pooping
rectal bleeding |
|
|
Term
|
Definition
|
|
Term
| what are two inflammatory bowel diseases |
|
Definition
ulcerative colitis
chrons disease |
|
|
Term
| define ulcerative colitis |
|
Definition
mucosal inflammation of the colon
contigous disease (one area, no skips) |
|
|
Term
|
Definition
inflammation of any part of GI tract
transmural inflammation (mucosa, submucosa, adventitia)
skip lesions (not confined to one area) |
|
|
Term
| what is the hallmark of ulcerative colitis |
|
Definition
|
|
Term
| what is the hallmark of chrons disease |
|
Definition
|
|
Term
| what are 5 signs of ulcerative collitis |
|
Definition
abdominal mass
clubbing
mucopurulent discharge
pseudopolyps
chronic: loss of mucosal folds |
|
|
Term
| what is a complication of ulcerative colitis |
|
Definition
|
|
Term
| what are 7 signs of chrons disease |
|
Definition
rectal bleeding
rectal inflammation
terminal ileum inflammation
fistula
stricture
malabsorption and growth failure
clubbing |
|
|
Term
| why does chrons disease have strictures and not ulcerative colitis |
|
Definition
| chrons has transmural inflammation leading to segmental narrowing |
|
|
Term
|
Definition
| thickening and loss of angle of nail bed |
|
|
Term
|
Definition
| congenital jaundice due to hypoplaia of bile ducts |
|
|
Term
| 4 signsle of alagile syndrome |
|
Definition
butterfly vertebrae (vertebral arch defect)
mild pulmonic stenosis
triangular faces
jaundice |
|
|
Term
| how dow you get celiac disease |
|
Definition
inherited genetic susceptability where DQ2 and or DQ8 are needed (but not alone)
triggered by enivornmental trigger (gluten) |
|
|
Term
| how does celiac disease cause problems |
|
Definition
autoimmine
autoantigens (transglutaminase) |
|
|
Term
| what is the disease with the highest prevlience of celiac disease |
|
Definition
|
|
Term
| name 11 diseases associated with celiac disease |
|
Definition
type 1 diabetes
down syndrome
turner syndrome
hashimotos syndrome
selective IgA deficiency
arthritis
autoimmune liver disease
sjogerns syndrome
idiopathic dilated cardiomyopathy
IgA nephrophathy |
|
|
Term
| what is a high indicator you have celiac disease |
|
Definition
| first degree relative with celiac disease |
|
|
Term
| when do gastrointestnal symptoms of celiac disease appear, why |
|
Definition
6-24 months
there isnt gluten in the diet befoe that |
|
|
Term
| what are 12 gastrointestinal symptoms of celiac disease |
|
Definition
diarrhea
vomiting
costipation
ABDOMINAL DISTENSION
abdominal pain
loss of subuctaneous fat (buttox)
FAILURE TO THRIVE
WEIGHT LOSS
MALNUTRITION
DEHYDRATION
irritability
celiac crisis - rare |
|
|
Term
| when do non-GI symptoms appear in celiac disease |
|
Definition
| older children and adults |
|
|
Term
| what are the non-gi symptoms of celiac disease (7) |
|
Definition
dermatitis herpetiformis
dental enamel hypoplasia
osteopenia/osteoperosis
short stature
delayed puberty/menarche
Fe deficient anemia resistant to oral Fe
asymptomatic, silent, or latent |
|
|
Term
| describe a dermatitis herpetiformis rash (5) |
|
Definition
macule > uticarial papule > tense vesicles
severe puritis
gluten sensitive
symmetric
does not usually occur with GI symptoms |
|
|
Term
| why is recognizing dental enamel hypoplasia in celiac disease important |
|
Definition
| sometimes the only presenting sign |
|
|
Term
| why do people with celiac disease get osteoperosis |
|
Definition
| low mineral density from poo absorption |
|
|
Term
| what precent of short kids have cealiac disease |
|
Definition
|
|
Term
| who normally gets Fe deficient anemia with celiac disease |
|
Definition
|
|
Term
| what are 4 rare non-gi symptoms that can occur with celiac disease |
|
Definition
| hepatitis, arthritis, epilepsy, occipital calcifications |
|
|
Term
| what are the clinical signs of celiac disease in a type 1 diabetic (4) |
|
Definition
patient is often asymptomatic
noctournal hypoglycemia
seizures
TTG may be false positive
gluten free diet is a challenge |
|
|
Term
| what is the chance of developing an autoimmue disease with celiac disease |
|
Definition
<2 years gluten exposure 5%
2-10 years 17%
>10 years 24% |
|
|
Term
| how is celiac disease diagnosed |
|
Definition
| seromarkers on blood tests |
|
|
Term
| who should always be checked for celiac disease (5) |
|
Definition
diabetics
hashimotos thyroiditis
down syndrome
turner syndrome
IgA deficiency |
|
|
Term
| what is the most common non-GI symptom of celiac disease in adults |
|
Definition
| Fe deficient anemia resistant to Fe supplementation |
|
|
Term
| what are 12 complications of celiac disease |
|
Definition
autoimmune disease
short stature
dermatitis herpatiformis
recurrent stomatitis
malabsorption
occipital calcifications causing epilepsy
infertility
refractory celiac disease
dental enamel hypoplasia
gluten ataxia
INTESTINAL LYMPHOMA
LACTOSE INTOLERENCE |
|
|
Term
| when do we see lactose intolerance with celiac disease |
|
Definition
| when diagnosis is delayed |
|
|
Term
| what special considerations must be taken for someone with lactose intolerence and celiac disease |
|
Definition
| increased Ca supplementation |
