MindMap Gallery Medicine-Diarrhea(1)
About medicine-diarrhea disease (1) mind map, including susceptibility factors, cause, pathogenesis, clinical manifestations, diagnosis, Treatment etc.
Edited at 2023-12-22 23:15:16Diarrheal disease
susceptibility factors
The digestive system is immature
Heavy gastrointestinal burden
Immunodeficiency of the body and mucous membranes
Intestinal flora imbalance
Artificial feeding
Cause
Infectious factors
Virus
Rotavirus, such as norovirus
bacteria
Escherichia coli, Campylobacter jejuni
Fungi
Candida, Aspergillus, Mucor
Parasite
Giardia giardia, amoeba
extraintestinal infection
caused by antibiotics
Long-term use of antibiotics causes intestinal flora imbalance
non-infectious factors
diet
Improper feeding
allergic diarrhea
Primary or secondary disaccharidase deficiency or reduced activity
climate
Pathogenesis
viral
Virus invades the small intestinal mucosa villous epithelial cells and replicate
Mucosal involvement, villus destruction
Decreased disaccharidase activity
Decreased absorption of disaccharides
Lactose, a small molecule of organic acid
carrier reduction
Glucose sodium combined with carrier Decreased transport-coupled absorption
Digestion and absorption area reduced
Decreased absorption of sugar and fat
increased osmotic pressure
watery diarrhea
Bacterial
Toxigenic Escherichia coli
subtopic
Improper diet
clinical manifestations
According to disease course
Acute, <2 weeks
Protracted type, 2 weeks to 2 months
Chronic, >2 months
According to condition
Lightweight
Gastrointestinal symptoms only
Increased frequency of bowel movements and changes in bowel movements
Heavy duty
gastrointestinal symptoms
Low appetite
Vomit
Frequent diarrhea
Dehydration and electrolyte imbalance
dehydration
According to degree
light
middle
Heavy
by nature
Hypotonic
Blood Na<130mmol/L
Mainly loses extracellular fluid, most susceptible to shock (hypovolemic shock)
Isotonic
Blood Na 130——150mmol/L
Most commonly, internal and external fluids are lost in equal proportions
Hypertonic
Blood Na>150mmol/L
The least common, mainly loss of intracellular fluid, not easy to go into shock, easy to be thirsty, and easy to be irritable
Acid substitute
vomitine
Eat less, produce more acid
Decreased blood volume → hypoxia → anaerobic glycolysis → acid production
Weak kidney acid excretion ability
Take a deep breath, pH <7.35
Low potassium <3.5mmol/L
Vomiting and diarrhea, loss of potassium
Eat less
Renal excretion does not decrease
Decreased neuromuscular excitability
Low calcium <1.85 Low magnesium<0.58
Tremors, convulsions
Symptoms of systemic infection and poisoning
Listlessness, restlessness, confusion, coma
Clinical characteristics of common types of enteritis
rotavirus enteritis
human rotavirus
More common in autumn and winter
More common in babies 6 months to 2 years old
Acute onset with fever and respiratory infection Vomiting and diarrhea, vomiting first and then diarrhea
It is a thin egg drop soup-like stool with no fishy odor.
Polyisotonic dehydration with acidosis and electrolyte imbalance
Self-limiting, disease duration 3 to 8 days
Escherichia coli enteritis
Most common in summer
Acute onset, mainly vomiting and diarrhea, mild systemic infection and poisoning
Watery or egg-like stools without mucus, pus or blood
Dehydration, electrolyte and acid-base balance disorders
Self-limiting, 3 to 7 days
Enteritis caused by invasive bacteria
Invasive Escherichia coli Campylobacter jejuni Yersinia enterocolitis Typhimurium
Acute onset, accompanied by high fever, nausea, vomiting, abdominal pain, tenesmus May have symptoms of severe poisoning
Mucus, pus, and blood in the stool, fishy smell, and microscopic examination shows red blood cells and white blood cells.
antibiotic-induced enteritis
fungal enteritis
Candida albicans
The course of the disease is protracted, often accompanied by oral thrush
Yellow and loose stools with lots of foam and mucus, and fine bean dregs-like pieces can be seen
Staphylococcus aureus enteritis
In mild cases, ejaculation occurs several times a day - recovery after stopping the drug Severe cases have frequent diarrhea - dehydration, electrolyte imbalance and acidosis may occur, accompanied by abdominal pain and poisoning symptoms
Yellow or dark green stool with a fishy smell
diagnosis
acute and chronic Light and heavy Viruses/Bacteria
Clinical manifestations Laboratory tests
treat
Principle: adjust diet, prevent and correct dehydration, use medication rationally, Strengthen care and prevent complications
adjust diet
No food, no water
Rational use of medication
Infection control, microbial preparations, mucosal protectants, zinc supplements No antidiarrheal agents
Correct dehydration and electrolyte acid-base balance disorders
fluid therapy
oral rehydration salts
Suitable for mild to moderate dehydration without obvious circulation disorders
Dosage
Mild: 50~80ml/kg
Moderate: 80~100ml/kg
usage
Cumulative loss amount (half of the total amount): Complete within 8 to 12 hours
Remainder: Dilute with equal amount of water and take orally
Total amount = cumulative loss, continued loss, physiological requirement
intravenous fluids
How much to make up
Quantitative (calculation)
According to the degree of dehydration
Light: 90~120ml/kg
Medium: 120~150ml/kg
Weight: 150~180ml/kg Volume expansion (anti-shock): 20ml/kg, no more than 300ml, refill within 30 minutes, expansion volume is part of the total volume
What to make up for?
Qualitative (drug selection)
According to the nature of dehydration
Isotonic: 1/2 sheet
2 (salt): 3 (sugar): 1 (alkali)
Hypotonic: 2/3 pictures
4:3:2
Hypertonic: 1/3 picture
1 (salt): 2 (sugar), hypertonic sodium is too much, no need to supplement alkali
Shock (expansion): isotonic, that is, 1 picture
2 (salt): 1 (alkali)
Mixed solution tension = salt ➕ alkali / salt ➕ sugar ➕ alkali
Physiological needs 1/5
1 (salt): 4 (sugar)
Commonly used isotonic solutions: 0.9% sodium chloride, 1.4% sodium bicarbonate, 1.87% sodium lactate
How to make up for it
Fixed speed (purpose)
Determine the rehydration phase
Principles of rehydration
Can be taken orally without infusion Fast first and then slow First thick and then light Salt first, then sugar Potassium supplementation in urine See Acid and Base Replenishment Calcium supplement when shocked