ABP Pediatric Gastroenterology flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Rome IV constipation criteria

For children, requires ≥2 of: ≤2 defecations/week, fecal incontinence, retentive posturing, painful stools, large fecal mass, large-diameter stools for ≥1 month.

Celiac disease diagnosis

IgA tTG >10× ULN with symptoms may allow diagnosis without biopsy; otherwise duodenal biopsy showing villous atrophy and crypt hyperplasia is required.

Acute pancreatitis criteria

Requires ≥2 of: abdominal pain, lipase >3× ULN, or imaging findings; lipase is preferred over amylase in children.

Hirschsprung disease diagnosis

Rectal biopsy showing absence of ganglion cells; presents with delayed meconium, distension, and bilious vomiting.

Eosinophilic esophagitis criteria

≥15 eosinophils/hpf on esophageal biopsy with symptoms of dysphagia or food impaction; associated with atopy.

Intussusception treatment

Air or contrast enema is both diagnostic and therapeutic; ultrasound shows target sign; surgery if enema fails or perforation.

Mid-parental height formula

Boys: (father + mother + 13 cm)/2; girls: (father + mother − 13 cm)/2; target range ±8.5 cm.

Failure to thrive definition

Weight-for-age <5th percentile or crossing ≥2 major percentile lines downward on growth chart.

Pyloric stenosis findings

Nonbilious projectile vomiting at 3–6 weeks, olive mass, hypochloremic hypokalemic metabolic alkalosis; ultrasound shows pyloric thickness ≥3 mm and length ≥15 mm.

H. pylori diagnosis

Urea breath test or stool antigen test; avoid serology in children; treat with PPI + amoxicillin + clarithromycin or metronidazole for 14 days.

Achalasia manometry

Absent esophageal peristalsis and failure of lower esophageal sphincter relaxation; barium swallow shows bird-beak.

Short bowel syndrome

Resection leaving <25% of expected small bowel length; management includes parenteral nutrition, enteral feeding, and medications to reduce secretions.

Lactose intolerance test

Breath hydrogen test showing rise >20 ppm after lactose load; treat with lactose avoidance or lactase supplements.

Fecal elastase

<200 µg/g suggests exocrine pancreatic insufficiency; used in chronic pancreatitis and cystic fibrosis.

Biliary atresia treatment

Kasai portoenterostomy before 60 days improves outcomes; jaundice beyond 2 weeks with direct hyperbilirubinemia and acholic stools warrants urgent evaluation.

Neonatal cholestasis definition

Conjugated bilirubin >1 mg/dL if total <5 mg/dL, or >20% of total; evaluate for biliary atresia, metabolic, infectious, and genetic causes.

Acute liver failure criteria

Coagulopathy (INR ≥1.5) with encephalopathy or INR ≥2.0 with or without encephalopathy; no chronic liver disease.

Wilson disease treatment

Chelators (penicillamine, trientine) and zinc; diagnosis with low ceruloplasmin, elevated urinary copper, Kayser-Fleischer rings.

Autoimmune hepatitis treatment

Prednisone and azathioprine; elevated transaminases, hypergammaglobulinemia, autoantibodies (ANA, anti-smooth muscle).

VEO-IBD genetic testing

Onset <6 years; consider IL-10 receptor mutations and other monogenic causes; genetic testing recommended.

FPIES management

Food protein-induced enterocolitis syndrome: repetitive vomiting 1–3 hours after ingestion, diarrhea, lethargy; treat with IV fluids and avoidance of trigger.

Upper endoscopy indications

Dysphagia, persistent vomiting, GI bleeding, suspected celiac disease, foreign body; contraindications include hemodynamic instability and suspected perforation.

Liver biopsy contraindications

Coagulopathy (INR >1.5) and thrombocytopenia (<50,000); percutaneous or transjugular approach.

Capsule endoscopy contraindication

Suspected obstruction or stricture; used for small bowel evaluation.

Informed consent elements

Must include risks, benefits, alternatives; assent from minors when appropriate; parental permission required.

GRADE system

Rates quality of evidence and strength of recommendations; used in evidence-based medicine.

PDSA cycle

Plan-Do-Study-Act; used in quality improvement to test changes and measure outcomes.

EER for infants

0–6 months: 108 kcal/kg/day; 7–12 months: 98 kcal/kg/day.

BMI percentile categories

Underweight <5th, normal 5th–<85th, overweight 85th–<95th, obese ≥95th.

Gastroparesis diagnosis

Delayed gastric emptying without obstruction; gastric emptying scintigraphy showing retention >60% at 2h or >10% at 4h.

Choledochal cyst treatment

Excision and Roux-en-Y hepaticojejunostomy; risk of cholangiocarcinoma; presents with pain, jaundice, mass.

Post-transplant immunosuppression

Tacrolimus or cyclosporine; monitor levels; complications include rejection, infection, EBV-related PTLD.