|
|
Term
| what are the three criteria for celiac disease |
|
Definition
enivornmental trigger: wheat, rye, barly
genetic predisposition: HLA DQ2 or DQ8
autoimmune disease: anti-tissue transglutaminase (autoantigen) |
|
|
Term
| what is gluten composed of, what part is a problem in celiac disease |
|
Definition
gliadin - problem
glutenin - alcohol insulable |
|
|
Term
| what is the species of plant making gluten |
|
Definition
| graminease festucoidae hordeae |
|
|
Term
| what are some viral triggers of celiac disease, why can they trigger it |
|
Definition
homologous with glidin
adenovirus 12, 7
RUBELLA
herpes |
|
|
Term
| what are some parasite triggers of celiac disease, why can they trigger it |
|
Definition
homologous with glidin
plasmodium yoelli |
|
|
Term
| what are 5 immune products or cells celiac disease increases |
|
Definition
IL-2
INFy
IL-15
IEL (CD8)
gamma delta T cell |
|
|
Term
| what antibodies are associated with celiac disease (4) |
|
Definition
anti-tissue transglutaminase
auto-gliadin
anti-actin
anti-endomysial |
|
|
Term
| what does transglutaminase do |
|
Definition
| gut enzyme released in injury that spabilizes proteins in granulation tissue |
|
|
Term
|
Definition
|
|
Term
|
Definition
| component of reticulin CT around smooth muscle |
|
|
Term
| what are 4 changes in the mucosa in celiac disease |
|
Definition
loss of epithelial cells
proliferation of crypt epithelial cells
malabsorption of Fe, folate, Ca, vit D
increased permeability to toxins |
|
|
Term
| what are the 5 ways to diagnose celiac disasse |
|
Definition
trial gluten removal
serology for antibodies
endoscopy
SI histology / biopsy
HLA typing |
|
|
Term
| why would you do serology testing for celiac disease (4) |
|
Definition
identify need for biopsy
screen at risk people
supportive evidence for diagnosis
monitor dietary compliance |
|
|
Term
| what are the three antibody tests for celiac disease |
|
Definition
anti-glyden
anti-endomyceal
anti-tissue transglutaminase |
|
|
Term
| what are the pluses and minuses of anti-glyden antibody testing |
|
Definition
increases suspicion for celiac disease, cheap
poor sensitivity and specificity |
|
|
Term
| what are the pluses and minuses of anti-endomyceal antibody testine |
|
Definition
more specific and sensitive than anti-glyden
false negative in young kids and IgA deficiency, time consuming, expensive, operator dependent |
|
|
Term
| what are the pluses and minuses of anti-tissue transglutaminase testing |
|
Definition
very sensitive and specific, not operator depdent, cheap
false negative in IgA deficiency |
|
|
Term
| which is more specific and why: anti-endomyceal or anti-tissue transglutaminase testing |
|
Definition
| ANTI-ENDOMYCEAL BECAUSE IT CAN DETECT CELIAC IN IGA DEFICIENT PATIENT |
|
|
Term
| what test must you always get in suspected celiac disease |
|
Definition
| ANTI-TISSUE TRANSGLUTAMINASE ANTIBODY SEROLOGY |
|
|
Term
| what are two signs on endoscopy of celiac disease |
|
Definition
|
|
Term
| what must always be done before treatment of celiac disease |
|
Definition
|
|
Term
| what are 8 signs of celiac disease on SI biopsy |
|
Definition
increased ILE (CD8)
loss of polarity
change columnar to cuboidal
laminal propria of cellular infiltrate
crypt elongation
crypt hyperplasia
increased mitotic index
progressive villous flattening |
|
|
Term
| what is the hallmark SI sign of celiac disease |
|
Definition
| TOTAL ARTOPHY OF THE VILLI |
|
|
Term
| what is the main treatment for celiac disease |
|
Definition
| strict gluten free diet for life (wheat, rye, barley) |
|
|
Term
| what is the prognosis of celiac disease |
|
Definition
| total resolution with complete diet adherence |
|
|
Term
| what happens if someone with celiac disease dosent follow the diet |
|
Definition
complications
morbidity
mortality |
|
|
Term
| what nutrients are low as a result of gluten free diet (13) |
|
Definition
Fe
Folate
B12
Vit ADEK
thiamine
niacin
B6
B-carotene
Zinc
essential FA |
|
|
Term
| what are three required nutritional supplements for celiac disease diet and why |
|
Definition
folate: increased absorption in brush border, apoptosis, cell division
Ca and Vit D: bone and mineral density, osteoperosis |
|
|
Term
| what nutrients are low in someone with celiac disease that are bad for pregnancy (8) |
|
Definition
Fe
zinc
folate
B12
protein
Vit K
B6
E |
|
|
Term
| what is the hardest part of celiac disease |
|
Definition
| GETTING COMPLIANCE TO THE DIET |
|
|
Term
| what are ovbious sources of gluten |
|
Definition
bread
bagel
cake
cereal
cookies
pasta
pastries
rolls |
|
|
Term
| what are potential sources of gluten |
|
Definition
wafers
candy
cured pork
drink mixes
gravy
immitation meat
sauce
soy |
|
|
Term
| what are rare potential sources of gluten |
|
Definition
seasonings
MALT FLAVORING
hop extract destrin
caramel color |
|
|
Term
| what are some gluten free options |
|
Definition
amaranth
arrowroot
buckwheat
corn
flax
millet
montina
OATS IF NOT CONTAMINATED
potatoes
wuinoa
rice
sorgum
topica
teff
flour of nuts and beans and seeds
starch
malodextrin
vinegar and alcohol (AVOID MALT) |
|
|
