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HD2 PBLs > PBL-4 Faltering Growth > Flashcards

PBL-4 Faltering Growth Flashcards

1
Q

Types of diarrhoea:

A

Osmotic
Secretory
Inflammatory

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2
Q

How much water enters the gut lumen and how much leaves?

A

1.5l enters, 100-200ml leaves

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3
Q

Why do you need water in the gut? (3)

A

Absorption, digestion (enzyme activity), propulsion movement

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4
Q

Diarrhoea on Bristol stool chart

A

6 / 7

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5
Q

GI disorders can be split into (3 of each)

A

Functional (non-organic) - stress, constipation, diarrhoea

Organic - coeliac, GORD, Chrons

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6
Q

Rotavirus works by (4) + type of diarrhoea

A 
Malabsorption, 
Increases Cl- secretion 
Increases motility
Ischaemia 
= OSMOTIC DIARRHOEA
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7
Q

Rotavirus

A

Group of RNA viruses
8 Species A-H
A most common - 90% of infections

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8
Q

One of the most common causes of lactose intolerance in children …

A

Gastroenteritis

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9
Q

Lactase is secreted by

A

Small intestine glands

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10
Q

Lactase is localised to

A

Brush border membrane of intestinal epithelial cells

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11
Q

Lactose intolerance

A

Inability to absorb lactose, often lactase is low / missing

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12
Q

Primary lactose deficiency

A

Caused by low levels of lactase, symptoms rarely develop before 6

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13
Q

Secondary lactose deficiency

A

Caused by damage to cells in the small intestine, can be caused by infection, chemotherapy e.c.t.

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14
Q

Epidemiology for N Europe and Hispanic countries for lactose intolerance

A

N Europe - 2 in 100

Hispanic countries - 80 in 100

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15
Q

Lactose intolerance Pathophysiology: (4)

A

Undirected latose reaches the colon
Increases the osmolality of the gut
Water moves in - diarrhoea
Lactose in colon fermented by bacteria into fatty acids (lactic acid), CO2, H2 and CH4

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16
Q

Diagnose lactose intolerance (2)

A

Hydrogen breath test

Blood test

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17
Q

Histological features of lactose intolerance (2)

A

Villous blunting

Lamina propria inflammatory changes

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18
Q

Faltering growth

A

Suboptimal weight in infants and toddlers

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19
Q

Mild faltering growth -

Severe faltering growth -

A

Drop of two centiles

Drop of three centiles

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20
Q

Weight below … Centile triggers an evaluation

A

0.4th centile

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21
Q

Children with recent onset faltering growth often maintain their …

A

Height

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22
Q

Children with recent onset faltering growth often maintain their …

A

Height

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23
Q

Coeliac disease symptoms: (4)

Organic disease

A

Dysmorphic features, distended abdomen, thin buttocks, irritability

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24
Q

Cystic fibrosis symptoms (2)

Organic disease

A

Respiratory signs

Malabsorption

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25
Q

Non organic causes of faltering growth: (3)

A

Alkaline phosphatise
Iron deficiency
Vitamin D deficiency

26
Q

Non -organic faltering growth caused by

A

Poor nutritional intake

27
Q

Non-organic due to a broad spectrum of

A

Psychosocial and environmental deprivation

28
Q

What percentage of children with faltering are subject to abuse / neglect?

A

5-10%

29
Q

Most common pathway for organic and non organic faliure to thrive

A

Under nutrition

30
Q

Less than …% of children with faltering growth will be found to have an organic cause

A

5%

31
Q

Comment organic causes:(5)

A 
Gastro-oesophageal reflux
Coeliac disease
Cystic fibrosis
Cardiac disease
Renal disease
32
Q

This scenario - history of abnormal stools, abdominal distension, buttock wasting and irritability suggests the child has…

A

Coeliac disease!

33
Q

Coeliac disease symptoms: (4)

Organic disease

A

Dysmorphic features, distended abdomen, thin buttocks, irritability

34
Q

Cystic fibrosis symptoms (2)

Organic disease

A

Respiratory signs

Malabsorption

35
Q

Non organic causes of faltering growth: (3)

A

Alkaline phosphatise
Iron deficiency
Vitamin D deficiency

36
Q

Non -organic faltering growth caused by

A

Poor nutritional intake

37
Q

Non-organic due to a broad spectrum of

A

Psychosocial and environmental deprivation

38
Q

What percentage of children with faltering are subject to abuse / neglect?

A

5-10%

39
Q

Most common pathway for organic and non organic faliure to thrive

A

Under nutrition

40
Q

Less than …% of children with faltering growth will be found to have an organic cause

A

5%

41
Q

Comment organic causes:(5)

A 
Gastro-oesophageal reflux
Coeliac disease
Cystic fibrosis
Cardiac disease
Renal disease
42
Q

This scenario - history of abnormal stools, abdominal distension, buttock wasting and irritability suggests the child has…

A

Coeliac disease!

43
Q

Coeliac disease symptoms: (4)

Organic disease

A

Dysmorphic features, distended abdomen, thin buttocks, irritability

44
Q

Cystic fibrosis symptoms (2)

Organic disease

A

Respiratory signs

Malabsorption

45
Q

Non organic causes of faltering growth: (3)

A

Alkaline phosphatise
Iron deficiency
Vitamin D deficiency

46
Q

Non -organic faltering growth caused by

A

Poor nutritional intake

47
Q

Non-organic due to a broad spectrum of

A

Psychosocial and environmental deprivation

48
Q

What percentage of children with faltering are subject to abuse / neglect?

A

5-10%

49
Q

Most common pathway for organic and non organic faliure to thrive

A

Under nutrition

50
Q

Less than …% of children with faltering growth will be found to have an organic cause

A

5%

51
Q

Comment organic causes:(5)

A 
Gastro-oesophageal reflux
Coeliac disease
Cystic fibrosis
Cardiac disease
Renal disease
52
Q

This scenario - history of abnormal stools, abdominal distension, buttock wasting and irritability suggests the child has…

A

Coeliac disease!

53
Q

Coeliac disease symptoms: (4)

Organic disease

A

Dysmorphic features, distended abdomen, thin buttocks, irritability

54
Q

Cystic fibrosis symptoms (2)

Organic disease

A

Respiratory signs

Malabsorption

55
Q

Non organic causes of faltering growth: (3)

A

Alkaline phosphatise
Iron deficiency
Vitamin D deficiency

56
Q

Non -organic faltering growth caused by

A

Poor nutritional intake

57
Q

Non-organic due to a broad spectrum of

A

Psychosocial and environmental deprivation

58
Q

What percentage of children with faltering are subject to abuse / neglect?

A

5-10%

59
Q

Most common pathway for organic and non organic faliure to thrive

A

Under nutrition

60
Q

Less than …% of children with faltering growth will be found to have an organic cause

A

5%

61
Q

Comment organic causes:(5)

A 
Gastro-oesophageal reflux
Coeliac disease
Cystic fibrosis
Cardiac disease
Renal disease
62
Q

This scenario - history of abnormal stools, abdominal distension, buttock wasting and irritability suggests the child has…

A

Coeliac disease!

HD2 PBLs (6 decks)

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