Oral Rehydration Therapy for Gastroenteritis Exam Questions and Answers Already Passed

Oral Rehydration Therapy for Gastroenteritis Exam Questions and Answers Already Passed Treatment of choice for child with mild to moderate dehydration. - Answers ORT - less traumatic, cheaper, easier to administer, can be done at home Children without dehydr should be fed age appropriate diet. When should children with dehydration be fed age approp diet? - Answers as soon as they are rehydrated Why discourage carbonated drinks and sweetened frut juices? - Answers high carb content, low electrolyte content and high osmolarity - can cause osmotic diarrhea if given in large quantities Contraindications to ORT as outlined by CPS. - Answers 1. protracted vomiting despite small frequent feeding 2. severe dehydration with shock like state 3. impaired consciousness 4. paralytic ileus 5. monosaccharide malabsorption How many diarrheal episodes/year do children <5yo experience in industrialized countries? - Answers 2.2 2 primary causes of M&M in Canadian native populations with acute gastroenteritis? - Answers 1. prolonged diarrhea 2. malnutrition Why hasn't ORT been used extensively in developed countries? - Answers lack of familiarity with ORT, fear of induction of iatrogenic hypernatremia, entrenched patterns of practice What is scientific basis for use of ORS? - Answers Cotransport of glucose and sodium across intestinal membrane. Na-K-ATPase bump on basolateral membrane of enterocyte enhances gradient - glucose enhances sodium and then water absorption - cotransport system is intact in infective diarrhea due to viruses or enteropathogenic bact, whether invasive or enterotoxigenic. What is optimal glucose to sodium ratio to ensure maximal sodium absorption? - Answers 1:1 What is the ideal composition of ORS for ORT? - Answers Na - 90mmol/L glucose - 111mmol/L K - 20mmol/L Cl - 80mmol/L HCO3 - 30mmol/L What is the osmolarity of ideal ORS? - Answers 311mOsm/L How does reduced osmolarity ORS compare with standard WHO recomm? - Answers fewer unscheduled IV therapy sessions, lower stool volume, less vomiting. They now recomm revised formulation of 245mOsm/L - Na 75mmol/L, K 20, Cl 65, citrate 10, glucose 75 ORS used in Canada and include WHO standard? - Answers Pedialyte Gastrolyte Enfalyte Cera What are the components of Pedialyte? - Answers K 20mmol/L, Cl 35mmol/L, base 30mmol/L, 25g/L carbs, sodium 45mmol/L, Osm 250mOsm/L