Diarrhoea Flashcards

1
Q

Define diarrhoea

A

Increase in the frequency, fluidity, and volume of faeces

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2
Q

What is the difference between acute and prolonged diarrhoea

A

Acute: 3 or more episodes of liquid/semi-liquid stools in a 24h period, lasting for <14 days

Prolonged: acute-onset diarrhoea that has persisted >14 days

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3
Q

What is the difference between food poisoning, dysentery and traveller’s diarrhoea

A

Food poisoning = illness caused by the consumption of food or water contaminated with bacteria and/or their toxins, or viruses, parasites, or chemicals

Dysentery = acute infectious gastroenteritis characterised by diarrhoea with blood and mucus

Traveller’s diarrhoea = developing diarrhoea at a destination abroad with at least one additional symptom (abdominal cramps, tenesmus, nausea, vomiting, fever, faecal urgency), involves travel from LMICs

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4
Q

Define outbreak

A

Two or more cases associated in time and place

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5
Q

What are the normal stool patterns for children 0-4 months

A

Breastfed: 2-4 per day (once per week normal), yellow to golden colour, porridge consistency, pH 5

Bottlefed: 2-3 per day, pale yellow-light brown, firm consistency, pH 7

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6
Q

What are the normal stool patterns of children 4 months - 1 year

A

1-3 per day
Darker yellow
Firmer

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7
Q

What are the stool patterns of children > 1 yo

A

Formed
Like adult stool in odour and colour

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8
Q

What are the causes of acute diarrhoea

A

Gastroenteritis
- Viral e.g. rotavirus, norovirus, adenovirus
- Bacterial e.g. shigella, E. coli, salmonella. campylobacter, yersinia
- Food poisoning: clostridium perfringens, bacilus cereus, staph aureus
- Parasitic e.g. cryptosporiodiosis, entamoeba, giardia
- Traveller’s
URTI, chest infections
Otitis media
UTI’s
Antibiotic induced
Non-infection e.g. intussusception

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9
Q

What investigations should be done for acute diarrhoea

A

Bedside: stool microscopy and culture, stool immunoassay (rotavirus), urine culture
Bloods: FBC, U&Es, blood culture
Other: CXR (Exclude pneumonia)

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10
Q

What is the management for acute diarrhoea

A

Assess hydration status
Not dehydrated → re-assure, discharge + advice (maintain fluids, eat as normal)
Dehydrated → ORS (young) or diluted apple juice (older chidlren)

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11
Q

What are the causes of chronic diarrhoea

A

Non-specific diarrhoea
Toddler diarrhoea
Functional constipation → overflow diarrhoea
Malabsorption: Lactose intolerance | cystic fibrosis | coeliac disease | CMPA | cholestatic liver disease | short-bowel syndrome
Inflammation: IBD
Infection: Giardiasis

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12
Q

What investigations should be done for chronic diarrhoea

A

Bedside: stool culture, stool sample for occult blood/ova and parasites/reducing substances and pH/chymotrypsin/microscopy, urine MC&S, breath hydrogen test
Bloods: FBC, U&Es, plasma viscosity/ESR, tTG, EMA
Other: sweat test, barium meal and enema, endoscopy, jejunal biopsy

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13
Q

What is toddler diarrhoea

A

chronic and non-specific diarrhoea
Commonest cause of loose stools in preschool kids
Underlying maturational delay in intestinal mobility → increased intestinal hurry (not malabsorption)

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14
Q

What are the signs and symptoms of toddler’s diarrhoea

A

Varying consistency stools (well-formed to explosive and loose ± presence of undigested vegetables in stool)
Child is well and thriving (no precipitating dietary factors and normal examination)

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15
Q

What is the management for toddler’s diarrhoea

A

Increased fibre and fat in diet (whole milk, yoghurts, cheeses) → relieve symptoms
Avoid fruit juice and squash

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