Diarrhoea + vomiiting Flashcards
common causes of Gastroenteritis in young children (3)
- norovirus
- salmonella
- e coli
- rotovirus
- enterovirus
1st and 2nd most common causes of gastroenteritis in children
1) rotovirus
2) adenovirus
differentials for blood in stools with diarrhoea + vomitign
- intussception
- shigella
- campylobacter
- e coli
- rotovirus
cause of haemolytic uremic syndrome
E coli
what is the most common cause of acute renal failure in children
Haemolytic uremic syndrome caused by E coli
toxin produced by e coli
shigella like toxin: verotoxin
symptoms caused by Shigella like toxin (5)
- abdo pain
- bloody diarrhoea
- fever
- seizures
- lethargy
organisms that cause bloody diarrhoea
- e coli
- rotovirus
- shigella
- campylobacter
- salmonella
what does the toxin from e coli cause in haemolytic uremic syndrome (3)
- thrombocytopenia
- renal insufficiency
- microangiopathic hemolytic anaemia (schistocytes)
treatment of thrombocytopenia
- supportive
- dialysis
- no abx
- plasmaphoresis/IVIG
projectile vomiting in a child under 2 months
pyloric stenosis
cause of bulging fontanelle (2)
raised ICP
- hydrocephalus
- meningitis
cause of faltering growth (3)
- chronic GI disorder
- GORD
- coeliac disease
most common cause of food poisoning in UK
campylobacter
foods salmonella found in
- undercooked meat
- raw eggs
- milk
chilled ready to eat foods
listeria
management of mild dehydration
Fluid challenge with ORS (frequent and in small amounts)
advisable breast feeding for infants
breast for 12 months followed by pausterised cows milk at 12 months
calories/protein requirements for infants
0-6 months: 115 kcal/kg
6-12 months: 96 kcal/kg
when should solid food be introduced, and what?
6 months
rice, pure fruit and veg
foods to avoid in first 6 months
- fish
- eggs
- wheat
when can i attend nursery again
48 hours after your last episode of D or V
management of mild dehydration from gastroenteritis
fluid challenge with ORS
and
5ml/kg after each watery stool
which children are at an increased risk of dehydration
- < 1 year olds
- low birth weight infants
- > 5 loose stools + 2 episodes of vomiting in previous 24 hours
- malnourished children
type of dehydration whereby water loss is greater than sodium loss
hypernatreamic
clinical features of hypernatraemic dehydration
- jittery movements
- increased muscle tone
- hyperreflexia
- convulsions
- drowsiness
peak age for intussception
3 months to 2 years
type of pain in intussception
paroxysmal, severe, colicky pain; child draws legs up in the episodes
pathophysiology in intussception
invagination of proximal bowel into distal segment commonly involving invagination of ileum into caecum through ileocaecal valve
stool feature in intussception
red currant jelly
signs of dehydration in infants
- sunken fontanelle
- decreased level of consciousness
- reduced skin turgor
- oliguria
- sudden weight loss
- eyes sunken & tearless
most common cause of food poisoning in UK
campylobacter
IV fluid for child in shock
Fluid bolus of 20 ml/kg of 0.9% saline
peak incidence of intussception
3 months to 2 years of age
red currant jelly stool containing blood & mucus
intussception
pathophysiology of intussception
invagination of proximal bowel into a distal segment of ileum into caecum through ileocaecal valve
