Diarrhoea and Its Impact on Children

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Questions and Answers

What is one of the primary causes of diarrhoea in children under five years old?

Unsafe drinking-water (correct)

Genetic predisposition

Excessive physical activity

High sugar diet

Which of the following describes the typical presentation of a patient with acute gastroenteritis?

Persistent cough and fatigue

Loss of appetite and weight gain

Frequent loose stools and dehydration (correct)

Intense abdominal pain and fever

Which type of solution is commonly used for rehydration in diarrhoea patients?

Oral rehydration solutions (correct)

Intravenous antibiotics

High-sodium sports drinks

Fizzy drinks

What role does hydration play in the treatment of diarrhoea?

It maintains necessary water and salt levels for survival. Signup and view all the answers

What is the significance of safe drinking-water in relation to diarrheal disease?

It is essential for the prevention of certain types of diarrhoea. Signup and view all the answers

What is the estimated annual number of global diarrheal disease cases?

1.7 billion Signup and view all the answers

Which of the following best describes the mucosal lining of the gastrointestinal tract?

Varies in type and function in different parts Signup and view all the answers

What common condition can result from prolonged diarrhoea, especially in young children?

Dehydration Signup and view all the answers

Why is a 290 mOsm/L urea solution considered hypotonic?

Urea can diffuse into cells, causing them to lyse. Signup and view all the answers

What role do Na+/K+-ATPases play in cells?

They regulate the balance of Na+ and K+ ions in and out of the cell. Signup and view all the answers

What is the main difference between interstitial fluid (ISF) and plasma?

Plasma contains proteins that cannot cross the capillary endothelium. Signup and view all the answers

Which ions are predominant in the extracellular fluid?

Na+ and Cl- Signup and view all the answers

What happens to osmotic pressure when the concentration of plasma proteins increases?

Osmotic pressure increases. Signup and view all the answers

What percentage of total body water (TBW) does blood plasma represent?

5% Signup and view all the answers

Which fluid is considered part of the transcellular fluid compartment?

Cerebrospinal fluid (CSF) Signup and view all the answers

What is the normal range for haematocrit in women?

0.36 - 0.45 Signup and view all the answers

What primarily determines the movement of water between fluid compartments?

Hydrostatic and osmotic pressures Signup and view all the answers

What is the normal osmolarity of body fluids?

290 mOsm/L Signup and view all the answers

What type of solution causes cells to lose water?

Hypertonic solution Signup and view all the answers

How does sodium typically behave in cell compartments?

Remains mainly in the blood vessels Signup and view all the answers

What effect does a hypotonic solution have on cells?

Causes cells to burst Signup and view all the answers

What type of epithelium lines the stomach and what is its primary function?

Simple columnar; Secretion Signup and view all the answers

Which fluid compartment constitutes approximately two-thirds of total body water?

Intracellular fluid Signup and view all the answers

What percentage of total body weight is accounted for by total body water in an average 70 kg male?

60% Signup and view all the answers

What is the primary component of extracellular fluid?

Interstitial fluid Signup and view all the answers

Which type of epithelium is found in the anal canal and what is its main role?

Stratified squamous non-keratinized; Protection Signup and view all the answers

How does body water percentage change with adiposity?

Decreases as adipose tissue increases Signup and view all the answers

Which of the following best describes the composition of the interstitial fluid?

Low in proteins and few cells in suspension Signup and view all the answers

What is the fate of water in relation to chemical reactions in the body?

Is required for all biochemical processes and exists in liquid form Signup and view all the answers

What is the primary consequence of diarrhoea that leads to the highest mortality rate?

Severe dehydration and fluid loss Signup and view all the answers

Which of the following groups is especially at risk of life-threatening diarrhoea?

Malnourished children and people with HIV Signup and view all the answers

What characterizes acute bloody diarrhoea?

It is also referred to as dysentery Signup and view all the answers

Which of these interventions is NOT effective in preventing diarrhoea?

Daily consumption of junk food Signup and view all the answers

How is diarrhoea typically defined?

The passage of three or more loose or liquid stools per day Signup and view all the answers

What is the most significant risk factor contributing to malnutrition in children due to diarrhoea?

Frequent episodes of diarrhoea Signup and view all the answers

What does the term 'persistent diarrhoea' refer to?

Diarrhoea that lasts 14 days or longer Signup and view all the answers

Which electrolyte is NOT typically lost during a diarrhoeal episode?

