Muhamad Na'im B Ab Razak (jacknaim) is a fresh graduate Muslim Doctor from Universiti Sains Malaysia and waiting for the enrollment into the housemanship program. Ambitious in pursuing master program in emergency and traumatology medicine and loves to spent his free time joining humanitarian missions, writing and speaks as an amateur public speaker in motivation and comparative religion. [HOME]

Acute Gastroenteritis in children (MCQ)


1)

a) False

Rotavirus. Furthermore, Vibrio cholera is a diarrhoe disease who did not cause enteritis.


b) True

All bacteria except enterotoxic E. coli is likely to cause dysentry


c) False

Antibiotic is not indicated unless systemic infection.


D) True

Due to intestinal mucosal injury which lead to reduce secretion of enzyme lactase.


E) True


2)

A) False

Damage to the villous brush border of the intestine, causing malabsorption of intestinal contents and leading to an osmotic diarrhea. Release of toxins that bind to specific enterocyte receptors and cause the release of chloride ions into the intestinal lumen, leading to secretory diarrhea [Adam Levine et al]


B) True

Though the prevalence of acute gastroenteritis in children has changed little over the past 4 decades, the mortality has declined sharply, from 4.6 million in the 1970s to 3 million in the 1980s to 2.5 million in the 1990s. One of the most important reasons for this decline has been the increasing international support for the use of ORS as the treatment of choice for acute diarrhea, with the proportion of diarrheal episodes treated with ORS rising from 15% in 1984 to 40% in 1993. [Adam Levine et al]


C) True

Vomiting alone without diarrhea prompt a careful analysis for diagnosis


d) True

The most common cause is Rotavirus. Bacteria pathogen account for small porportion of causes including Campylobacter, Salmonella, Shigella, and enterohemorrhagic Escherichia coli (EHEC)


E) False

If Present of systemic infection.


3)

A) False

Clinical trials show no benefit of lactose free formula over lactose containing formula. even though patient may develop lactose intolerence, it is however transient


B) False

Breast feeding should be continued and given as much as the child want.


C) False

ORS is for mild and uncomplicted moderate dehydration only. Severe rehydration need to be managed with IV fluid. A resuscitation of 20 mls per kg bolus with Normal saline or Hartmann solution is later being followed with replacement of fluid deficit with 1/2 SD5% and maintanence with 1/5NS.


D) True

due to osmotic load.


E- True

Most cases of gastroenteritis are self limited. however meningitis can occur especially with salmonella infection. Other complication includes dehydration, malabsorption, transient lactose intolerence, chronic diarrgea, systemic infection, sepsis, hemolytic uremic syndrome, toxic megacolon, persistent diarrgea, Thrombotic thrombocytopenic purpura and Guillain Barre syndrome