Medex Objectives Winter 2003



Medex Objectives Winter 2003

MEDEX Northwest Physician Assistant Objectives Home:

MCHPediatric Gastroenteritis

 

1.         Gastroenteritis (Acute Diarrhea)- Discuss incidence, pathophysiology, clinical presentation, work-up, laboratory tests, and treatment.

incidence:  in US, acute diarrhea strikes each child under 3 y.o. 1.3-2.3X/yr.  An avg. of 220,000 kids under 5 are hospitalized yearly, with 900,000+ hospital days.  9% of all hospitalizations of kids under 5 secondary to diarrhea.  300 kids under 5 die each yr from diarrhea and dehydration.

pathophysiology: 5 mechanisms exist:  A. Osmotic diarrhea occurs with osmotically active particles in intestine.  B. Secretory d. results from inhibition of ion absorption or stimulation of ion secretion.  C. Deletion or inhibition of a normal active ion absorptive process (congenital or acquired).  D. Inflammation usu. results from decrease in functional areas of bowel.  E.  Abnormal intestinal motility.

clinical presentation:  Usually last few days to a week.  Diarrhea lasting more than 2 weeks is something else (malabsorption, malnutrition or both).  Mostly caused by intestinal infections or food intolerance; other poss. causes include food poisoning, inflammatory disorders, iatrogenic agents (antibiotics, laxatives).

work-up:  

Hx: including dietary record, & changes in diet must be correlated with stool frequency and form.  Family health, travel to place with contaminated water system, endemic infections, day care, foods recently ingested are all important factors.  Thorough fam. hx, GI ROS important to elicit.  Short incubation, short duration ( ................
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