Podcast
Questions and Answers
What is the typical fate of ingested foreign bodies in the gastrointestinal tract?
What is the typical fate of ingested foreign bodies in the gastrointestinal tract?
- They usually cause immediate perforation.
- They must be monitored radiologically.
- 95% pass through without difficulty. (correct)
- They always need surgical removal.
What size of objects typically does not pass through the pylorus in infants and toddlers?
What size of objects typically does not pass through the pylorus in infants and toddlers?
- Objects <3 cm in length
- Objects >2 cm in length
- Objects >3 cm in length or >20 mm in diameter (correct)
- Objects that are rounded in shape
What should be monitored if a patient ingests a sharp foreign body?
What should be monitored if a patient ingests a sharp foreign body?
- The color of the stool
- Weekly assessments of symptoms (correct)
- Blood pressure levels
- Gastrointestinal pH levels
What is the recommended action if a magnetic object is ingested?
What is the recommended action if a magnetic object is ingested?
If a foreign body is not progressing within 3-4 weeks, what does this indicate?
If a foreign body is not progressing within 3-4 weeks, what does this indicate?
What is the primary symptom that should prompt immediate medical attention after foreign body ingestion?
What is the primary symptom that should prompt immediate medical attention after foreign body ingestion?
Which of the following objects generally should be surgically removed if ingestion occurs?
Which of the following objects generally should be surgically removed if ingestion occurs?
What is the appropriate initial management for drug-related foreign body ingestion?
What is the appropriate initial management for drug-related foreign body ingestion?
What should not be used in the treatment of ingested foreign bodies?
What should not be used in the treatment of ingested foreign bodies?
What should be done if symptoms recur after discontinuing antisecretory therapy in children with idiopathic ulcers?
What should be done if symptoms recur after discontinuing antisecretory therapy in children with idiopathic ulcers?
What genetic risk is higher among relatives of patients with Crohn disease compared to those with ulcerative colitis?
What genetic risk is higher among relatives of patients with Crohn disease compared to those with ulcerative colitis?
What is the concordance rate for Crohn disease in monozygotic twins?
What is the concordance rate for Crohn disease in monozygotic twins?
Which condition is NOT mentioned as a possible cause of idiopathic ulcers?
Which condition is NOT mentioned as a possible cause of idiopathic ulcers?
What percentage of patients with ulcerative colitis typically have a perinuclear antineutrophil cytoplasmic antibody?
What percentage of patients with ulcerative colitis typically have a perinuclear antineutrophil cytoplasmic antibody?
What breakthrough occurred in the field of genetic research for IBD in 2001?
What breakthrough occurred in the field of genetic research for IBD in 2001?
What is the pediatric dosage recommendation for Famotidine?
What is the pediatric dosage recommendation for Famotidine?
For a child weighing more than 20 kg, what is the approved maximum daily dosage of Omeprazole?
For a child weighing more than 20 kg, what is the approved maximum daily dosage of Omeprazole?
Which medication is approved for use in children older than 2 years?
Which medication is approved for use in children older than 2 years?
What is the pediatric dosage range for Rabeprazole for a child weighing more than 15 kg?
What is the pediatric dosage range for Rabeprazole for a child weighing more than 15 kg?
What is the pediatric dosing recommendation for Pantoprazole in children older than 5 years weighing more than 40 kg?
What is the pediatric dosing recommendation for Pantoprazole in children older than 5 years weighing more than 40 kg?
Which of the following medications is dosed according to the patient's weight and has a maximum dosage of 30 mg for children older than 1 year?
Which of the following medications is dosed according to the patient's weight and has a maximum dosage of 30 mg for children older than 1 year?
What is the pediatric dosage range for Nizatidine?
What is the pediatric dosage range for Nizatidine?
Which cytoprotective agent is dosed at 40-80 mg/kg/day?
Which cytoprotective agent is dosed at 40-80 mg/kg/day?
What is the dosage of Esomeprazole for a child weighing between 3 kg and 5 kg?
What is the dosage of Esomeprazole for a child weighing between 3 kg and 5 kg?
What is the primary risk associated with the ingestion of multiple magnets by children?
What is the primary risk associated with the ingestion of multiple magnets by children?
In asymptomatic children, what is the recommended approach for managing the ingestion of a single magnet?
