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GIR Test 2 > B5-020 Diarrhea > Flashcards

B5-020 Diarrhea Flashcards

(85 cards)

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1
Q

the colon takes up approximately […]% of the fluid presented to it

A

90

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2
Q

when the large reserve capacity of the small intestine and colon is exceeded or impaired […] manifests

A

diarrhea

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3
Q

the site for intestinal fluid movement is the

A

epithelial lining

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4
Q

has specialized properties for fluid movement

A

epithelial lining

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5
Q

restrict passive flow of solutes once secreted or absorbed

A

tight junctions

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6
Q

normal crypt to villi ratio

A

2 villi to one crypt

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7
Q

movement of solutes and water through tight junctions

A

paracellular trans epithelial transport

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8
Q

dictated primarily by electrochemical gradient

A

paracellular trans-epithelial transport

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9
Q

requires membrane transport proteins to drive the transcellular transport of ions

A

trans-epithelial transport

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10
Q

transport of ions sets up the electrochemical gradient

A

trans-epithelial transport

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11
Q

electrochemical gradients allow […] transport of fluid through tight junctions

A

paracellular

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12
Q

primary function is nutrient absorption

A

villi

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13
Q

primary function is secretion

A

crypt

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14
Q

primarily depends on Na+ transport

A

villi absorption

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15
Q

primarily follows Cl- and bicarbonate

A

crypt secretion

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16
Q
  • bricarbonate secretion
  • electroneutral NaCl absoprtion
  • chloride secretion

occurs where

A

small intestine

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17
Q

chloride secretion mainly occurs where in GI tract?

A

colon

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18
Q

calcium and iron absorption occur where

A

small intestine

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19
Q

what transporter is responsible for sodium glucose reabsorption?

A

SGLT1

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20
Q

what transporter allows for the secretion of Cl-

A

CFTR

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21
Q
  • solute driven water losses
  • more prominent in the colon
A

osmotic diarrhea

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22
Q

crypt secretion leads to more prominent small intestinal losses

A

secretory diarrhea

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23
Q

normal osmotic gap

A

50-100

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24
Q

calculation for osmotic gap

A

290-2 x (Na + K)

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25
osmotic gap > 100 mosm/kg
osmotic diarrhea
26
osmotic gap <50 mosm/kg
secretory diarrhea
27
frequent, small volume bloody stool
inflammatory diarrhea
28
fundamentally indicates disrupted and inflamed mucosa
inflammory diarrhea
29
caused by: * infectious processes * IBD * ischemic colitis
inflammatory diarrhea | `
30
* greasy, bulky stools * weight loss * floating feces
fatty diarrhea | osmotic diarrhea, but with fat content
31
celiac disease causes what type of diarrhea?
fatty diarrhea | fat malabsorption
32
loss of large volumes without inflammation of enterocytes
osmotic diarrhea
33
stool volume decreases with fasting
osmotic diarrhea
34
stool pH <5.3 | acidic ## Footnote normal is 6.6
osmotic diarrhea
35
caused by: * giardiasis * osmotic laxatives * lactose intolerance
osmotic diarrhea
36
osmotic laxatives | 5
* **MiraLax** * milk of mag * sorbitol * lactulose * PEG
37
caused by an osmotically active substance drawing **hypotonic** solution into lumen
osmotic diarrhea
38
caused by ingestion of poorly absorbed sugars or ions
osmotic diarrhea
39
loss of large volumes of **isotonic** watery diarrhea without inflammation
secretory diarrhea
40
stool volume continues unabated by fasting
secretory diarrhea
41
stool pH usually 6.6 | normal or close to normal
secretory diarrhea
42
caused by increased Cl- channel activation via increased cAMP
secretory diarrhea
43
is further workup necessary for acute diarrhea?
no
44
* CRP and ESR elevated * low serum albumin
inflammatory diarrhea
45
curved rods gram negative | 2
c. jejuni vibrio
46
* common in southern states * through summer (May-Aug) * found in oysters
vibrio parahaemolyticus
47
improves with fasting
osmotic diarrhea
48
osmotic gap >125 mosm/kg
osmotic diarrhea
49
what does a high magnesium output indicate?
**laxative abuse** inadvertent digestion
50
* associated with laxative abuse * damaged cells express pigmentation
melanosis coli
51
sorbitol should be limited to
10 g/day
52
what kind of laxative is Senna?
stimulant
53
stimulant laxatives increase | 2 things
motility and secretions
54
stimulant laxatives cause [...] diarrhea
secretory
55
absorbed carbohydrates and sugar alcohols intaken orally in large quantities cause
osmotic diarrhea
56
do enzymes help digest polyol/sugar alcohols?
no
57
measures anaerobic bacteria production of hydrogen from undigested sugars
hydrogen breath test
58
osmotic gap <50
secretory diarrhea
59
what additional test may you want in the setting of secretory diarrhea?
colonoscopy sigmoidoscopy CT scan
60
indomethacin inhibits [...]
prostaglandins | reduces Cl- pumped into lumen
61
how does an adenoma cause secretory diarrhea?
1. adenoma secretes PGE2 2. PGE2 stimulates increased intracellular cAMP 3. cAMP phosphorylates CTFR 4. CTFR allows Cl- movement into small intestine. water follows -> secretory diarrhea
62
villous adenomas secrete electrolytes and mucin causing secretory diarrhea and dehydration
McKittrick Wheelock syndrome
63
**pre-renal acute kidney injury** * hyponatremia * hypokalemia * **elevated creatine**
McKittrick Wheelock syndrome
64
treatment for secretory diarrhea caused by adenoma
NSAIDs can be supportive but must be resected
65
* reduced duodenal folds * no duodenal villi * increased intra-epithelial lymphocytes * no villi
celiac
66
anti-TTG IgA anti-gliadin IgA | are markers for
celiac
67
what kind of diarrhea does celiac disease cause?
osmotic | unabsorbed nutrients pull fluid into the lumen
68
how does celiac cause issues with bone health?
1. decreased Ca+ absorption in small intestine 2. decreased serum calcium signals thyroid to release PTH 3. PTH signals for increased calcium uptake from bones and kidneys
69
autoimmune disease where consumption of gluten will lead to damage of small intestine
celiac
70
associated with bone health issues
celiac
71
treatment for celiac
strict gluten free diet
72
dermatitis herpetiformis is associated with
celiac
73
decreased stool pH is associated with
lactose intolerance
74
what kind of diarrhea does lactase insufficiency result in?
osmotic
75
T. whippelii presents with | 4
* fever * steatorrhea * joint pain * fatigue
76
celiac can lead to decreased [...], resulting in edema
albumin
77
usually experiences some benefit with loperamide and diet change
IBS
78
pancreatic exocrine insufficiency causes
frequent loose, foul smelling stools (steatorrhea)
79
* bloody stools * abdominal pain * fever * elevated CRP * low Hb * low albumin
UC
80
frequent watery, non-bloody diarrhea and abdominal cramping
collagenous collitis
81
gram negative non-motile rods in a stool sample can belong to which two genera?
campylobacter and vibrio
82
continue to grow at 4 degrees C | 2
* yersinia * listeria
83
causes issues with refrigerated blood supplies
yersinia
84
causes issues with refrigerated foods
listeria
85
thiosulfate citrate bile salts sucrose agar is selective for
vibrio

GIR Test 2 (18 decks)

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