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PHARMACY PRACTICE II > DIARRHOEA IN CHILDREN > Flashcards

DIARRHOEA IN CHILDREN Flashcards

1
Q

What is diarrhea

A

3 or more loose or watery stools within 24 hours

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2
Q

Important considerations in diarrhea

A

Usual habit
Increased stool fluidity and frequency

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3
Q

Reasons for increased stool fluidity and frequency in diarrhea

A

Increased gut motility
Increased gut secretion
Decreased gut absorption

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4
Q

Types of diarrhea

A

Acute watery diarrhea
Dysentery
Persistent diarrhea
Severe persistent diarrhea
Chronic diarrhea

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5
Q

Duration for persistent diarrhea

A

> 14 days

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6
Q

Duration for acute watery diarrhea

A

<14 days

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7
Q

Dysentery

A

Bloody diarrhoea

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8
Q

Severe persistent diarrhoea

A

Persistent diarrhoea with signs of dehydration

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9
Q

Features of acute watery diarrhoea

A

No visible blood in stools
+- Vomiting
Lasts<14 days

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10
Q

Three main classes of E. coli

A

Commensal strains
Intestinal pathogenic
Extraintestinal pathogenic

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11
Q

Name the intestinal E. coli strains

A

Enterotoxigenic E. coli (ETEC)
Enteroaggregative or Enteroadherence E. coli (EAEC)
Diffusely adhering E. coli (DAEC)
Enteropathogenic E. coli (EPEC)
Enterohemorrhagic E. coli (EHEC)
Adherence Invasive E. coli (AIEC)
Enteroinvasive E coli (EIEC)

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12
Q

Name the extraintestinal E. coli strains

A

Uropathogenic E. coli (UPEC)
Neonatal meningitis E. coli (NMEC)
Avian pathogenic E. coli (APEC)
Sepsis associated E. coli (SEPEC)

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13
Q

Intestinal strains of E. coli that cause diarrhea

A

EPEC
ETEC
EHEC
EIEC
EAEC
DAEC

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14
Q

Disease caused by NMEC

A

Neonatal meningitis

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15
Q

Disease caused by UPEC

A

UTIs and pyelonephritis

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16
Q

AIEC

A

Cron’s disease (persistent intestinal inflammation)

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17
Q

Which E coli strain causes dysentery and watery diarrhoea

A

EIEC

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18
Q

Which e coli strains cause watery diarrhea and vomiting (Acute watery diarrhea)

A

EPEC
ETEC

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19
Q

Which E. coli causes haemorrhagic colitis
which presents as bloody diarrhoea?

A

EHEC

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20
Q

Which E. coli strain causes persistent diarrhea (watery diarrhoea, mucus and vomiting )

A

EAEC

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21
Q

Causative agents of acute watery diarrhoea

A

Rotavirus
Norovirus
ETEC, EPEC
Shigella
C. jejuni
Cryptosporidium
V. cholerae

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22
Q

Features of dysentery

A

Blood in stool
Anorexia
Rapid weight loss
Intestinal mucosal damage

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23
Q

Causative organisms of dysentery

A

SCEES
Shigella
C. jejuni
EIEC
E. histolytica
Salmonella

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23
Q

Causative organims of persistent diarrhoea

A

(CEGS)
Cryptosporidium
EAEC
G. lamblia
Shigella

24
Q

Chronic diarrhoea

A

Recurrent diarrhea not due to infectious causes but rather metabolic disorders

25
Q

Features of persistent diarrhoea

A

14days or more
Starts as acute diarrhea or dysentery
Marked weight loss

26
Q

Mechanism of viral diarrhoea

A

Replication within epithelia cells
Villous destruction
Shortening and loss of dissaccharidase enzymes
Replacement with immature enzymes
Water and electrolyte secretion

