You are on page 1of 5

PBL : Vomitting and Diarrhoea in a Child 1. Mechanism and pathophysiology of vomiting and diarrhea.

Vomitting - Forceful expulsion of gastric contents through the mouth. - Stomach, oesophagus and associated sphincter are relaxed during emesis. - The major force of expulsion comes from contraction of respiratory muscle which are diaphragm (major inspiratory muscle) and abdominal muscle (muscle of active expiration). - Emesis is coordinated by vomiting center at medulla. - Begin with deep inspiration and closure of glottis. - The contracting diaphragm force the stomach downward, simultaneously contraction of abdominal muscle compressing abdominal cavity cause increased intra-abdominal cavity which then force the viscera organ of abdomen upward. - The stomach squeezed the gastric contents forced upward through relaxed sphincter and esophagus. - The glottis closed so vomited material do no enter into respiratory airways and also the uvula is raised to close the nasal cavity. - Vomiting cycle is repeated several time until the stomach is emptied. - Preceded by profuse salivation, sweating, rapid heart rate, and sensation of nausea. characteristics of generalized discharge of ANS.

Diarrhoea Excessive small intestine motility which either by local irritation of the gut wall or emotional stress. Rapid transition of small intestine contents not allow enough time for adequate absorption of fluid. Lactase deficiency : excess osmotically active particle in the digestive tract lumen. These particle cause excessive fluid to enter and retained in the lumen increase fluidity of feces. Toxins of the vibro cholera or other microorganisms promote the secretion of excessive amounts of fluid by the small intestine mucosa. It is the leading cause of death of small children.

2. What are the causes of diarrhea and vomiting in children.

3. Infective causes in diarrhea and vomiting.

4. What is relation between symptoms and disease pathogenesis 5. What the difference characteristics of vomiting and diarrhea caused by various group of organisms. 6. What are the factors that increases susceptibility to gastroenteritis in children. 7. What are the signs and symptoms of dehydration. 8. Normal values of vital sign in children. 9. How do you monitor growth in children. 10. What are other investigation to confirm your hypothesis. 11. How does the giardia cause lactose intolerance and fat malabsorbtion 12. What is giardia, how do people get the infection, clinical features and diagnosis. 13. How do you manage vomiting and diarrhea in children and treat giardiasis 14. What advice would you give parents about preventive measures of filarial disease 15. What are the notifiable infections diarrhoeal disease.

You might also like