WorksheetsExam 3 (Peds) - GI/Autism
Total questions: 85
Worksheet time: 45mins
SATA: What are the most common consequences of GI dysfunction in children?
rapid weight gain
fluid and electrolyte imbalances
malnutrition
poor growth
malabsorption
Diarrhea in children is associated with abnormal intestinal water and _______ transport.
electrolyte
protein
lipid
glucose
Diarrhea has higher rates of mortality and morbidity among infants and children under 5 years old.
True
False
Which type of diarrhea is often infectious, such as gastroenteritis?
Acute
Chronic
Osmotic
Secretory
What is the first step in therapeutic management for dehydration?
Initiate oral or IV rehydration as appropriate.
Administer antibiotics immediately.
Begin with surgical intervention.
Restrict all fluid intake.
In regards to nursing management of diarrhea, what is the guideline for replacing ongoing stool losses?
Replace ongoing stool losses 1:1 with oral rehydration solution
Replace ongoing stool losses 2:1 with plain water
Replace ongoing stool losses 1:2 with intravenous fluids only
Do not replace ongoing stool losses unless dehydration occurs
What is the forceful expulsion of stomach contents called?
Vomiting
Regurgitation
Absorption
Exhalation
What is the typical etiology of pediatric vomiting according to the worksheet?
Gastroenteritis
GERD
Appendicitis
Crohn's
Which of the following should be ruled out as causes of vomiting?
Head trauma
Pregnancy
Migraine
All of the above
Pica is characterized by the ingestion of which types of substances?
Only food picas
Only nonfood picas
Food picas and nonfood picas
Only liquids
The physiologic theory of pica states that:
Pica arises from malnutrition and unmet needs.
Pica arises from compulsive neuroses.
Pica arises from congenital defects.
Pica is an autosomal recessive disorder.
The psychologic theory of pica states that:
Pica arises from malnutrition and unmet needs.
Pica arises from compulsive neuroses.
Pica arises from congenital defects.
Pica is an autosomal recessive disorder.
Constipation is a ______ rather than a disease.
symptom
byproduct
infection
disorder
Within how many hours of life should the first meconium be passed in the newborn period?
24-36 hours
12-18 hours
48-60 hours
72-84 hours
SATA: If the first meconium is not passed in an appropriate timeframe, select some conditions to assess for.
Hirschsprung disease
Hypothyroidism
Intussusception
Gastroesophageal reflux
Cystic fibrosis
Constipation in exclusively breast-fed infants is almost unknown.
True
False
What is encopresis?
Pediatric constipation.
Inappropriate passage of feces, often with soiling.
Pediatric diarrhea.
Inappropriate passage of urine and stool simultaneously.
SATA: What are the 3 "Fs" of pediatric encopresis management?
Fiber increase
Fluid increase
Fitness increase
Fiber decrease
Fecal increase
Fill in the blank: Encopresis may result from _______.
stress
exercise
sunlight
hydration
Which of the following is an age-appropriate dietary modification for encopresis?
High-fiber diet
High-sugar diet
Low-fluid diet
High-fat diet
Management of obstruction in encopresis may require ______ months of behavioral, dietary, and pharmacologic interventions.
6-12
1-2
3-5
7-9
Cleft lip and palate can occur independently or together.
True
False
What is the primary cause of cleft lip and palate?
Failure of facial tissues to fuse during early gestation.
Vitamin C deficiency during pregnancy.
Neural thrombus defect in pregnancy due to maternal lack of folic acid.
Improper feeding techniques after birth.
Which anatomical structures are involved in cleft lip? (Highly doubt she'll ask about this on the exam)
Vermillion border, Cupid’s bow, and philtrum.
Mandible, maxilla, and zygomatic arch.
Nasal septum, inferior turbinate, and hard palate.
Tongue, soft palate, and uvula.
What is the cause of cleft palate?
Incomplete fusion of palatal shelves.
Excessive growth of the mandible.
Overproduction of saliva during development.
Premature eruption of teeth.
Etiology: Which gene mutation is associated with cleft lip and palate?
BMP4 gene mutation
CFTR gene mutation
HTT gene mutation
BRCA1 gene mutation
Epidemiology: How does the prevalence of cleft lip and palate vary globally?
Higher rates in Asian populations
Higher rates in African populations
No variation across populations
Lower rates in Asian populations
Higher rates in Caucasian populations
Epidemiology: Is cleft lip more common in males or females?
Cleft lip more common in males, cleft palate equal in both genders.
Cleft lip more common in females, cleft palate more common in males.