In asymptomatic children, what is the recommended approach for managing the ingestion of a single magnet?
What should be done if a lithium battery is ingested?
What should be done if a lithium battery is ingested?
What complication is likely if multiple coins are ingested?
What complication is likely if multiple coins are ingested?
When should endoscopic retrieval be performed for ingested magnets?
When should endoscopic retrieval be performed for ingested magnets?
What can occur as a result of battery leakage after ingestion?
What can occur as a result of battery leakage after ingestion?
What is true regarding the duration of retention for batteries larger than 15 mm?
What is true regarding the duration of retention for batteries larger than 15 mm?
What is indicated when abdominal pain or peritoneal signs are present after ingestion of a foreign body?
What is indicated when abdominal pain or peritoneal signs are present after ingestion of a foreign body?
What critical factor impacts the management of ingested magnets?
What critical factor impacts the management of ingested magnets?
What is a significant complication that can arise from the ingestion of toy medallions containing lead?
What is a significant complication that can arise from the ingestion of toy medallions containing lead?
What size of batteries is unlikely to pass spontaneously in children younger than 6 years of age?
What size of batteries is unlikely to pass spontaneously in children younger than 6 years of age?
What action should be taken if a patient develops peritoneal signs after battery ingestion?
What action should be taken if a patient develops peritoneal signs after battery ingestion?
How long does it typically take for a battery that is beyond the duodenum to pass per rectum?
How long does it typically take for a battery that is beyond the duodenum to pass per rectum?
What is the recommended action for lead-based foreign bodies if lead intoxication is suspected?
What is the recommended action for lead-based foreign bodies if lead intoxication is suspected?
What is a bezoar primarily composed of?
What is a bezoar primarily composed of?
If objects are placed in the rectum, what size typically passes spontaneously?
If objects are placed in the rectum, what size typically passes spontaneously?
What should be done to assist in removing an object from the rectum?
What should be done to assist in removing an object from the rectum?
What is a potential risk if water-absorbing polymer balls are ingested?
What is a potential risk if water-absorbing polymer balls are ingested?
Which hotline can be contacted for help in identifying batteries?
Which hotline can be contacted for help in identifying batteries?
What is the first step if an object is proximal to the rectum?
What is the first step if an object is proximal to the rectum?
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Study Notes
Foreign Bodies in the Stomach and Intestine
- 95% of ingested objects pass through the gastrointestinal tract without difficulty
- Objects longer than 6 cm or wider than 20 mm in diameter often fail to pass through the pylorus
- Open safety pins require urgent endoscopic removal
- Small magnets should be removed if in the esophagus
- Multiple magnets can cause bowel perforation
- Lead-based foreign bodies can cause lead poisoning
- Water-absorbing polymer balls can expand in the small intestine and cause obstruction
- Objects inserted into the rectum typically need to be retrieved
- Batteries larger than 15 mm are less likely to pass spontaneously
Bezoars
- A bezoar is an accumulation of matter in the stomach or intestine
- They are primarily composed of food or fiber
Antisecretory Therapy With Pediatric Dosages
- H2 Receptor Antagonists
- Ranitidine: 4-10 mg/kg/day divided 2 or 3 times a day
- Famotidine: 1-2 mg/kg/day divided twice a day
- Nizatidine: 5-10 mg/kg/day divided twice a day
- Proton Pump Inhibitors
- Omeprazole: 1.0-3.3 mg/kg/day
- Lansoprazole: 0.8-4 mg/kg/day
- Rabeprazole: 5-10 mg/day
- Pantoprazole: 0.3-1.2 mg/kg/day (limited data)
- Esomeprazole: 2.5-10 mg (depending on weight)
- Dexlansoprazole: 30-60 mg
- Omeprazole sodium bicarbonate: Not approved for use < 18 years
- Cytoprotective Agents
- Sucralfate: 40-80 mg/kg/day
IBD (Inflammatory Bowel Disease)
- Ulcerative colitis and Crohn disease have a higher prevalence among relatives of patients with the same disorder
- The concordance rate for twins is higher for Crohn disease (36%) than for ulcerative colitis (16%)
- The first IBD gene, NOD2, was identified in 2001
- Since 2006, there has been an exponential growth in the set of validated genetic risk factors for IBD
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