while many of you gave admirable answers here to this question:
358. Which of the following is the most common cause of lower gastrointestinal bleeding in school-aged children?
A. Anal fissures
B. Color of the vomitus
C. History of constipation
D. Presence of high fever
E. Resting tachycardia
all answers were wrong and here is why:
lower gastrointestinal bleeding is uncommon in children and is estimated to account for less than 0.5% of all pediatric emergency department visits. the likelihood of the etiology is age dependent. anal fissures are most common in infants younger than 1 year. it is thought that anal fissures are associated with constipation and the passage of hard stool. these infants typically have blood-streaked stool and pain with bowel movements. infectious diarrhea is the most common cause of lower gastrointestinal bleeding in school aged children. bacterial infections typically infect the bowel wall of the colon and cause local inflammatory effects. because of the vascularity of the bowel lumen wall, bleeding typically accompanies. treatment for bloody diarrhea primarily involves treating any dehydration if present. anti-nausea and anti-diarrheal medications are not indicated and can lead to complications such as excessive sleepiness and bowel hypo-activity/obstruction. antibiotics are seldom indicated in well appearing school-aged children even when a bacterial etiology has been identified. antibiotics prolong the carrier state in cases of salmonella gastroenteritis and increase the frequency of kidney problems in e. coli type infection. only one bacteria known to commonly cause diarrhea is susceptible to a shortened course from antibiotics.
this question was trickier than i realized at first glance.
this is one more reason why going to the doctor to get antibiotics can be frustrating.
thank you all for participating. i'm sad no one gets the prize this time around...we'll try again though. 10 more days of board review till the inservice exam...focus, focus.
358. Which of the following is the most common cause of lower gastrointestinal bleeding in school-aged children?
A. Anal fissures
B. Color of the vomitus
C. History of constipation
D. Presence of high fever
E. Resting tachycardia
all answers were wrong and here is why:
lower gastrointestinal bleeding is uncommon in children and is estimated to account for less than 0.5% of all pediatric emergency department visits. the likelihood of the etiology is age dependent. anal fissures are most common in infants younger than 1 year. it is thought that anal fissures are associated with constipation and the passage of hard stool. these infants typically have blood-streaked stool and pain with bowel movements. infectious diarrhea is the most common cause of lower gastrointestinal bleeding in school aged children. bacterial infections typically infect the bowel wall of the colon and cause local inflammatory effects. because of the vascularity of the bowel lumen wall, bleeding typically accompanies. treatment for bloody diarrhea primarily involves treating any dehydration if present. anti-nausea and anti-diarrheal medications are not indicated and can lead to complications such as excessive sleepiness and bowel hypo-activity/obstruction. antibiotics are seldom indicated in well appearing school-aged children even when a bacterial etiology has been identified. antibiotics prolong the carrier state in cases of salmonella gastroenteritis and increase the frequency of kidney problems in e. coli type infection. only one bacteria known to commonly cause diarrhea is susceptible to a shortened course from antibiotics.
this question was trickier than i realized at first glance.
this is one more reason why going to the doctor to get antibiotics can be frustrating.
thank you all for participating. i'm sad no one gets the prize this time around...we'll try again though. 10 more days of board review till the inservice exam...focus, focus.
and from a canal in st. petersburg, russia, here is amy's requested 'i know you didn't' look:
a look i've come to know and love :)
