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Gastrointestinal > Constipation > Flashcards

Constipation Flashcards

1
Q

What is the ROME III criteria for constipation?

A

Two or more of the following for at least three months:

  • Fewer than 3 defecations per week
  • straining
  • lumpy/hard stools
  • sensation of blockage/incomplete evacuation
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2
Q

What do you have to r/o with constipation?

A

IBS

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3
Q

If constipation alternates with normal stools/diarrhea is suggestive of what?

A

Blockage that occasionally dumps out diarrhea

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4
Q

What endocrine disorder can cause constipation?

A

DM

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5
Q

Why do past GI surgeries cause constipation?

A

strictures

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6
Q

Do fluids really help with constipation?

A

Not really

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7
Q

Onset of acute constipation in the elderly?

A

BO

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8
Q

Weight loss over what amount of weight is concerning with constipation?

A

10 lbs

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9
Q

What are the three major endocrine causes of constipation?

A

DM
Hypothyroidism
Hypercalcemia

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10
Q

What are the three major neurological diagnoses that can lead to constipation?

A

Parkinson’s

MS

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11
Q

What are the two myogenic problems that can lead to constipation?

A

Scleroderma

Amyloidosis

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12
Q

What are the three psychiatric disorders that should be considered with elderly constipation?

A

Depression
Eating disorders
OCD

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13
Q

What are the PE things you should pay attention to with constipation?

A 
Mucus membranes (dehydration)
DRE
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14
Q

What type of antacids are concerning for constipation?

A

Al containing

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15
Q

What supplement may cause constipation?

A

Fe

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16
Q

What two antiarrhythmics may cause constipation?

A

CCB

Beta blockers

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17
Q

What are the psychiatric drugs that can cause constipation? (3)

A

Antispasmodics
Antidepressants
Antipsychotics

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18
Q

What labs should be considered with constipation?

A

Thyroid

Hgb A1C

19
Q

What are the bulk laxative that are used to treat constipation?

A

Psyllium

Methylcellulose

20
Q

What are the osmotic laxatives that are used to treat constipation?

A

Lactulose

21
Q

What are the stimulant laxatives that are used to treat constipation?

A

Senna

Bisacodyl

22
Q

What type of enemas should be used for constipation in the elderly?

A

Warm water

23
Q

What muscle is working for stooling?

A

Puborectalis

24
Q

The internal and external sphincter are composed of what type of muscle?

A

Smooth

25
Q

What signals the sensation to defecate?

A

Distention of the rectum

26
Q

What is encopresis?

A

Prolonged and repetitive stool withholding and avoidance of defecation leads to large amount of retained stool in the rectum.

27
Q

What is the sign of encopresis?

A

Overflow from the rectum

28
Q

True or false: straining with the passage of soft stool in infants is normal

A

True

29
Q

Why do infants have to strain with their stool?

A

Incoordination of their rectal muscles

30
Q

Up until what age is infantile dyschezia resolve?

A

6 months

31
Q

Most children have achieved bowel and bladder control by what age?

A

4 years

32
Q

What is the best way to toilet train children?

A

Praise

33
Q

What is the most common cause of constipation in children?

A

functional fecal retention–voluntary tightening of the external anal sphincter and contraction of the gluteal muscles preventing the passage of stools

34
Q

What should be in the ddx for childhood constipation?

A

Hypothyroidism
TCAs
Spinal cord damage/hirschsprung’s disease

35
Q

When should you have your first stool?

A

first 24 hours

36
Q

What is the early presentation of Hirschsprung’s disease?

A

If stools do not occur within 24-48 hours

37
Q

Meconium of the ileus causes what?

A

delayed passage of meconium in CF

38
Q

What parts of the PE should be done with constipation?

A

DRE for sphincter tone

39
Q

What are the labs that can be done to screen for laxative abuse?

A

BMP + Mg

40
Q

What are the three phases of medical management?

A
  1. complete evacuation or disimpaction
  2. Sustained evacuation to restore normal colorectal tone
  3. Weaning from intervention
41
Q

Why should you not use mineral oil under 1 yo?

A

Risk for aspiration

42
Q

What are the components of sustained evacuation? How long does this last?

A

Habitual toilet use, stool softeners

3-9 months

43
Q

What is involved in the weaning stage?

A

use of laxative gradually reduced, increase fiber

This usually occurs when children can better understand

Gastrointestinal (42 decks)

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