GI Flashcards
Acute inflammation of gastric causing abdominal pain, nausea, vomiting, diarrhea, increased bowel sounds, sick feeling
Gastroenteritis
What is the most common cause of gastroenteritis
Viral
What are viral pathogens that cause
gastroenteritis
Rotavirus 50%
Adenovirus
Norovirus
This virus can cause gastroenteritis year-round and is more commonly in older children and adults
Norovirus
Caused by fecal oral route through contaminated food or water
This virus can cause gastroenteritis is seen in children 2 to 4 years old
Adenovirus
Rotavirus
50% of cases of gastroenteritis
Acute fever, emesis, watery no blood diarrhea
less than five years
Last 3 to 8 days, highly contagious
Fecal oral spread
Bacterial causes of gastroenteritis
Salmonella
Shigella
Campylobacter
E.coli
Common parasitic cause of gastroenteritis
Giardia lambia
What stool is associated with Campylobacter bacterial gastroenteritis
Odorous
What symptoms are associated with Shigella bacterial gastroenteritis
Fever spikes, bloody stool, febrile seizures
6m-3yrs
E.Coli has what type of stool associated in bacterial gastroenteritis
Mild loose stool
Giardia lambia
Flagellate protozoan parasitic causes of gastroenteritis
Found in contaminated food and water
Abdominal pain, flatulence, bloating, watery greasy foul smelling stool
Intermittent symptoms or a asymptomatic 1-4 week
Need stool culture to identify
Giardia lambia parasitic gastroenteritis treatment?
Albendazole, metronidazole
X7-10 days
When are diagnostic test done for gastroenteritis
Symptoms greater than 72 hours or presence of bloody stool
Stool guaiac + bacterial
Culture
Stool wbc
Ova and parasites
What pathogens of gastroenteritis are excluded from school
Rotavirus, E. coli, shigella
E. coli and shigella need what to return to school
Two negative stools
Moderate oral rehydration
50 mL / hr
Severe oral rehydration
100 mL/hr
When her antibiotics given in gastroenteritis
If 72 hours or labs are done
Or 8-10 stools /day
Antibiotic management for gastroenteritis
Bactrim (trimethoprim/sulfamethoxazole) x5 days
Azithromycin 2nd line
Not given in salmonella
Early sign of dehydration
Normal vital signs decreased output
Blood pressure, heart rate, cap Refill, turgor, fontanel normal
Urine decrease slightly, normal mentation
Mild dehydration 3 to 5%
Moderate dehydration percentage & symptoms
6-9% Normal blood pressure, cap Refill Heart rate increased Turgor decreased Urine <1mL/kg/h Sunken fontanel
Severe dehydration percentage and symptoms
> 10%
BP normal/decreased HR decreased >3s cap Refill Turgor decreased Fontanel decreased Cool mottled Normal to lethargic to comatose mentation
Affects anywhere in the G.I. tract chronic inflammation of the intestine triggered by pathogen
Crohn’s disease
Large uncontrolled inflammatory response wants a free radicals proteases, platelet activating factor causing tissue destruction is released
Cobblestone appearance of the G.I. tract
Crohn’s disease
Scattered areas of the affected ileum colon or G.I. tract
Symptoms of crohns
Diarrhea Bloody stool Malabsorption Pain with no diarrhea Decreased wt Pain RLQ Food related pain Cobblestone intestinal tract
Family hx increases
Severe frequent diarrhea with blood pain in left lower quadrant
Symptoms of ulcerative colitis
More diarrhea because decrease H2O absorption of the large intestine which is the main goal of that organ
Inflammation of the colon or large intestine
Ulcerative colitis
Ulcer created along the lumen of the large intestine spots in the mucosa tissue is eroded away, circumferential and continuous
UC
Causes of ulcerative colitis
Diet/stress is a secondary cause
Auto immune origin —-T cells destroy lining
Family history plus environmental
>females
teens to 30s
Whites/Eastern European Jews
Diagnostics for IBD
Stool-cal protein neutrophils in poop show inflammation in the intestinal lining
Upper G.I. shows IBD changes in extent
Endoscopy/colonoscopy with biopsy is the gold standard
CBC w/diff microcytic anemia; increase white blood cells, ESR, CRP
Treatment for IBD
Referral to G.I.
Nutritional therapy to increase growth
Anti-inflammatory agents
Sulfasalazine,mesalamine
Immunosuppressant
Corticosteroids, cyclosporine,azathroprine
Biologics
Inflixamab,adalimimab
Surgery Ileocecectomy/ ostomy=CD
Coloectomy=UC
Episodic/continuous abdominal pain occurs at least weekly ,at least x2 a month With no other cars
Functional abdominal pain, chronic abdominal pain, recurrent abdominal pain
What age group is most common to have functional abdominal pain
School aged 8 to 15 years
13 to 17%
Functional abdominal pain risk factors
School-aged
Male
Certain personality traits: maladaptive coping, protective parents, common absence from school due to pain
Management of functional abdominal pain
Pain is real even with no organic cause reinforce normal behavior, decrease hectic lifestyle and hurried meals, identify stress, pain diary , no medication as needed
Symptoms of functional abdominal pain
Cranky dull pain No radiation Peri umbilical No relief Not related to food No nighttime awakenings Normal weight Interferes with activity Diffuse tenderness No guarding
How to calculate dehydration
Weight 7kg
Now 6.5 kg
Pre-illness Weight - illness weight
/ pre-illness weight x100
7 kg-6.5 =500 g
0.5/7=0.07x 100=7%
Most common symptom of a pinworm infection
Anal itching
Pinworms transmission
I don’t worm lives in rectum comes out at night to lay eggs on the perianal skin and dies causing itching; scratching and then finger to mouth contact transfers eggs into the intestines because children swallow them and then once they reach the duodenum they develop into mature worms and repeat the cycle
Easily float in air can be swallowed by others
Worm like thread seen on toilet or underwear
Pinworms
Enterobius vermicularis
Medication for pinworm
Pyrantel pamoate 11 mg/kg one dose
Albendazole 400mg POx1 repeat in 2 weeks
Tight anal canal with no stool in vault
Hirschsprung’s disease
Impacted stool with fissure and large dilated rectum
Constipation
