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NR 602 Midterm Study Guide
Topics 26-30: Cryptosporidium, Pyloric stenosis, Intussusception, Celiac Disease, & Juvenile Idiopathic
Arthritis
Cryptosporidium
Cryptosporidium is a parasite. This is a living organism that live sin, or on, another organism. It can
infect bowels and cause cryptosporidiosis. This is a form of bowel infection called Gastroenteritis, which
leads to diarrhea and vomiting.
In most healthy people, the infection produces a bout of watery diarrhea and will go away within a week
or two. Immunocompromised patients…This can be a life -threatening disease.
SSX: The first SSx usually appear within the week after infection
• Watery diarrhea
• Dehydration
• Lack of appetite
• Weight loss
• Stomach cramps
• Fever
• N/V
Some people infected will have no symptoms.
Preventing the spread with good hand hygiene, washing fruits and veggies, avoid fecal exposure, avoid
contaminated water
Symptoms usually resolve on their own
Pyloric Stenosis
Characterized by hypertrophied pyloric muscle, causing narrowing of the pyloric sphincter.
• Occurs in 3/1000 births
• Males >females
• Familial
• Common in first born Caucasian males
Clinical findings:
• Regurgitation and NON projectile vomiting first few weeks of life
• PROJECTILE vomiting at 2 to 3 weeks old
• Insatiable appetite, with weight loss
• Dehydration, constipation
• Linked to erythromycin administration n first weeks of life
PE:
• Weight loss
• Vomit that can contain blood
This study source was downloaded by 100000825073966 from CourseHero.com on 05-20-2021 11:48:20 GMT -05:00
https://www.coursehero.com/file/32530132/Midterm-Study-Guide-Topics-26-30docx/
, 2
• A distinct “olive” mass that is often palpated in the epigastrium to the right of the midline
• Reverse peristalsis is seen
Diagnostics
• US
• Upper GI series shows a “string sign”
Management
Surgery (Pyloromyotomy) after correction of fluid balance
Prognosis is excellent
Intussusception
• Thought to be the most frequent reason for intestinal obstruction in children
• Most commonly occurs in children 5 to 10 months of age
• Most common cause of intestinal obstruction in children 3 months to 6 yo
• 80% occur before age 2
Generally idiopathic in younger infants
Sometimes in older children, underlying medical predisposing factors: polyps, Meckel diverticulum,
constipation, lymphomas, lipomas, parasites, rotavirus, adenovirus, and foreign bodies.
Can be a complication of CF.
Clinical Findings
Classic Triad: 1) intermittent colicky abdominal pain, 2) vomiting, 3) Bloody mucous stools
• Episodic abd pain with vomiting every 5 to 30 minutes
• Screaming and drawing legs up, with periods of calm or lethargy b/w episodes
• “currant jelly” stools
• Hx of URI common
• Lethargy
PE
• Child may appear glassy-eyed in b/w episodes
• Sausage like mass may be felt in RUQ with emptiness in the RLQ (DANCE SIGN)
• Abd is distended and tender
• Guaiac + stools
Diagnostics
Abd flat plate can appear normal
Plain x ray may show sparse or no intestinal gas or stool with air fluid levels and distention in small bowel
only
ABD US is very accurate in detecting intussusception and is TEST OF CHOICE
This study source was downloaded by 100000825073966 from CourseHero.com on 05-20-2021 11:48:20 GMT -05:00
https://www.coursehero.com/file/32530132/Midterm-Study-Guide-Topics-26-30docx/
NR 602 Midterm Study Guide
Topics 26-30: Cryptosporidium, Pyloric stenosis, Intussusception, Celiac Disease, & Juvenile Idiopathic
Arthritis
Cryptosporidium
Cryptosporidium is a parasite. This is a living organism that live sin, or on, another organism. It can
infect bowels and cause cryptosporidiosis. This is a form of bowel infection called Gastroenteritis, which
leads to diarrhea and vomiting.
In most healthy people, the infection produces a bout of watery diarrhea and will go away within a week
or two. Immunocompromised patients…This can be a life -threatening disease.
SSX: The first SSx usually appear within the week after infection
• Watery diarrhea
• Dehydration
• Lack of appetite
• Weight loss
• Stomach cramps
• Fever
• N/V
Some people infected will have no symptoms.
Preventing the spread with good hand hygiene, washing fruits and veggies, avoid fecal exposure, avoid
contaminated water
Symptoms usually resolve on their own
Pyloric Stenosis
Characterized by hypertrophied pyloric muscle, causing narrowing of the pyloric sphincter.
• Occurs in 3/1000 births
• Males >females
• Familial
• Common in first born Caucasian males
Clinical findings:
• Regurgitation and NON projectile vomiting first few weeks of life
• PROJECTILE vomiting at 2 to 3 weeks old
• Insatiable appetite, with weight loss
• Dehydration, constipation
• Linked to erythromycin administration n first weeks of life
PE:
• Weight loss
• Vomit that can contain blood
This study source was downloaded by 100000825073966 from CourseHero.com on 05-20-2021 11:48:20 GMT -05:00
https://www.coursehero.com/file/32530132/Midterm-Study-Guide-Topics-26-30docx/
, 2
• A distinct “olive” mass that is often palpated in the epigastrium to the right of the midline
• Reverse peristalsis is seen
Diagnostics
• US
• Upper GI series shows a “string sign”
Management
Surgery (Pyloromyotomy) after correction of fluid balance
Prognosis is excellent
Intussusception
• Thought to be the most frequent reason for intestinal obstruction in children
• Most commonly occurs in children 5 to 10 months of age
• Most common cause of intestinal obstruction in children 3 months to 6 yo
• 80% occur before age 2
Generally idiopathic in younger infants
Sometimes in older children, underlying medical predisposing factors: polyps, Meckel diverticulum,
constipation, lymphomas, lipomas, parasites, rotavirus, adenovirus, and foreign bodies.
Can be a complication of CF.
Clinical Findings
Classic Triad: 1) intermittent colicky abdominal pain, 2) vomiting, 3) Bloody mucous stools
• Episodic abd pain with vomiting every 5 to 30 minutes
• Screaming and drawing legs up, with periods of calm or lethargy b/w episodes
• “currant jelly” stools
• Hx of URI common
• Lethargy
PE
• Child may appear glassy-eyed in b/w episodes
• Sausage like mass may be felt in RUQ with emptiness in the RLQ (DANCE SIGN)
• Abd is distended and tender
• Guaiac + stools
Diagnostics
Abd flat plate can appear normal
Plain x ray may show sparse or no intestinal gas or stool with air fluid levels and distention in small bowel
only
ABD US is very accurate in detecting intussusception and is TEST OF CHOICE
This study source was downloaded by 100000825073966 from CourseHero.com on 05-20-2021 11:48:20 GMT -05:00
https://www.coursehero.com/file/32530132/Midterm-Study-Guide-Topics-26-30docx/
