Gastroenterology Flashcards
Red flags of vomiting
What are the red flags of vomiting in children what are they assoicated with?
- Bile stained vomit
- Haematemesis
- Projectile vomiting, in first few weeks of life
- Vomiting at the end of paroxysmal coughing
- Abdominal tenderness/Abdo pain on movement
- Abdominal distension
- Hepatosplenomeglay
- Blood in the stool
- Severe dehydration, shock
- Bulging frontanelle or seizures
- Failure to thrive
Haematemesis: can also be oesophageal variceal bleeding.
Hepatosplenomegaly: can also be due to inborn error of metabolism
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Normal stool patterns
What are the normal stool patterns for:
- 0 to 4 months (breast and bottle fed)
- 4 months to 1 year
- After 1 year
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Investigations to consider
What are the main investigations, indications and expected findings in Acute Diarrhoea?
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Diarrhoea Diagnosis clues
What are the ages, stool features, pain (?), fits (?), vomiting (?), high fever (?) and typical season for:
- Rotavius
- Shigella
- E.Coli
- Salmonella
- Campylobacter
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Acute Diarrhoea
What are the common causes of Acute Diarrhoea?
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Chronic Diarrhoea
What are the common causes of Chronic Diarrhoea?
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Blood, stool and other investigations
What are the key blood, stool and other investigation, their findings and significance?
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Causes of Vomiting
What are the main causes of vomiting in Infants, Preschool children and school age children?
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Gastroenteritis
What is the ateiology, symptoms, complications and investigations of Gastroenteritis?
Ateiology:
- There are 3 main causes:
- Viral
- Bacterial
- Protazoan: Giardia and Cryptosporidium
Investigations:
- Usually none reqired
Treatment:
- Clincal Dehydration: Give ORS often and in small amounts
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Gastroenteritis
What is the management of Gastroenteritis?
Short hand version:
- No clincal dehydration = Feed more/ORS
- Clincal Dehydration = ORS 50ml/kg over 4 hours & maintenance fluids
- Shock = IV Bolus 20ml/kg
- If still in shock > PICU
- If shock resolves > IV Saline 100ml/kg over 4 hours & maintenance fluids
Maintenance fluids = (100ml/kg/24hrs for 1st 10 kg), (50ml/kg/24hrs for 2nd 10 kg), (20ml/kg/24hrs up to 50kg)
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Gastroenteritis
Outline the features of: No clinical dehydration, Clinical Dehydration and Shock including:
- General appearnace
- Concious level
- Urine output
- Skin colour
- Extermities
- Eyes
- Mucous membranes
- HR
- Breathing
- Peripheral pulses
- Capilliary refil time
- Skin Turgour
- BP
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Appendicitis
Outline the symptoms, ateiology, complications, investigastions and management of Appendicitis
Symptoms:
- Abdo pain: initially central, then RIF
- Oral fetor = unpleasant odour from mouth
- Gaurding: particularly in the RIF, McBernie’s point
Investigstions:
- USS: also can identify abscess, abdominal mass or perforation
Management:
- Complicated (perforation, abdo mass or abcess) or uncomplicated
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Pyloric Stenosis:
Outline the symptoms, ateiology, complications, investigations and management of Pyloric stenosis
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Molrotation/Volvus
Outline the symptoms, ateiology, complications, differentials, investigations and management of Molrotation/Volvus
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Mesenteric Adenitis
Outline the symptoms, ateiology, complications, differentials, investigations and management of Mesenteric Adenitis
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