4.2.1 Pathophysiology of Diarrhea Flashcards Preview

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Flashcards in 4.2.1 Pathophysiology of Diarrhea Deck (37):
1

Patient has linear ulceration. What is the diagnosis?

Chron's Dz

2

Answer

B) carcinoid (neuroendocrine tumor)

3

Describe how solute absorption/secretion is related to water absorption/secretion

4

What are some of the more important/common causes of acute diarrhea?

Drugs, Bacterial infection, Viral infection, Protozoa infection, Parasite infection, Traveler's diarrhea

5

What are some of the pathophysiologies that cause diarrhea due to dismotility?

6

What is considered acute diarrhea? Chronic?

Acute: <2 wks

Chronic: >4 wks

7

What are some of the charcteristics features of bacterial entertoxins that cause diarrhea?

8

How does nutrient and electrolyte assimulation differ in regions of the adult intestine?

9

What are some labratory exams that could be useful in understanding the cause of a patient's diarrhea?

CBC, electrolytes, BUN, Cr, total protein, albumin, globulin

Stool: weight, fat, culture, ova/parasite

Na, K, Mg, pH, occult blood, fecal WBC

laxative screen, C. diff PCR

Stool osmolality

Endoscopy

Abdominal imaging

10

What is considered fatty diarrhea?

> 14 g/day of fat is considered steatorrhea (normal is < 6 g/day)

11

Describe how permeability changes as you pass through the bowels

Decreases as you go through

12

What is the most common type of drug that causes acute diarrhea?

Antibiotics (duh, you're changing the gut microflora)

13

What are the three characteristics of diarrhea?

>3 BM/day

Weight >200g/day

Increased liquidity

 

14

What is this condition?

Traveler's diarrhea

15

Give some examples of pumps/channels/carriers present in intestinal cells

16

Give some examples of ion transporters found in intestinal cells

17

What are some of the factors that regulate/module intestinal solute and water transport?

18

What are some characteristic features of the three types of chronic diarrhea?

Watery: No fecal WBC/RBC (Osmotic - stops with fasting/high osmotic gap; secretory - variable clinical picture)

Exudative: bloody, pus, other inflammatory reactions

Fatty: severe, weight and nutrient loss

19

What are some of the possible causes of steatorrhea?

20

What are some of the locations/issues that can cause chronic diarrhea?

21

What are some of the different classifications of bacterial diarrheas and toxins that cause them?

22

What are some important points to elucidate while taking a clinical history of a patient with dirrhea?

  1. Duration
  2. Severity
  3. Stool characteristics
  4. Relationship to eating/fasting
  5. Surgery
  6. Medications
  7. Diet
  8. History of radiation
  9. Travel

23

What are some of the pathophysiologies associated with secretory diarrhea?

24

What vitamins are not absorbed properly in steatorrhea?

Fat soluble (Vits ADEK)

25

What is the diagnostic approach to chronic diarrhea?

26

Compare and constrast diarrheas as a result of small bowel colonic issues versus recto-sigmoid issues

27

What pathophysiologies are asssociated with exudative diarrhea?

28

What are the arrows pointing at? What organism can cause this?

Pseudomembranous colitis; C. Diff

29

What are the three types of chronic diarrhea?

Watery (osmotic/secretory), Exudative (infection/inflammation), Fatty (Malabsorption/maldigestion)

30

What staining method is shown here? What type of diarrhea is this used for?

Sudan; Fatty diarrhea

31

How do you calculate stool osmotic gap?

32

D) IBS

33

What are some of the pathophysiologies associated with osmotic diarrhea?

34

D) Celiac spruce

35

What are the characteristics of stool in steatorrhea?

Greasy, oily, floats, malodorous

36

What 6 points should be covered in your clinical examination?

  1. Assess severity
  2. Skin
  3. Thyroid exam
  4. R side heart murmur
  5. Arthritis
  6. Lymphadenopathy

37

What is associated with exudative diarrhea?

Pain, tenesmus (cramping rectal pain), urgency

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