Diarrhoea + vomiiting

Question 1

common causes of Gastroenteritis in young children (3)

Answer 1

• norovirus
• salmonella
• e coli
• rotovirus
• enterovirus

Question 2

1st and 2nd most common causes of gastroenteritis in children

Answer 2

1) rotovirus

2) adenovirus

Question 3

differentials for blood in stools with diarrhoea + vomitign

Answer 3

• intussception
• shigella
• campylobacter
• e coli
• rotovirus

Question 4

cause of haemolytic uremic syndrome

Answer 4

E coli

Question 5

what is the most common cause of acute renal failure in children

Answer 5

Haemolytic uremic syndrome caused by E coli

Question 6

toxin produced by e coli

Answer 6

shigella like toxin: verotoxin

Question 7

symptoms caused by Shigella like toxin (5)

Answer 7

• abdo pain
• bloody diarrhoea
• fever
• seizures
• lethargy

Question 8

organisms that cause bloody diarrhoea

Answer 8

• e coli
• rotovirus
• shigella
• campylobacter
• salmonella

Question 9

what does the toxin from e coli cause in haemolytic uremic syndrome (3)

Answer 9

• thrombocytopenia
• renal insufficiency
• microangiopathic hemolytic anaemia (schistocytes)

Question 10

treatment of thrombocytopenia

Answer 10

• supportive
• dialysis
• no abx
• plasmaphoresis/IVIG

Question 11

projectile vomiting in a child under 2 months

Answer 11

pyloric stenosis

Question 12

cause of bulging fontanelle (2)

Answer 12

raised ICP

• hydrocephalus
• meningitis

Question 13

cause of faltering growth (3)

Answer 13

• chronic GI disorder
• GORD
• coeliac disease

Question 14

most common cause of food poisoning in UK

Answer 14

campylobacter

Question 15

foods salmonella found in

Answer 15

• undercooked meat
• raw eggs
• milk

Question 16

chilled ready to eat foods

Answer 16

listeria

Question 17

management of mild dehydration

Answer 17

Fluid challenge with ORS (frequent and in small amounts)

Question 18

advisable breast feeding for infants

Answer 18

breast for 12 months followed by pausterised cows milk at 12 months

Question 19

calories/protein requirements for infants

Answer 19

0-6 months: 115 kcal/kg

6-12 months: 96 kcal/kg

Question 20

when should solid food be introduced, and what?

Answer 20

6 months

rice, pure fruit and veg

Question 21

foods to avoid in first 6 months

Answer 21

• fish
• eggs
• wheat

Question 22

when can i attend nursery again

Answer 22

48 hours after your last episode of D or V

Question 23

management of mild dehydration from gastroenteritis

Answer 23

fluid challenge with ORS

and

5ml/kg after each watery stool

Question 24

which children are at an increased risk of dehydration

Answer 24

• < 1 year olds
• low birth weight infants
• > 5 loose stools + 2 episodes of vomiting in previous 24 hours
• malnourished children

Question 25

type of dehydration whereby water loss is greater than sodium loss

Answer 25

hypernatreamic

Question 26

clinical features of hypernatraemic dehydration

Answer 26

- jittery movements - increased muscle tone - hyperreflexia - convulsions - drowsiness

Question 27

peak age for intussception

Answer 27

3 months to 2 years

Question 28

type of pain in intussception

Answer 28

paroxysmal, severe, colicky pain; child draws legs up in the episodes

Question 29

pathophysiology in intussception

Answer 29

invagination of proximal bowel into distal segment commonly involving invagination of ileum into caecum through ileocaecal valve

Question 30

stool feature in intussception

Answer 30

red currant jelly

Question 31

signs of dehydration in infants

Answer 31

- sunken fontanelle - decreased level of consciousness - reduced skin turgor - oliguria - sudden weight loss - eyes sunken & tearless

Question 32

most common cause of food poisoning in UK

Answer 32

campylobacter

Question 33

IV fluid for child in shock

Answer 33

Fluid bolus of 20 ml/kg of 0.9% saline

Question 34

peak incidence of intussception

Answer 34

3 months to 2 years of age

Question 35

red currant jelly stool containing blood & mucus

Answer 35

intussception

Question 36

pathophysiology of intussception

Answer 36

invagination of proximal bowel into a distal segment of ileum into caecum through ileocaecal valve