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5_Paeds > Gastroenteritis in a child > Flashcards

Gastroenteritis in a child Flashcards

1
Q

What is gastroenteritis?

A

Caused by infection and is characterised by the sudden onset of diarrhoea (± vomiting)

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2
Q

How many cases and deaths from gastroenteritis in a child are there worldwide?

A

2 billion cases

1.9 million deaths

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3
Q

What % of <5y/os present with gastroenteritis per year?

A

10%

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4
Q

What is the most common causative agent of gastroenteritis and what % of cases does it account for?

A

Rotavirus

56%

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5
Q

What are some other causative agents of gastroenteritis and how common are they?

A 
Campylobacter - 28%
Salmonella - 11%
Norovirus - 3%
Shigella - 1%
E. Coli - 1%
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6
Q

What are the risk factors of gastroenteritis?

A

Poor hygiene
Lack of sanitation (e.g. water)
Immunocompromised
Food (poorly cooked, cooked food that has been left out, uncooked food, insufficient reheating)

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7
Q

What are the general symptoms and signs of gastroenteritis?

A

Sudden change to loose/watery stool ± vomiting
Contact w/ someone w/ acute diarrhoea
Recent travel abroad
Fever

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8
Q

What important question should be part of the history and why?

A

Recent antibiotics

Because of C. difficile

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9
Q

What are some specific symptoms of Campylobacter jejuni gastroenteritis?

A

Severe abdo pain, bloody stools

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10
Q

What are some specific symptoms of Shigella and Salmonella gastroenteritis?

A

Dysentery = blood and pus in the stool, abdo pain, and tenesmus (incomplete bowel emptying)
High fever - Shigella

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11
Q

What are some specific symptoms of Cholera and E. coli gastroenteritis?

A

Profuse, rapidly dehydrating diarrhoea

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12
Q

What is the most accurate measure of dehydration?

A

Weight loss during the diarrhoeal illness

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13
Q

What are some red flags of dehydration?

A 
Altered responsiveness
\+HR
\+RR
-Skin turgor
Sunken eyes
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14
Q

What is the most important think to look out for in gastroenteritis and why?

A

Dehydration

As it can lead to shock

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15
Q

What is the role of further investigations in gastroenteritis?

A

Aren’t absolutely required to determine causative agent

Used to assess severity and monitor pt

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16
Q

What investigations could you do for gastroenteritis?

A

Bloods - FBC, renal function, electrolytes
Stool culture –> MC+S
Blood culture

17
Q

When is a stool culture done in gastroenteritis?

A

Septicaemia suspected
Blood/mucus in stool
Immunocompromised
Hx of recent travel

18
Q

When is a blood culture done in gastroenteritis?

A

If giving Abx

19
Q

What is the most important part of the management of gastroenteritis?

A

Rehydration

20
Q

What is the management of a child with gastroenteritis and no clinical dehydration?

A

Encourage breastfeeding/other milk feeds
Encourage fluid intake
Discourage fruit juices/carbonated drinks
Offer oral rehydration salt (ORS)

21
Q

What is the management of a child with gastroenteritis and clinical dehydration?

A

Low osmolarity ORS solution (240-250mOsm/L)
50ml/kg of fluid deficit replacement over 4 hours
Maintenance fluid

22
Q

What fluid should you use for fluid replacement in a child with gastroenteritis and clinical dehydration?

A

Isotonic solution (e.g. 0.9% sodium chloride ± 5% glucose)

23
Q

When are antibiotics given in gastroenteritis?

A 
Suspected/confirmed septicaemia
Extraintestinal spread of infection
<6 months and Salmonella
Immunocompromised and Salmonella
C. diff associated pseudomembranous colitis
24
Q

What particular medication should be avoided?

A

Antidiarrhoeal medications

25
Q

What is the root of most complications of gastroenteritis?

A

Dehydration

26
Q

Who are at higher risk of dehydration in gastroenteritis?

A 
<6 months
-birthweight
>5 diarrhoeal stools in the last 24 hours
>3 vomits in the last 24 hours
Unable to tolerate extra fluids
Malnutrition
27
Q

What serious complication can occur with E. coli gastroenteritis?

A

Haemolytic uraemic syndrome

28
Q

What is a common complication after gastroenteritis?

A

Lactose intolerance

29
Q

What is the prognosis of gastroenteritis?

A

Usually good

30
Q

How long does the diarrhoeal illness of gastroenteritis last for?

A

5-7 days

31
Q

How long does the vomiting in gastroenteritis last for?

A

1-2 days

32
Q

What is the mortality rate from rotavirus gastroenteritis in the UK per year?

A

3-4 deaths per year

5_Paeds (18 decks)

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