Gastrointestinal Disease Flashcards
What is the most common cause of gastroenteritis in children?
Rotavirus
vaccine introduced in July 2013
Transmission of rotavirus?
Faecal-oral
What type of vaccine is rotavirus vaccine?
Live attenuated (weakened) vaccine given orally
Name one very rare risk associated with rotavirus vaccine
Intussusception (Sx = abdo pain, vomiting, red currant stool)
When is rotavirus vaccine given?
At 2 months and at 3 months. Must be given at least 4 weeks apart.
Define dysentry
Diarrhoea + blood/mucus
What 4 bacteria cause dysentry
E.coli, shigella, campylobacter, salmonella
What antibiotic is given for amoebic dysentery?
Metronidazole
Haemolytic uraemic syndrome (HUS) is a triad of…
1) Microangiopathic haemolytic anaemia (coombs negative)
2) Thrombocytopenia
3) Renal impairment
Typical (or infection induced) HUS usually follows infection with what organism?
E.Coli VTEC O157
VTEC = VeroToxin producing E.Coli also known as enterohaemorrhagic E.Coli
What are the indications for sending a stool sample in a child with gastroenteritis?
Recent travel abroad No improvement by day 7 Uncertain diagnosis Blood and/or mucus in stool Suspected septicaemia Immunocompromised child
Antibiotics are not usually indicated in gastroenteritis but what antibiotic would you give for E.coli/shigella/campylobacter if particular severe infection?
Ciprofloxacin
What age does pyloric stenosis usually occur?
2 to 8 weeks
What sign may you see in the abdomen with a test feed in pyloric stenosis?
Visibile peristalsis
Palpable mass ‘pyloric tumour’
Gastro-oesophageal reflux is very common. What groups of babies is GOR more severe in?
Preterm infants
Cerebral palsy
Chronic respiratory disorders
What treatment advice can you offer mothers whose children are suffering with reflux?
Feed little and often
Frequent winding during feeds
Feed thickeners
Upright after feeds, elevation of cot head
Antacids e.g. Gaviscon infant; H2 blockers e.g. ranitidine; PPIs e.g. omeprazole
What surgery is done for severe reflux? (usually underlying neurological disorder e.g. CP)
Fundoplication (upper midline laparotomy scar)
What is the classical blood picture of pyloric stenosis?
Hypokalaemic, hypochloraemic alkalosis
How is pyloric stenosis managed?
- Rehydration and correction of alkalosis by giving IV NaCl
- Surgery: Ramstedts pyloromyotomy (see ramstedts scar)
