GROUP 3-Problem 2 B
Transcript of GROUP 3-Problem 2 B
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GROUP 3 - Problem 2 B
Gastrointestinal system
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Unfamiliar terms
Diarrhea isthe frequent passing ofloose or watery stools
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&in &apping
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%r$ %aniel
Name NIM
'ri (artati )*+*,**)
Agutinus Bayu B )*+*,*#+)
Ray Leonar )*+*,*2*3
%imas Priyantono )*+*,*2*+
Putu Re.a )*+***2)
/ao /essi0a )*+***3,
1iyasari )*+***#
Riny 1ahyuni )*+**#,ran0is4a Lu0iana )*+**#5
Amana /ohanna )*+**22)
'tephanie )*+**23#
&elya )*+**2)2
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A6U78 %9ARR(8A
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%89:979O:
A0ute iarrhea is e;ne as anabnormally frequent is0harge ofsemisoli or
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8piemiology
8piemiology of a0ute iarrhea" e>elope >ersus
e>eloping 0ountries$
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6LA''996A79O:
7ime A0ute ?@ #) ays
6hroni0 ?C #) ays
Pathophysiology&e0hanism 'e0retori0
Osmoti0= et0
'e>ereness &il
'e>ere
9nfe0tious 0auses
9nfe0tion :on-9nfe0tion
Organi0 0auses Organi0
un0tional
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Pathogenesis %iarrhea
D#D# #*
Predisposition
Small Intestinal Dysfunction
Diarrhea
Malnutrition
Pancreatic &
Gastric DysfunctionSpecific
Deficiencies e.g Zn
Infection
Immune
Deficiency
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D#D# ##
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8EALUA79O: ofA6U78
%9ARR(8A
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8A7UR8' O %9ARR(8AL %9'8A'8
FEATURESLOCATION OF INFECTION
Small Bowel Large Bowel
Pathogens
V. cholerae
8786= 8P86= 8Agg86Rota>irus:orwal4 >irusGiardia
Shigella8986= 8(866ampyloba0terE.histolytica
Location of
ain&iabomen Lower abomen= re0tum
T!e of stool 1atery &u0oi anDor blooy
"ol#me ofstool
Large 'mall
Fre$#enc! 9n0rease (ighly in0rease
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8A7UR8' O %9ARR(8AL %9'8A'8
FEATURES
LOCATION OF INFECTION
Small Bowel Large Bowel
% Possibly +$+ C+$+
Recing s#'stances Possibly positi>e :egati>e
(BCs in stool +Dhigh power ;el6ommonly C#*Dhigh
power ;el
Ser#m (BCs :ormal Possible leu4o0ytosis
Protosco! :ormal&u0osal ul0ersFhemorhageF friablemu0os
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Clinical manifestations an&&iagnosis
8pisoes of iarrhea 0an be
0lassi;e into three 0ategories
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6lini0al features of infe0tion withsele0te iarrheal pathogens
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Ris4 a0tors
Ma)or
8n>ironmental 0ontamination
9n0rease to e!posure to enteropathogens
A&&itional oung age
9mmune e;0ien0y
&easles
&alnutrition
&i0ronutrient e;0ien0y
La04 of e!0lusi>e or preominant breast-
feeing
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6ompli0ation
Dehydration
Malnutrition
Micronutrient deficiencies Secondary infections
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7R8A7&8:7
Rehyration
'upplemental .in0 therapy=multi>itamins= an minerals
%iet
:onspe0i;0 antiiarrheal treatment
Antimi0robials Pre>ention
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7ypes of E.coli :
+ types of 8$ 0oli ha>e beenre0ogni.e as pathogens in theintestinal tra0t$
8a0h 0auses iarrhea by iHerentme0hanism= in>ol>ing a istin0t setof >irulen0e fa0tors an geneti0
elements$
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*+ Enteroathogenic E+ coli ,EPEC-
atta0h to the intestinal mu0osa= 0ausing iarrhea in
0hilren an aults$
7he pre0ise me0hanism of ersial$
6on>entional to!ins or in>asi>e me0hanisms ha>e not
been ienti;e$
'ubtle 0hanges in the mi0ro>illus surfa0e ha>e been
note in asso0iation with atta0he 8P86= an this
amage may 0ause iarrhea$
.+ Enteroto/igenic E+ coli ,ETEC-
0ause iarrhea by elaboration of two to!ins "
a heat-labile to!in ?L7= whi0h resembles 0holera to!in
a heat-stable to!in ?'7$
0+ Enteroin1asi1e E+ coli ,EIEC-
prou0e ysentery an a 0lini0al pi0ture that is
inistinguishable from that of 'higella$
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2+ Enterohemorrhagic E+ coli ,E%EC- ,E+coli
3*456%5-
0auses a se>ere 0olitis with the passage of grossly blooy
stools$
7hese organisms prou0e a 'higa-li4e to!in that amages
the large bowel mu0osa$
Besies iarrheal isease this organism may also 0ause the
hemolyti0-uremi0 synrome ?(U'$
4+ Enteroaggretati1e ,EaggEC-0auses isease by atta0hment of the organism to the small
intestine an subsequent amage to the mu0osal lining$
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Bacterial infection
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Parasit infection
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Fungal infection
Candida sp
C. albicans is most common cause of Candida enteritis
Characteried by !atery diarrhea and abdominal pain.
