Gastroenteritis

Question 1

Acute Gastro i

Answer 1

Acute infection causes v/d/ and fever
Sequence is usually
Fever - vomiting - diarrhoea

Acute Diarrhoea >3 loose stools /24hours <14 days

Question 2

Acute gastro cuases

Answer 2

Viral 70% of cases
Rotavirus most common
Adenovirus rash blanching and epidemic
Norovirus seen in school camps and childcare’s

Question 3

Rotavirus

Answer 3

Most common cuases of acute g
Rotavirus vaccination
LIVE vaccination
Don’t give >6/12

Reduces risk of severeity by 85-100%
Reduces risk of any G by 70&
1 extra case of intussuption /yr

Question 4

Bacterial causes of Acute G

Answer 4

Salmonella
Campylobacter chicken / abdo pain V/D
Yersinia can mom appendicitis

Question 5

Degrees of dehydration

Answer 5

0%. No signs. Decreased UO/ thirst
3% dry mm and mild tachycardia
5% as above dry mm. Tachycardia and reduced skin tugor /sicken eyes
Fontanel sucken

10% sever all of the above poor perfusion low BP reduced cap refill>2sec
Mottled and cool

Question 6

Surgical dd of acute gastro

Answer 6

Acute appendicitis
Inguinal hernia strangulation
Intussecption USS red current stool

Question 7

Medical dd of acute gastro

Answer 7

Sepsis UTI , meningitis 
Lower lobe pneumonia 
DKA
Raised ICP
HUS
Inflammatory bowel disease 
Inborn errors of metabolism

Question 8

Red flags

Answer 8

Blood in stool 
Green vomit =obstruction 
Headache ? Meningitis raised ICP
Temp >39 ?sepsis 
Young child <3/12 DONT localise 
Vomiting alone DKA Meningitis sepsis 
Severe abdo pain with distant ion

Question 9

Treatment of child with gastro

Answer 9

0% -3.%dehydrated trial of oral rehydration 0.5ml/kg every 5mins
Small freq feeds
If does not tolerate NG

5% rehydration NG/IV
2 ways rapid or standard
Rapid is 10ml/kg /hr NG or IV for 4 hours and then reassess
NG ORS IV NS and 5% dextrose NO K+
Standard is IV ns and % 5 dextrose with 20mmKcl

Question 10

Don’t use a NG

Answer 10

Surgical problem
Decreasing LOC
Don’t use rapid NG if child <6/12
Or problem with medical problem with fluid overload

Question 11

Don’t use rapid iv

Answer 11

Child <6/12
Reducing loc
Abnormal sodium

Question 12

Standard rehydration

Answer 12

Usual needs + amount dehydrated

4.2.1. + the degree dehydration

Question 13

Ondensetron may help reduce the length of stay T/F

Antibiotics not helpful in bacterial Gastro T/F

Answer 13

True