Chapter 73: Disorders Presenting Primarily With Diarrhea Flashcards

(50 cards)

1
Q

Amount to tell if acute diarrhea?

A

10ml/kg/d

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2
Q

What is diarrhea?

A

An increased frequency of defecation, usually greater than 3 bowel movements per day for a daily stoll weight exceeding 250grams

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3
Q

In normal conditions, how many ml fluids is lost in the stool per day?

A

<100ml

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4
Q

Intestinal absorption occurs through the ____, and secretion occurs through the ____

A

Intestinal absorption occurs through the villi, and secretion occurs through the crypts

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5
Q

Two mechanism of fluid absorption and which of this is affected with toxin?

A

Passively with the transport of sodium which are afffected with toxin and actively with the absorption of glucose

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6
Q

In diarrheal states, enterotoxins, inflammation, or ischemia. Which are more affected, villi or crypt?

A

Villi so decrease absorption. Cryspts are more resilient after injury

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7
Q

Diarrheal illness is primarily a?

A

Diarrheal illness is primarily a viral infection (norovirus)

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8
Q

This drug stimulates small bowel motility

A

Clavulanate

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9
Q

How can you say if it acute or chronic diarrhea?

A

Acute (<3 weeks) whihc are of greatest concern or chronic (>3 weeks)

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10
Q

Patient with diarrhea had seizure episode. What is your diagnosis?

A

Shigellosis
Theophylline toxicity
Hyponatremia

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11
Q

After rural hiking, patient had diarrhea. What is your diagnosis?

A

Giardiasis

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12
Q

Reiter’s syndrome, the triad of arthritis, conjunctivitis, and urethritis or cervicitis

A

Salmonella, Shigella, Campylobacter, or Yersinia infection

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13
Q

An elderly patient presented at ED with bloody diarrhea and abdominal pain that is out of propoprtion. What will you suspect?

A

Mesenteric ischemia

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14
Q

The most common cause of antibiotic-associated or nosocomial diarrhea

A

Clostridium difficile

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15
Q

Patient had diarrhea and cough. Upon xray shows pneumonia. What is the cause?

A

Legionella

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16
Q

Fluid of choice for diarrhea patient that can tolerate oral feeding

A

Glucose- containing, caffeine-free beverages are the fluids of choice example is Gatorade

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17
Q

The major bacteria responsible are the toxin- and non–toxin-producing diarrhea is

A

E. coli

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18
Q

What symptoms need microbiologic studies to rule out bacterial or amoebic infection?

A
  • Severe abdominal pain
  • Fever
  • Bloody stool
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19
Q

It is recommended treatment for all patients believed to have an infectious diarrhea

A

Ciprofloxacin

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20
Q

Complication of shiga toxin-producing E.coli in children

A

Hemolytic uremic syndrome

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21
Q

First choice for use in South and Southeast Asia. Safe for children and pregnant women

A

Azithromycin 1000mg as single dose

22
Q

Treatment for E. histolytica diarrhea?

A

Metronidazole 750 milligrams PO three times a day for 10 days AND paromomycin 10 milligrams/kg three times a day PO for 7 days

23
Q

Implicated in reducing the inci- dence of C. difficile infection if taken concomitantly with antibiotics but have no role in treating active or recurrent disease

24
Q

Treatment for Salmonella non-typhi diarrhea?

A

Ciprofloxacin 750 milligrams PO twice a day for 5 days

Azithromycin 500 milligrams PO once a day for 7 days

25
Treatment for Shigella diarrhea?
Ciprofloxacin 750 milligrams PO twice a day for 3 days | Azithromycin 500 milligrams PO once a day for 3 days
26
How many days after start of antibiotic will diarrhea start in C. difficile infection?
7 to 10 days
27
Gold standard in diagnosis of C. difficile infection?
Cell culture cytotoxicity using selective growth medium
28
It is diagnostic procedure use if patient cannot produce a stool specimen due to ileus or negative assay
Colonoscopy
29
Primary treatment for C. difficile infection
Fidaxomicin (macrolide antibiotic) 200 milligrams PO twice a day for 10 days
30
Mild C.difficile (WBC <15,000mm3) diarrhea can be treated with
Vancomycin 125 milligrams PO four times a day for 10 days
31
What part of the GI is most commonly involved in crohn's disease?
Ileum
32
The peak incidence of crohn's disease occurs at what age group?
15-22 y/o
33
It worsens the crohn's disease
- Smoking - Oral contraceptive use - NSAIDs
34
The most important pathologic feature of Crohn’s disease is?
The involvement of all the layers of the bowel and extension into mesenteric lymph nodes
35
What are the 3 general types of Crohn's presentation?
- Inflammatory - Stricture - Penetrating
36
Crohn’s disease should also be considered in the differential diagnosis of patients with ____
Crohn’s disease should also be considered in the differential diagnosis of patients with fever of unknown etiology
37
This laboratory use to monitor disease activity
CRP and ESR
38
The best modality for imaging perianal fistulae in crohns disease
pelvic MRI
39
The diagnostic modality of choice for biliary complications in crohns disease
Ultrasound
40
How to confirm diagnosis of crohns disease?
Colonoscopy
41
Treatment for mild to moderate crohn's disease
Sulfasalazine 3-5gm/day
42
If patient with crohns disease is medically resistant. What to give?
Anti-tumor necrosis factor antibodies - infliximab - adalimumab - certolizumab gel
43
Complications of biologics drug for crohns disease?
Tuberculosis and hepatitis B
44
The most common reason for emergent surgery in Crohn’s disease
Obstruction. The distal small bowel is the most common site
45
The characteristic symptom of ulcerative colitis is ____
Bloody diarrhea
46
Part of GI that involved in the vast majority of ulcerative colitis patient
Rectosigmoid area
47
Can be effective in fulminant colitis nonresponsive to IV corticosteroids
``` IV cyclosporine (4 milligrams/kg per day) Infliximab (5 to 10 milligrams/kg per dose) ```
48
The only biologic indicated for ulcerative colitis
Infliximab (5 milligrams/kg per dose)
49
Most common complication of ulcerative colitis?
Blood loss from sustained hemorrhage
50
Plain radiograph of abdomen in toxic megecolon. You can see what?
- Air-filled colon greater than 6 cm in diameter | - Loss of colonic haustra and thumb printing