Calcium Signup and view all the answers

Study Notes

Diarrhoea

Diarrhoeal disease is the second leading cause of death in children under five
Diarrhoea kills around 760,000 children under five yearly
Diarrhoea is preventable and treatable
Contaminated drinking water, inadequate sanitation, and poor hygiene contribute a lot to diarrhoeal disease
Diarrhoea results in nearly 1.7 billion cases globally every year
It is a leading cause of malnutrition in children under five

Types of Diarrhoea

Acute watery diarrhoea – lasts for several hours or days, cholera is an example
Acute bloody diarrhoea – also called dysentery
Persistent diarrhoea – lasts 14 days or longer

Scope of Diarrhoeal Disease

Diarrhoeal disease is a leading cause of mortality and morbidity in children worldwide
780 million individuals lack access to improved drinking-water
2.5 billion lack improved sanitation
Diarrhoea due to infection is prevalent in developing countries
Children under three years old experience on average three diarrhoea episodes per year in developing countries
Diarrhoea leads to malnutrition and malnourished children are more susceptible to diarrhoea

Dehydration

Dehydration is the most serious consequence of diarrhoea
Water and electrolytes are lost through stools, vomit, sweat, urine, and breathing during diarrhoea
Dehydration is classified into three degrees:
- Early dehydration – no signs or symptoms
- Moderate dehydration – signs and symptoms present
- Severe dehydration – serious signs and symptoms

Parts of the Gastrointestinal Tract

Oral cavity: Stratified squamous non-keratinized epithelium, function is protection
Oesophagus: Stratified squamous non-keratinized epithelium, function is protection
Stomach: Simple columnar epithelium, function is secretion
Small intestine: Simple columnar epithelium with brush border, function is secretion and absorption
Large intestine: Simple columnar epithelium with goblet cells, function is secretion and absorption
Anal canal (lower part): Stratified squamous non-keratinized epithelium function is protection

Body Fluid Compartments and Constituents

Total body water (TBW) is about 60% of body weight in a 70 kg man
TBW percentage varies with age and weight (adiposity)
Babies at birth are approximately 80% water, while elderly people may only have around 50% water
As adipose tissue increases, the proportion of body water decreases
TBW is divided into two major compartments:
- Intracellular fluid (ICF) – about two-thirds of TBW, found inside all cells
- Extracellular fluid (ECF) – about one-third of TBW, surrounds all cells
ECF is further divided into:
- Interstitial fluid (ISF) – about three-quarters of ECF, surrounds cells, contains very little proteins and few cells
- Blood plasma – one quarter of ECF, found inside blood vessels, carries red and white blood cells, plasma proteins, and platelets
ECF also includes fluids in particular areas such as cerebrospinal fluid, fluid inside the eye, fluid inside joints, in the peritoneum, pericardium, and pleura
These fluids are also called transcellular fluids
There are also fluids in the gastrointestinal and urinary tracts
Total blood volume for a 70 kg male is approximately 5.5 L, but only 3.5 L is blood plasma
The ratio of red blood cells volume to whole blood volume is called the haematocrit, averaging 0.36 to 0.53
Fluid compartments are separated by semi-permeable barriers with different characteristics
Cells are surrounded by cell or plasma membranes that allow water movement but restrict major extracellular cation sodium
ISF is separated from blood plasma by the endothelial cells of the capillaries
Gaps between cells allow the movement of water and ions, but under normal conditions restrict blood cells and proteins to the vascular compartment
Water moves freely among compartments, but sodium does not enter cells, proteins and blood cells remain in the blood vessels

Hydrostatic and Osmotic Pressures

Movement of water between compartments is determined by differences in hydrostatic and osmotic pressures
Hydrostatic pressure is generated by the heart's pumping and osmotic pressure is from the concentration of solute particles
Water moves from dilute to concentrated solutions
The greater the number of solute particles, the higher the water pull
Osmolarity is determined by the number of osmotically active particles per litre
Normal osmolarity of body fluids is 290 mOsm/L
Tonicity refers to the actual effect of a solution on a living cell
An isotonic solution does not cause cells to gain or lose water
A hypertonic solution causes cells to lose water and shrink
A hypotonic solution causes cells to gain water until they burst (lysis)
Tonicity depends not only on solute concentration but also on the nature of the solute
Example: A 290 mOsm/L NaCl solution is isotonic, but 290 mOsm/L urea solution is hypotonic (cells lyse) because urea can permeate cells

Solute Contents

Major extracellular ions are sodium (Na+) and chloride (Cl-)
Major intracellular ions are potassium (K+) and large anions such as proteins and phosphates
The distribution of Na+ and K+ is regulated by specific transporters, the Na+/K+-ATPases
ISF differs from plasma as blood contains proteins that cannot cross the endothelium of the capillary
ISF and plasma have the same ionic content, but the proteins in plasma have an osmotic pull (colloid osmotic pressure = oncotic pressure) that opposes the hydrostatic pressure of blood
Ions in solution are electrolytes, capable of conducting electricity

Composition of Intracellular and Extracellular Fluids

Ion	Extracellular (mmol/L)	Intracellular (mmol/L)
Na+	145	12
K+	4	155
Cl-	120	3.8
Bicarbonate (HCO3-)	27	8
Phosphates	2	13
Protein anions	0-9	155
Ca2+	1.8

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Description

Explore the critical issue of diarrhoeal diseases, which pose a significant threat to children under five worldwide. This quiz covers the causes, types, and scope of diarrhoea, highlighting its preventable and treatable nature. Understand the statistics and factors contributing to this global health challenge.