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Children's Health > Diarrhoea and Vomiting > Flashcards

Diarrhoea and Vomiting Flashcards

1
Q

What are the physical features of dehydration in an infant?

A
  • Sunken anterior fontanelle
  • Dry mucous membranes
  • Tachycardia
  • Reduced CRT
  • Reduced skin turgor
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2
Q

What are the 2 most common viruses causing gastroenteritis in young children?

A
  • Rotavirus

- Adenovirus

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3
Q

What are the red flag features associated with vomiting in children?

A
  1. Haematemesis
  2. Bile in the vomit
  3. Projectile vomit
  4. Abdominal distention/tenderness
  5. Blood in the stool
  6. Bulging fontanelle
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4
Q

What are the possible causes, in paediatrics, of; bile stained vomit?

A

Intestinal obstruction

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5
Q

What are the possible causes, in paediatrics, of; haematemesis?

A
  • Oesophagitis
  • Gastric ulcer
  • Oral/nasal bleeding
  • Vomiting swallowed blood
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6
Q

What are the possible causes, in paediatrics, of; Projectile vomiting (<2/12 old)?

A
  • Pyloric stenosis
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7
Q

What are the possible causes, in paediatrics, of; abdominal distention/tenderness?

A
  • Intestinal obstruction
  • Strangulated inguinal hernia
  • Surgical abdomen
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8
Q

What are the possible causes, in paediatrics, of; Blood in stool?

A
  • Gastroenteritis (salmonella or campylobacter)

- Intussusception

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9
Q

What are the possible causes, in paediatrics, of; severe dehydration and shock?

A
  • Severe gastroenteritis

- Systemic infection e.g. UTI, meningitis, DKA

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10
Q

What are the possible causes, in paediatrics, of; bulging fontanelle/fits?

A
  • Raised intracranial pressure due to a. meningitis b. hydrocephalus
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11
Q

What are the possible causes, in paediatrics, of; faltering growth (failure to thrive)?

A
  • GORD
  • Coeliac disease
  • Chronic gastrointestinal conditions
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12
Q

What are the possible causes, in paediatrics, of; vomiting with paroxysmal cough?

A
  • Whooping cough
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13
Q

What characteristics put children at higher risk of dehydration?

A
  • Low BW
  • <1 year old
  • > 2 vomiting episodes and >5 diarrhoea episodes in 24 hours
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14
Q

How do we manage paediatric patients that are dehydrated?

A
  • Encourage oral fluid intake
  • Use of oral rehydration solution (ORS) - frequently in small amounts
  • ORS may have to be given by NG tube or IV if the patient is very ill
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15
Q

What percentage of children under the age of 5 years present to the NHS annually with gastroenteritis?

A

10%

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16
Q

What is the most common bacteria that causes gastroenteritis in chidlren?

A

Campylobacter jejuni

17
Q

What is isonatraemic dehydration?

A

Where the loss of sodium and water are proportional and the plasma sodium is at normal levels.

18
Q

What is dehydration?

A

Excessive water loss from the body. This is when fluid loss>fluid intake.

19
Q

When does dehydration become fatal?

A

When >15% of the body’s total water is lost

20
Q

What is hyponatraemic dehydration?

A

Where there is a greater net loss of sodium than water. This happens when large quantities of water/hypotonic fluids are taken in. This leads to a shift in water from extracellular to intracellular causing brain oedema, extracellular dehydration and shock.

21
Q

What is hypernatraemic shock?

A

Water loss exceeds the sodium loss with resultant increase in plasma sodium. This can happen with insensible water loss (diarrhoea and vomiting).

22
Q

What are the signs of hypernatraemia?

A
  • Jittery movements
  • Increased muscle tone
  • Hyperreflexia
  • Convulsions
  • Drowsiness/coma
23
Q

When is a stool culture indicated in someone with diarrhoea?

A
  • Recent travel abroad
  • No improvement by day 7
  • Suspected septicaemia
  • Blood and/or mucus in the stool
  • Immunocompromised child
24
Q

What are the indications for commencing and IV fluid regime in dehydrated children?

A
  • Hypovolaemic shock
  • Red Flag Sx
  • Persistent vomiting
  • Hypoglycaemia
25
Q

What is the fluid regime to follow when treating a child with hypovolaemic shock?

A

1st fluid bolus = 20ml/kg of 0.9% NaCl by rapid IV infusion

2nd fluid bolus = 20ml/kg of 0.9% NaCl by rapid IV infusion

26
Q

Which D+V causing bacteria are treated with Abx?

A
  • Campylobacter
  • C. Diff
  • Non-typhoid salmonella
  • Shigella
  • Vibrio cholerae
  • Giardia
  • Yersinia
  • Cryptosporidium

Children's Health (14 decks)

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