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18 Cards in this Set
- Front
- Back
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Epidemiology of gastro
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rotavirus is most common, 20% of all emergency visits, 6% of all hospital inpatients
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diagnosis of gastro
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increased watery stools, vomiting, fever, infectious contacts
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Causes of acute gastro- bacterial
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15%, C. jejuni, Salm spp, atypical enteropathogenic E. coli, typical, shigella, yersinia enterocolitica, shiga e coli, salm typhi and paratyphi, cholera
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Protozoa causes of gastro
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cryptosporidium, giardia lamblia, entamoeba histolytica
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helminth cause of gastro
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strongyloides stercoralis
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Viral causes of gastro
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70%, rota, enteric adeno, small round, calici, astro, entero
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Hx of gastro
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vomiting, stools, intake, uo, lethargy, duration, weight, contacts, prev ill, fam hx
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assessment of dehydration
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None (<3%, reduced uo, thirst, no signs) some (5%- reduced uo, thirst, dry mucous, mild tach 7-9%- as above, lethargy, reduced turgor, sunken fontanell, sunken eyes), severe (>10%, above signs, weak, rapid breathing, poor perfusion, hypotension, shock)
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How reliable is capillary refill in dehydration
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correlates but fever, high ambient temp can make unreliable
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Ix in gastro
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mild dehydration (none), mod (euc, fbc, stool micro culture virology)
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Compostion of gastrolyte
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glucose 90 (stimulates cotransport of na), sodium 60, cl 60, k 20, citrate 10
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IV fluids in gastro
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NS or half NS, use 5% replacement as max
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tx of gastro
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mild(Oral), mod (IV/NG fluid, rehydration/replace, maintenance), severe (iv, bolus (10-20ml/kg), replace, maintenance)
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What may need to be added to fluid in gastro
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potassium, check uo first, 3mmol/kg/24hrs or 10mmol/500ml bag
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What changes in fluid resus if the child is hypernatraemic
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replacement over 48 hrs, doughy skin
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When should food be reintroduced in gastro
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earlier the better, continue breastfeeding throughout, benefits include enterocyte regeneration, recovery of brush border, no role of lactose free feeds unless presence of reducing sugars in stools or malnourished
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When are abs indicated in gastro?
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neonates with severe salmonella or sepsis, strongolyoides (albendazole), shigella
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Should antimotility/antidiarrhoeal/antiemetics be used?
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no
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