Abdominal pain Flashcards
What are the red flags for abdominal pain?
Poor growth Weight loss Nocturnal symptoms Blood in stool Age under 5 Persistent right-sided pain FH of IBD Chronic NSAID use
Investigations for suspected IBD
FBC LFTs CRP ESR IGA TTG Faecal calprotectin
What are the features of dehydration in an infant?
Sunken fontanelle Dry mucous membranes Reduced skin turgor Tachycardia Increased cap refill
What are common organisms for gastroenteritis in infants?
Adenovirus
Rotavirus
What can cause bloody stools in infants?
Rotavirus E coli Shigella Campylobacter Intusussception
What are the red flags for vomiting?
Blood or bile
Projectile vomit
Bulging fontanelle
How does whooping cough present?
Vomiting with paroxysmal cough
How does intestinal obstruction present?
Bile stained vomit
What does projectile vomiting under 2 months suggest?
Pyloric stenosis
How much ORS should be given after each watery stool?
5ml
What advise should be given to parents when child has diarrhoea?
Wash hands after changing nappies and before preparing food
No nursery till 48 hours after symptoms end
What is a mild fluid deficit?
Up to 40ml/kg
What is a moderate fluid deficit?
40-60ml/kg
What is a severe fluid deficit?
Over 70ml/kg
What can cause hypernatraemic dehydration?
Low sodium diarrhoea
High insensible water losses
What are the clinical features of hypernatraemia?
Jitteriness Hypertonia Hyperreflexia Convulsions Drowsiness or coma
When is stool microscopy and culture indicated?
Over a week duration
Blood/mucus
Recent travel
Suspected septicaemia
What are the indications for IV fluid?
Shock
Red flags
Persistent vomiting
Hypoglycaemia
What is the fluid treatment for shock?
Fluid bolus of 20ml/kg 0.9% sodium chloride
How are maintenance fluids calculated?
100ml/kg for first 10kg
50ml/kg for next 10kg
20ml/kg from then on
Added together = dose in 24 hours
What needs to be done before giving fluids?
Weight
U&Es
Blood glucose
How much ORS should be given for mild dehydration?
50ml/kg over 4 hours
How much ORS should be given for moderate dehydration?
100ml/kg over 4 hours
What antibiotics should be used for campylobacter infection?
Erythromycin
What antibiotics should be used for a c diff infection?
Metronidazole or vancomycin
What does haemolytic uraemic syndrome? cause?
Progressive renal failure
Thrombocytopaenia
Haemolytic anaemia
What is a long term complication of HUS?
Hypertension
What is the treatment for IBD?
5-aminosalicylate drugs
Steroids if needed
Azathioprine (immunosuppressive)
Infliximab
