Term
|
Definition
• Weight loss
• Unexplained fevers
• Pain radiating to the back
• Bilious emesis
• Hematemesis
• Hematochezia (bright red)/ melena (black tarry)
– the passage of fresh blood through the anus, usually in or with stools
– Melena: black, "tarry" feces that are associated with upper gastrointestinal bleeding
• Chronic diarrhea (>2 weeks)
• Occult GI blood loss
• Recurrent Oral ulcers (e.g. cyclic neutropenia- do a cbc to dx this)
• Dysphagia (difficult/painful swallowing)
• Unexplained rashes
• Nocturnal symptoms (does it wake them up in middle of night?)
• Arthritis
• Anemia/pallor
• Dysuria, hematuria, flank pain
• Delayed puberty
• Deceleration of linear growth velocity |
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Term
| Greatest risk factor for IBD |
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Definition
| first - degree relative w/ IBD |
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Term
| Extraintestinal manifestations of IBD (9) |
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Definition
| arthralgias, arthritis, osteopenia, nonspecific elevation of aminotransferases, chronic hepatitis, anemia, growth delay, pubertal delay, increased risk of colonic malignancy w/ chronic colonic inflammation |
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Term
|
Definition
| IBD has anemia and weight loss |
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Term
|
Definition
| Endoscopy with biopsy, and Xray of the small bowel with attention to the terminal ileum for diagnosing CD |
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Term
|
Definition
- IBD
- causes ulceration and inflammation of the inner lining of the colon and rectum |
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Term
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Definition
| BLOODY DIARRHEA (MOST COMMON) w/ pus and mucus (10-20x/day), also abd pain w/ poo, nausea, loss of appetite, irritability, anxiety, weakness, weight loss, vomiting |
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Term
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Definition
| an inflammation that extends into the deeper layers of the intestinal wall, and also may affect other parts of the digestive tract, including the mouth, esophagus, stomach, and small intestine (mouth to anus). |
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Term
|
Definition
| Abdominal pain any time that may AWAKEN PATIENT AT NIGHT (RLQ, periumbillical, epigastric), diarrhea in 50% of patients, N/V, fever, perirectal inflammation |
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Term
| What is special about Crohns abdominal pain? |
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Definition
| awakens the patient at night |
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Term
| Most common sx of ulcerative colitis? |
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Definition
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Term
| Acute types of diarrhea (9) |
|
Definition
- salmonella (no tx, short-lived w/ throw up, fever, and sometimes bloody stool)
- shigella - invasive, bloody and mucus stool. tx w/ antibiotics seizure is possible
- camylobacter - usually watery, but may be bloody. Treat severe prolonged cases with Erythromycin.
- Yersinia - 10% bloody, often has systemic sx.’s. Mostly, no rx. Needed
- E.coli - e.g. Shiga toxin-producing E.coli 0157:H7 (can cause hemolytic uremic syndrome)
- Staphylococcal - food poisoning, sx appear 6-12 hrs after ingestion
- protozoa
- cryptosporidium - watery stool (immunocompromised pts)
- giardia - contaminated water. bloating and abdominal pain, non-bloody. |
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Term
|
Definition
- 24 hour Intraluminal esophageal pH recording
- pH less than 4 esophagososcopy and biopsy can document esophagitis |
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Term
|
Definition
P ain (front, back, sides, shoulder)
• E lectrolytes Fall, Shock
• R igidity
• I mmobile abdomen and patient
• T enderness (rebound)
• O bstruction
• N ausea and Vomiting
• I ncreasing pulse, decreasing BP
• T emperature falls, then rises
• I ncreasing girth of abdomen
• S ilent abdomen (no bowel sounds) |
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Term
| Intussusception - type of pain |
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Definition
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Term
|
Definition
- A bdominal sausage (RUQ, or epigastrum)
- B lood from rectum (“currant jelly” stools)
- C olic (Draw up knees)
- D istention, dehydration, shock
- E mesis (bilious)
- F ace pale (pallor) |
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Term
|
Definition
%): sudden onset of crampy abdominal pain- knees up, sudden crying out and pallor every 15 min, alternate with lethargy. Later see bilious emesis and then “currant jelly” stools.
- CRIES then suddenly okay, like he’s been demonized |
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Term
| Hypertrophic pyloric stenosis |
|
Definition
- 2-6 weeks, male
- projectile vomiting!!
- sx: palpable olive, visible peristaltic waves LUQ, weight loss, dehydration |
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Term
| ***Hypertrophic pyloric stenosis imbalance |
|
Definition
| Hypochloremic, hypokalemic metabolic alkalosis |
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|
Term
| Hypertrophic pyloric stenosis tx |
|
Definition
- correct the metabolic alkalosis and dehydration
- pyloromyotomy |
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Term
|
Definition
| contrast enema – RECTAL BIOPSY (not colonoscopy) |
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Term
| Obesity Complications (8) |
|
Definition
o Psychosocial: poor self-esteem, depression, eating disorders, withdrawal from peers
o Pulmonary: sleep apnea, asthma, exercise intolerance
o GI: gallstones, steatohepatitis(fatty liver disease)
o Renal: glomerulosclerosis (scarring of the kidneys’ tiny blood vessels, the glomeruli, the functional units in the kidney that filter urine from the blood)
o Musculoskeletal: Slipped capital femoral epiphysis (a hip problem that starts if part of the growing end [the epiphysis] of the femur slips off from the top of the thigh bone), flat feet, arthritis
o Neuorological: pseudotumor cerebri/benign intracranial hypertension (SEVERE HEADACHE)…do an LP as soon as they pull, the pressure gets relieved and the feel better
o Cardiovascular: dyslipidemia (abnormal cholesterol and triglyceride levels), hypertension, artherosclerosis, coronary artery disease
o Endocrine: Type 2 diabetes, precocious puberty, polycystic ovary syndrome (girls), hypogonadism (boys) |
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Term
|
Definition
| - border line levels of total cholesterol 170-199 and LDL 110-120 mg/dl or elevated levels cholesterol of >200mg/dl and >130 mg/dl for LDL cholesterol |
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Term
|
Definition
ORAL REHYDRATION
• Initial: Mild 50ml/kg over 4 hours
• Subsequent 100ml/kg/24 hours
• Moderate: 100ml/kg over 6 hours
• 100ml/kg over 24 hours
• Stool losses add 10-15 ml/kg/hr.
• Continue until diarrhea stops
• Offer breast feeding and H2O- but still needs pedialyte for electrolytes
*NO IMMODIUM, PEPTOBISMOL, AND KAOPECTATE
• Pain before vomiting – abdominal cause
• Vomiting before pain – extra abdominal |
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Term
|
Definition
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|
Term
|
Definition
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|
Term
| Hypertrophic pyloric stenosis age |
|
Definition
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|
Term
|
Definition
| tx: fluid resuscitation and air enema |
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Term
| Pyloric stenosis dx and tx |
|
Definition
dx: Ultrasound
tx: must correct metabolic alkalosis and dehydration
then pyloromyotomy |
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Term
| Malrotation w/ midgut volvulus age |
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Definition
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|
Term
| Malrotation w/ midgut volvulus s/s |
|
Definition
• POOR WEIGHT GAIN
• Bloody stool but not currant jelly, bile stained emesis, tender distended abdomen, looks REALLY SICK!!! |
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Term
|
Definition
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Term
|
Definition
|
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Term
|
Definition
| 2 stage colectomy or laparascopic pull through procedure |
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