15- vomiting Flashcards Preview

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Flashcards in 15- vomiting Deck (8)
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1
Q

manage mild-moderate dehydration

A

oral rehydration therapy

50-100 mL/kg of oral rehydration over 24 hours
(small vol given frequently)
10 ml/kg oral given for each diarrhea stool
2 ml/kg for each additional emesis

2
Q

manage mod-severe dehydration

A

IV bolus -20 ml/kg isotonic, non-dextrose (saline or lactated ringers) until improved

3
Q

differential for vomiting + dehydration in 6 week old

A
GERD
viral gastroenteritis
malrotation +- volvolus
intususpeption
inborn errors of metabolism
pyloric stenosis
CNS disease- hydrocephalus, neoplasm, trauma
UTI
4
Q

labs to confirm pyloric stenosis

A
  1. pylorus US
  2. Upper GI contrast study “string sign”

Electrolytes

5
Q

treat pyloric stenosis

A

before surgery: Repeated boluses of normal saline or lactacted Ringers solution, in 10-20 ml/kg aliquots, until mild dehydration or normal fluid status.

after surgery; Rehydration either orally or with ongoing IV fluids.

6
Q

surgery for pyloric stenosis

A

pyloromyotomy :
pyloric muscle is split (divided) without cutting through the mucosa.
via a small upper abdominal incision or laparoscopically.

relatively short and simple and have very low complication rates. return home in couple of days

7
Q

blood streaked emesis think in 6 month old think…

A

GERD

8
Q

work up for infectious diarrhea

A

stool Wright’s stain for fecal WBCs- bacteria

Rotazyme test- rotavirus

stool sample for culture and sensitivity.

stool guaiac (for occult blood)

stool C. diff toxin.