PAEDIATRICS GASTROENTEROLOGY EXAM WITH WELL
DETAILED QUESTION & ANSWERS PERFECTLY A+
GRADED WITH RATIONALE NEW UPDATE
Recurrent abdominal pain CORRECT ANSWER>>>>Child presents with repeated
episodes of abdominal pain without an identifiable underlying cause. The pain is described as
non-organic or functional. This is common and can lead to psychosocial problems, such as
missed days at school and parental anxiety.
Episodes of central abdominal pain lasting more than 1 hour. Associated with N&V, pallor,
headache, photophobia and aura CORRECT ANSWER>>>>Abdominal migraine -
examinations will be normal.
Acute mx of abdominal migraine CORRECT ANSWER>>>>Low stimulus environment
(quiet, dark room)
Paracetamol
Ibuprofen
Sumatriptan
Preventative Mx of abdominal migraine CORRECT ANSWER>>>>Pizotifen, a serotonin
antagonist (MAIN preventative medication)
,Propranolol, a non-selective beta blocker
Cyproheptadine, an antihistamine
Flunarazine, a calcium channel blocker
Pizotifen CORRECT ANSWER>>>>serotonin antagonist
blocks the 5-HT2A and 5-HT2C receptors
used in migraine prevention
Needs to be withdrawn slowly when stopping as associated with withdrawal symptoms e.g.
depression, anxiety, poor sleep and tremor
Rabbit dropping stools CORRECT ANSWER>>>>Suggest constipation
Encopresis CORRECT ANSWER>>>>Term for faecal incontinence. Not considered
pathological until 4 years of age
secondary causes of constipation CORRECT ANSWER>>>>Hirschsprung's disease
Cystic fibrosis (particularly meconium ileus)
Hypothyroidism
Spinal cord lesions
Sexual abuse
Intestinal obstruction
, Anal stenosis
Cows milk intolerance
Complications of chronic constipation CORRECT ANSWER>>>>Desensitisation of the
rectum - over time they loose sensation of the need to open the bowels leading to faecal
impaction leading to stretching of the rectum and further desensitisation -> encopresis
Ribbon stool CORRECT ANSWER>>>>Sign of anal stenosis
Red flags CORRECT ANSWER>>>>Not passing meconium within 48 hours of birth
(cystic fibrosis or Hirschsprung's disease)
Neurological signs or symptoms, particularly in the lower limbs (cerebral palsy or spinal cord
lesion)
Vomiting (intestinal obstruction or Hirschsprung's disease)
Ribbon stool (anal stenosis)
Abnormal anus (anal stenosis, inflammatory bowel disease or sexual abuse)
Abnormal lower back or buttocks (spina bifida, spinal cord lesion or sacral agenesis)
Failure to thrive (coeliac disease, hypothyroidism or safeguarding)
DETAILED QUESTION & ANSWERS PERFECTLY A+
GRADED WITH RATIONALE NEW UPDATE
Recurrent abdominal pain CORRECT ANSWER>>>>Child presents with repeated
episodes of abdominal pain without an identifiable underlying cause. The pain is described as
non-organic or functional. This is common and can lead to psychosocial problems, such as
missed days at school and parental anxiety.
Episodes of central abdominal pain lasting more than 1 hour. Associated with N&V, pallor,
headache, photophobia and aura CORRECT ANSWER>>>>Abdominal migraine -
examinations will be normal.
Acute mx of abdominal migraine CORRECT ANSWER>>>>Low stimulus environment
(quiet, dark room)
Paracetamol
Ibuprofen
Sumatriptan
Preventative Mx of abdominal migraine CORRECT ANSWER>>>>Pizotifen, a serotonin
antagonist (MAIN preventative medication)
,Propranolol, a non-selective beta blocker
Cyproheptadine, an antihistamine
Flunarazine, a calcium channel blocker
Pizotifen CORRECT ANSWER>>>>serotonin antagonist
blocks the 5-HT2A and 5-HT2C receptors
used in migraine prevention
Needs to be withdrawn slowly when stopping as associated with withdrawal symptoms e.g.
depression, anxiety, poor sleep and tremor
Rabbit dropping stools CORRECT ANSWER>>>>Suggest constipation
Encopresis CORRECT ANSWER>>>>Term for faecal incontinence. Not considered
pathological until 4 years of age
secondary causes of constipation CORRECT ANSWER>>>>Hirschsprung's disease
Cystic fibrosis (particularly meconium ileus)
Hypothyroidism
Spinal cord lesions
Sexual abuse
Intestinal obstruction
, Anal stenosis
Cows milk intolerance
Complications of chronic constipation CORRECT ANSWER>>>>Desensitisation of the
rectum - over time they loose sensation of the need to open the bowels leading to faecal
impaction leading to stretching of the rectum and further desensitisation -> encopresis
Ribbon stool CORRECT ANSWER>>>>Sign of anal stenosis
Red flags CORRECT ANSWER>>>>Not passing meconium within 48 hours of birth
(cystic fibrosis or Hirschsprung's disease)
Neurological signs or symptoms, particularly in the lower limbs (cerebral palsy or spinal cord
lesion)
Vomiting (intestinal obstruction or Hirschsprung's disease)
Ribbon stool (anal stenosis)
Abnormal anus (anal stenosis, inflammatory bowel disease or sexual abuse)
Abnormal lower back or buttocks (spina bifida, spinal cord lesion or sacral agenesis)
Failure to thrive (coeliac disease, hypothyroidism or safeguarding)
