Pediatric Gastroenterology Quiz

A scoring system to predict pancreatitis severity in children based on age, weight, blood test results, and 48-hour calcium levels

Age less than 7 years old increases the risk of severe pancreatitis

Weight less than 23 kg increases the risk of severe pancreatitis

A high white blood cell count (WBC) at admission (greater than 18.5 x 10^9/L) suggests a higher severity of pancreatitis.

Elevated lactate dehydrogenase (LDH) levels at admission (greater than 2000 IU/L) indicate a higher risk of pancreatitis severity.

Low calcium levels after 48 hours (below 5 mg/dL) indicate an increased risk of severe pancreatitis.

Fluid resuscitation is crucial in managing acute pancreatitis in children, aiming for adequate hydration and restoring metabolic balance.

Pancreatic rest involves keeping the child nil by mouth for 3-5 days to decrease pancreatic activity and promote healing.

Acute pancreatitis is a sudden inflammation of the pancreas. It's defined by the presence of two out of three key features: 1) Abdominal pain radiating to the back with nausea and vomiting. 2) Elevated pancreatic enzymes (amylase and lipase) in the blood, at least three times the normal level. 3) Imaging evidence of inflammation in the pancreas, such as edema, on ultrasound, CT scan or MRI.

The INSPIRRE criteria are a set of guidelines used to diagnose acute pancreatitis. They state that a patient is considered to have acute pancreatitis if they exhibit two out of three specific symptoms: 1) Characteristic clinical symptoms, including abdominal pain radiating to the back, nausea, and vomiting. 2) Elevated pancreatic enzymes (amylase and lipase) in the blood, at least three times the normal level. 3) Imaging evidence of inflammation in the pancreas, such as edema, on ultrasound, CT scan or MRI.

Abdominal pain that spreads to the back is a common symptom of acute pancreatitis. This pain also often comes with nausea and vomiting.

Pancreatic amylase and lipase are enzymes produced by the pancreas. Their levels in the blood are often significantly raised in acute pancreatitis. If these enzyme levels are at least three times the upper limit of normal, it strongly supports the diagnosis of acute pancreatitis.

Imaging techniques like ultrasound, CT scan, MRI or MRCP can be used to visualize the pancreas. In acute pancreatitis, the pancreas often appears swollen (edematous) on these images.

Pancreatic edema refers to swelling of the pancreas. This is a common finding on imaging tests like ultrasound, CT scan or MRI in patients with acute pancreatitis.

The INSPIRRE criteria help standardize the diagnosis of acute pancreatitis. These criteria ensure that doctors rely on a consistent set of clinical, laboratory, and imaging findings to make the diagnosis.

The INSPIRRE criteria focus on 3 key areas: clinical presentation, pancreatic enzyme levels, and imaging findings. These three pieces of information work together to confirm a diagnosis of acute pancreatitis.

A type of medication that relieves pain.

A class of drugs that kill or inhibit the growth of bacteria.

A procedure to surgically remove the gallbladder, often performed for gallstones.

A collection of fluid within the pancreas, usually caused by pancreatitis.

A condition where the pancreas is infected and dying, often requiring surgery.

A localized collection of pus within the pancreas.

Vomiting blood.

Passage of bright red blood from the rectum.

Passage of black, tarry stools, indicating bleeding higher in the digestive tract.

A tear in the lining of the esophagus, often caused by forceful vomiting.

Acute pancreatitis can be caused by certain medications, including chemotherapy drugs, pain relievers like acetaminophen, and some antibiotics.

Viral infections, such as EBV, Coxsackie B, and hepatitis viruses, can trigger acute pancreatitis.

Blockages in the pancreatic duct, such as gallstones or tumors, can lead to acute pancreatitis.

A severe inflammatory response in the body, often triggered by an infection, can lead to acute pancreatitis.

Diabetes can increase the risk of developing acute pancreatitis.

High levels of triglycerides in the blood can trigger pancreatitis.

Certain genetic mutations can make someone more susceptible to pancreatitis.

A higher-than-normal level of calcium in the blood, often caused by hyperparathyroidism, can contribute to pancreatitis.

Damage to the pancreas due to blunt trauma, burns, or surgery can lead to acute pancreatitis.

A laboratory test that measures the level of an enzyme produced by the pancreas.

Similar to amylase, it is another enzyme produced by the pancreas, which is measured during tests.

A blood test showing a complete blood count, including red blood cells, white blood cells, platelets, and hematocrit.

A test that measures the time it takes for blood to clot.

A test that assesses the intrinsic coagulation pathway, measuring how long it takes for blood to clot.

A test that measures the rate at which red blood cells settle in a tube of blood, indicating inflammation.

A group of disorders that cause diarrhea due to impaired carbohydrate digestion and absorption, primarily affecting glucose and galactose.

A condition characterized by diarrhoea, abdominal distention, and malabsorption following a viral gastroenteritis infection.

An infection caused by the parasite Giardia lamblia, leading to persistent diarrhoea, abdominal pain, and bloating.

A deficiency in the enzymes sucrase and isomaltase needed to break down certain sugars, leading to abdominal discomfort and diarrhoea after consuming sugars.

A rare condition characterized by severe diarrhoea, malabsorption, and failure to thrive, caused by abnormalities in the microvilli lining of the small intestines.

An autoimmune disorder affecting the small intestine, leading to malabsorption, diarrhoea, and abdominal pain.

A variety of tumours in the intestines can cause diarrhea.

A condition where the immune system is weakened, making individuals more susceptible to infections, including those that can cause diarrhoea.

Diarrhea that occurs only during the day, often linked to digestive issues that are generally not serious.

Diarrhea primarily occurring at night, suggesting a more significant underlying medical condition.

The presence of blood in stool often points to dietary intolerances, inflammatory bowel disorders, or other gastrointestinal issues.

A pale or white stool color indicates a lack of bile flow, likely caused by conditions like Celiac disease.

A family history of digestive disorders, autoimmune diseases, or certain cancers can increase the risk of similar conditions in individuals.

Consuming "sugar-free" foods containing fructose or sorbitol can trigger diarrhea due to osmotic imbalances.

Excessive juice intake can lead to osmotic diarrhea due to the high sugar content.

Consuming raw milk can be associated with Brainerd diarrhea, a persistent diarrhea lasting at least four weeks.

Exposure to contaminated water can increase the risk of diarrhea caused by various bacterial infections or parasites.

Diarrhea lasting for more than four weeks, potentially linked to recurring bacterial infections or certain parasitic infections.