Cleft lip and palate both more common in females.
Cleft lip and palate both more common in males.
What is the surgical treatment for cleft lip called?
Cheiloplasty
Palatoplasty
Mastectomy
Cleftiostomy
Hirschsprung Disease is caused by mechanical obstruction from inadequate motility of which organ?
Stomach
Intestine
Liver
Pancreas
Hirschsprung Disease is characterized by the absence of ganglion cells in the colon.
True
False
Which of the following is a typical stool characteristic in Hirschsprung Disease?
Watery stool
Ribbon like stool
Bloody stool
Hard pellet like stool
Which of the following is NOT a clinical manifestation of Hirschsprung Disease?
A) Aganglionic segment of colon
B) Accumulation of stool with distention
C) Failure of internal anal sphincter to relax
D) Increased motility of the colon
Fill in the blank: In more than 80% of cases, Hirschsprung Disease affects the internal sphincter, rectum, and a few centimeters of the ______ colon (short-segment disease).
sigmoid
ascending
transverse
descending
Which diagnostic test is used to confirm Hirschsprung Disease?
Occult stool blood test
Rectal biopsy
Lithotripsy
MRI
Therapeutic management of Hirschsprung Disease may involve two stages. What is the first stage?
Pull Through procedure
Temporary ostomy
Medication therapy
Dietary changes
What is GER defined as? Fill in the blank: GER is defined as the transfer of _______ contents into the esophagus.
gastric
intestinal
pulmonary
hepatic
GER occurs in everyone.
True
False
Fill in the blank: Frequency and persistency may make GER _______.
abnormal
normal
temporary
irrelevant
GERD occurs in everyone.
True
False
GERD may occur without regurgitation.
True
False
Fill in the blank: 50% of infants less than 2 months old are reported to have ______ GER.
physiologic
pathologic
infectious
congenital
At what age does physiologic GER in infants usually resolve spontaneously?
By age 1 year
By age 6 months
By age 2 years
By age 3 months
Fill in the blank: GER becomes pathologic when failure to thrive, bleeding, or ______ develop.
dysphagia
cough
fever
rash
List two feeding alterations in infants with GER/GERD.
Thickening feedings and upright positioning
Reducing fluid intake and skipping feeds
Feeding only solid foods and avoiding milk
Delaying feeds and using cold formula
What is the surgical intervention mentioned for GER/GERD management?
Nissen fundoplication
Appendectomy
Cholecystectomy
Colectomy
Fill in the blank: Irritable Bowel Syndrome is identified as a cause of recurrent ______ pain in children.
abdominal
chest
head
leg
Fill in the blank: A characteristic of Irritable Bowel Syndrome is alternating ______ and ______.
diarrhea; constipation
vomiting; nausea
pain; fever
bloating; weight loss
Which point is associated with epigastric pain in appendicitis?
McBurney's point (RLQ abd)
Murphy's point (RUQ abd)
Lanz point (left iliac fossa)
Rovsing's point (LLQ abd)
What is the treatment for appendicitis?
IV antibiotics, surgery
Bed rest, increased fluid intake
Topical ointments, painkillers
Physical therapy, massage
What is the pathophysiology of hypertrophic pyloric stenosis?
Constriction of the pyloric sphincter with obstruction of the gastric outlet
Dilation of the pyloric sphincter with increased gastric emptying
Inflammation of the gastric mucosa leading to ulceration
Loss of peristalsis in the small intestine
Which clinical manifestation develops in the first weeks of life in hypertrophic pyloric stenosis?
Nonbilious projectile vomiting
Bloody diarrhea
Jaundice
Severe abdominal distension
What is the laparoscopic procedure is the treatment for hypertrophic pyloric stenosis?
Pyloromyotomy
Appendectomy
Cholecystectomy
Colectomy
What is the pathophysiology of intussusception?
Telescoping of one portion of intestine into another
Inflammation of the intestinal mucosa
Obstruction due to gallstones in the intestine
Formation of diverticula in the colon
What is the classic presentation of intussusception involving stools?
Current jelly-like stools
Watery diarrhea
Clay-colored stools
Rice-water stools
SATA: Which of the following is part of the classic triad of intussusception symptoms?
Gradual onset of abdominal pain
Sudden onset of abdominal pain
Sausage-like abdominal mass
Spherical mass in the perineal area
"Dance sign", retraction of the RLQ
Fill in the blank: Retraction of the RLQ in intussusception is also known as the ________ sign.
dance
murphy
blumberg
cullen
What is the first line of treatment for intussusception?
