13: Diarrhea

Question 1

Acute vs chronic diarrhea timing

Answer 1

Acute: <2 weeks
Chronic: >4 weeks

Question 2

Mild N/V with acute diarrhea vs prominent vomiting with acute diarrhea: differentials

Answer 2

1. Mild N/V: toxin producing bacteria (ETEC, S. Aureus, B. Cereus, C. Perfringens, shigella)
2. Prominent vomiting: viral enteritis, s. Auerus

Question 3

Five invasive bacterial species causing inflammatory diarrhea

Answer 3

1. Shigellosis
2. Salmonella
3. Campylobacter
4. Yersinia
5. Amebiasis

Question 4

Three bacteria that create toxins that cause inflammatory diarrhea

Answer 4

C. Diff, aeromonas, STEC

Question 5

Four main causes of motility disorders causing diarrhea

Answer 5

1. IBS
2. Systemic disorders like gastroparesis
3. Radiation enteritis
4. Surgery

Question 6

Definition of orthostatic hypotension

Answer 6

Sustained reduction of SBP of 20mmHg OR DBP of 10mmHg within 3 minutes of standing

Question 7

How to check orthostatic vital signs

Answer 7

1. Take BP after pt has been supine for 3-10 minutes
2. Have pt stand -> recheck BP after 3 minutes
3. Compare readings

Question 8

Five reasons to admit a pt with infectious diarrhea

Answer 8

1. Inability to maintain hydration
2. Bloody diarrhea where cause isn’t evident
3. Signs of sepsis, severe infection, or HUS
4. Pt 70+ yrs old
5. Pt immunocompromised