27
Q

Mechanisms of bacteria diarrhoea

A

Mucosal adhesion
Toxin secretion
Mucosal invasion

28
Q

Mechanism of protozzoal diarrhoea

A

Mucosal adhesion
Mucosal invasion

29
Q

Which part of theGUT does cyptosporidium and G. lamblia adhere to

A

Ileum

30
Q

Mucosa adhering protozoa

A

G. lamblia
Cryptosporidium

31
Q

Mucosa invading protozoa

A

E. histolytica

32
Q

E. histolytica invades which part of the gut

A

Colon
Ileum

33
Q

Classification of diarrhoea based on mechanisms

A

Invasive diarrhoea
Secretory diarrhoea
Osmotic diarrhoea

34
Q

Invasive diarrhoea causing pathogens

A

(SCEEVEYS)
Shigella
C. jejuni
EIEC
EHEC
Virbio parahaemolitica
E. histolytica
Yersinia enterocolitica
Salmonella

34
Q

Secretory diarrhea occurs at which part o the gut

A

Ileum

34
Q

Invasive diarrhoea occurs in which part of the gut

A

Distal ileum
Colon

34
Q

Pathogens that cause secretory diarrhoea

A

Due to enterotoxin (SEVECS)
Salmonella
ETEC
V. cholera
EPEC
Campylobacter
Shigella

Not due to enterotoxin
Rotavirus
Norovirus

34
Q

Agents causing both secretory and invasive diarrhoea

A

Shigella
Salmonella
Campylobacter

34
Q

Agents causing osmotic diarrhoea

A

Purgatives
Improperly prepared ORS/ Salt sugar solutions
Lactose in lactose intolerance
Glucose in glucose malabsorption

34
Q

Effects of diarrhoea

A

Hypovolaemia
Multiple organ failure
Tissue damage
Abnormal physiology
Acidosis
Hypokalemia

34
Q

Chemical mediators released in hypoperfusional state that cause tissue damage

A

Complements
Lipopolysaccharides
Leukotrienes
Interleukins
TNF
Coagulation cascade
Leucocytes
Endorphin
PAF

34
Q

Abnormal physiology encountered in diarrhoea

A

Plugged capillaries
Change in blood viscosity
Abnormal starling mechanism
Altered interstitium
Damaged barrier function
Ileus
Coagulation cascade

35
Q

Effects of potassium depletion

A

General muscle weakness
Cardiac arrhythmias
Paralytic ileus

36
Q

Types of dehydration

A

Isotonic
Hypotonic
Hypertonic

37
Q

Normal serum sodium level and osmolarity

A

130-150mEq/l
275-295mOsmol/l

38
Q

Causes of isotonic dehydration

A

Diarrhoea
Vomiting

39
Q

Causes of hypotonic dehydration

A

Ingestion of large amounts of water
IV hypotonic fluids (
5% glucose infusions)

40
Q

Effects of hypotonic dehydration

A

Lethargy
Seizures

41
Q

At which degree of dehydration does signs of dehydration occure

A

Lesser degrees- Hypotonic dehydration

Higher degrees- Hypertonic dehydration

42
Q

Causes of hypertonic dehydration

A

Ingestion of hypertonic saline
Insufficient water intake
Low sloute drinks

43
Q

How to perform skin pinch

A

Pinch skin in longitudinal plane between thumb and bent forefinger

43
Q

Classes of skin pinches

A

Normal- goes back immediately
Slowly: fold visible <2sec
Very slowly: visible >2s

44
Q

WHO degrees of dehydration

A

No dehydration (<5% loss)
Mild-Moderate dehydration (5-10%loss)
Severe dehydration (>10% loss )

45
Q

General condition assessment for dehydration

A

No dehydration: well alert
Mild-moderate: irritable
Severe: lethargic/ unconscious

45
Q

Eyes assessment for dehydration

A

NO dehydration: normal
Mild-Moderate: sunken
Severe: sunken

46
Q

Thirst evaluation for dehydration

A

No dehydration: drinks normally
Mild-Moderate: drinks eagerly
Severe: drinks poorly or unable to drink

47
Q

Diarrhoea immunizations

A

Rotavirus
Norovirus
Cholera
Measles

48
Q

Prevention of diarrhoea

A

Hand washing
Food hygiene
Safe disposal of excreta
Good nutrition
Immunizaton

PHARMACY PRACTICE II (17 decks)

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