Surgical reduction
Air enema
Immediate antibiotics
immediate corticosteroids
If conservative/nonsurgical treatment for intussusception is unsuccessful, what is the next step?
Repeat enema
Progress to surgical treatment
Increase fluid intake
Discharge the patient
Fill in the blank: Malrotation is due to abnormal rotation around the ________ during embryonic development.
superior mesenteric artery
inferior vena cava
hepatic portal vein
descending aorta
inferior mesenteric artery
Volvulus occurs when the intestine is twisted around itself and comprises ______ supply to intestines.
Blood
HCl acid
Pepsin
Bilirubin
What is a classic symptom of malrotation and volvulus in the newborn period?
Constipation
Bilious emesis
Non-bilious vomiting
Fever
Fill in the blank: Emergent surgical intervention is required in malrotation and volvulus to prevent ________.
death
infection
paralysis
bleeding
Celiac disease is also known as ________.
Gluten-induced enteropathy
Lactose intolerance
Crohn's disease
Ulcerative colitis
Which of the following is NOT a main characteristic of celiac disease?
A) Steatorrhea
B) General malnutrition
C) Abdominal distension
D) Hypertension
Fill in the blank: Coffee-ground emesis is a symptom of ________ GI bleeds.
Upper
Lower
Distal
Chronic
Fill in the blank: Bright red (rectal) bleeding, also known as hematochezia, is a symptom of ________ GI bleeds.
Lower
Upper
Middle
Esophageal
______-fed infants may develop constipation because ______ is thick and harder to digest.
Breast
Formula
Cow's milk
Honey
What is the surgical treatment for cleft palate called?
Chelioplasty
Palatoplasty
Chelosectomy
Palatrum
What is the difference between GER and GERD?
In GERD, the reflux causes tissue damage
In GERD, the reflux causes regurgitation
GERD is less severe than GER
In GERD, the regurgitation causes reflux
If an infant is reported as "always hungry", but they are failing to thrive, which condition does the infant most likely have?
intussusception
appendicitis
hypertrophic pyloric stenosis
malrotation
Tarry, black stools, also known as melena, is indicative of:
biliary atresia
upper GI bleeds
lower GI bleeds
hypertrophic pyloric stenosis
SATA: Select the clinical manifestations of biliary atresia.
prolonged jaundice
white stools
steatorrhea
bile duct obstruction
renal failure
Tracheoesophageal fistula is a congenital defect in which the esophagus fails to develop as a ____________ to the stomach.
single continuous passage
network of branching paths
create an esophageal atresia
group of multiple intertwined tubules
A patient with a tracheoesophageal fistula is considered a _______ risk for ______.
low, renal anomalies
high, aspiration
high, gastroschisis
low, anal atresia
A patient with a tracheoesophageal fistula should be placed on a strict NPO diet.
True
False
What is the difference between omphalocele and gastrochisis?
Omphalocele has the bowel protrude, but the bowel is contained in the peritoneal sac. In gastroschisis, the bowels feely spill out to the right of the umbilical cord.
Gastroschisis has the bowel protrude, but the bowel is contained in the peritoneal sac. In omphalocele, the bowels feely spill out to the right of the umbilical cord.
Umbilical hernias are common in the newborn period. When do they typically resolve on their own?
within the first few days of life
within the first few weeks of life
within the first few months of life
within the first few years of life
What is a persistent cloaca?
an embryonic GI structure that was supposed to be temporary
an incarcerated inguinal hernia
a form of tracheoesophageal fistula
a form of esophageal atresia
SATA: The core symptoms of autism involve alterations in:
Appearance
Behaviors
Communications
Social Deficits
SATA: What are some autism associated NEUROLOGICAL issues?
seizures
anxiety
immune dysfunction
sleep deficit
hyperactivity
Select the autism associated SYSTEMATIC issues.
mood disorders, anxiety
OCD, ADHD
immune dysfunction, GI disorders
seizures, sleep deficit
SATA: What are some autism related disorders?
COPD
GERD
OCD
ADHD
SPD
Choose the BEST answer (Hint: you want to do all of these). The most important treatment strategy for children with autism is:
Include parents in the treatment plan.
Create a calming sensory environment.
Consider the child's communication methods.
Give the patient some degree of predictability.
Be patient with the child.
Sensory processing disorder is defined as:
Problems identifying social cues when conversing with others.
Difficulty with a change in routine or schedule.
Difficulty in the way brain takes in, organizes, and uses sensory information.
Problems with appropriate behaviors and communications.