Predisposing factors "prolonged antibiotic or
immunosuppressi#e therapyyeast forms are
ubi$uitous and occur in fecal flora of normal persons% their
presence alone is not diagnostic.
Definiti#e diagnosis re$uires demonstration of intestinal
mucosal in#asion by Candida on biopsy or isolation of
Candida from ulcerati#e lesions.
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Candida albicans
Usually infe0te " premature infants
those who 0onsume antibioti0s I 0orti0osteroi inlong term
malnutrition
iabetes melitus$
6ommonly infe0ts neonatus an early infan0y
'ymptoms "
iarrhea= oral trush= oni4ia= parono4ia= ermatitis Laboratory ;ning "
?J if yeasts I mi0ellium are foun
7herapy "
:istatin= Amfoterisin B= atty a0i resin 0omple!
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6(RO:96 %9ARR(8A
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6(RO:96 %9ARR(8A
6hroni0 iarrhea is e;ne as loosestools that last for at least fourwee4s
A wie range of problems 0an 0ause0hroni0 iarrheaF some of the most0ommon 0auses in0lue irritable
bowel synrome= ine 0olitis= malabsorption
synromes= an 0hroni0 infe0tions$
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%9AG:O'9' of6(RO:96%9ARR(8A
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%8(%RA79O:
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%ehyration
7he boy nees the 0orre0t amount ofwater an ele0trolytes ?salts to fun0tionproperly$
%iarrhea 0auses e!0ess loss of
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PA7(OP('9OLOG
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PA7(OP('9OLOG
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l f h i i hil
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Le>els of ehyration in 0hilren
with a0ute iarrhea
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6ompli0ations
7i&ne! fail#re Coma Shoc8 %eat9relate& illnessesI asso0iate 0ompli0ations
Electrol!te a'normalities 9n ehyration= ele0trolyte abnormalities may o00ur sin0eimportant 0hemi0als ?li4e soium an potassium are lostfrom the boy through sweat$
9f rehyration is one too slowly "
--C hypotensi>e I in sho04 for too long 9f one too qui04ly "
--C water an ele0trolyte 0on0entrations within organ 0ells0an be negati>ely aHe0te --C 0ausing 0ells to swell --C ie$
7 t t f
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7reatment of
%ehyration
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6on0lusion
Probably this 0hil is suHere bya0ute iarrhea J moerateehyration
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REFERENCES
Pri0e= 'yl>ia A$= 1ilson= Lorraine &$Patofsiologi vol 1$ 8 $ /a4arta "8G6= 2**$
au0i= Braunwal= asper= 44$(arrisonMs Prin0iples of 9nternal&ei0ine >ol 99$ 8 #5$Unite 'tate "m0Graw-(ills= 2**,$
'herwoo= Lauralee$ Physiology from6ells to 'ystems$ 8 $ Unite 'tate" 7homson (igher 8u0ation= 2**5$
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1illiam wh=&yron Nl= /uith ms=44$6urrent %iagnosis An 7reatment inPeiatri0s #, th e$ :ew or4" Lange
&ei0al Boo4sF 2**5$ au0i= Braunwal= asper= 44$
(arrison Prin0ipal 9nternal &ei0ine
#5th e$ :ew or4 " &0 Graw (illF2**,$