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Maddy - GI II Exam I - some pharm > Clin - Diarrhea > Flashcards

Clin - Diarrhea Flashcards

(49 cards)

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1
Q

describe the bristol stool chart

A

1: separate hard lumps
2: sausage shaped but lumpy
3: sausage but with cracks on surface
4: sausage or snake, smooth
5: soft blobs
6: fluffy pieces w/ ragged edges
7: watery

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2
Q

duration of acute and chronic diarrhea

A

acute: less than 2 weeks
chronic: more than 4 weeks

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3
Q

compare inflammatory and non-inflammatory acute diarrhea

A

inflammatory: blood or pus, fever, invasive or toxin producing bacteria, need stool culture

non-inflammatory: watery, non bloody, mild, virus or non-invasive bacteria

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4
Q

most common cause of acute diarrhea

A

90% is infectious, 75% of that is viral

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5
Q

most common cause of noninfectious acute diarrhea

A

1) medications
- most frequently antibiotics
2) artificial sweeteners
- sorbitol, chewing gum

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6
Q

antibiotic that commonly causes antibiotic-associated diarrhea

A

amoxicillin-clavulanate (augmentin)

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7
Q

top 3 causes of chronic diarrhea

A

1) medications
2) IBS
3) lactose intolerance

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8
Q

what symptoms are inconsistent with medications causing chronic diarrhea and warrant further evaluation

A

1) nocturnal diarrhea
2) weight loss
3) anemia
4) positive fecal occult blood test

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9
Q

compare osmotic gap between osmotic diarrhea and secretory diarrhea

A

osmotic: increased stool osmotic gap (50-75)
secretory: normal stool osmotic gap

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10
Q

sx osmotic diarrhea

A

abd distention, bloating, flatulence due to increased colonic gas production

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11
Q

most common causes osmotic diarrhea

A

1) medications
2) disaccharidase deficiency (lactose intolerance)
3) laxative abuse
4) malabsorption syndromes

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12
Q

sx secretory diarrhea

A

high volume watery diarrhea (>1L day)

- hyponatemia

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13
Q

causes of secretory diarrhea

A

1) endocrine tumors (zollinger ellison, carcinoid syndrome VIPoma)
2) bile salt malabsorption (ileal resection, crohn ileitis)
3) factitious diarrhea (laxative abuse)
4) villous adenoma

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14
Q

what is the sudan stain used for

A

qualitative staining for fat to test to malabsorption disorders

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15
Q

diagnostic study for most patients with chronic persistent diarrhea

A

colonoscopy with mucosal bipsy

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16
Q

what diagnostic test is performed when suspected a small intestinal malabsorptive disorder

A

upper endoscopy with small bowel biopsy

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17
Q

what fecal elastase level indicates pancreatic insufficiency (which could be causing chronic diarrhea)

A

less than 100 mcg/g

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18
Q

what breath test is used in testing for carbohydrate malabsorption (lactase deficiency)

A

hydrogen breath test

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19
Q

what diagnostic study will localize neuroendocrine tumors if present

A

somatostatin receptor scintigraphy

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20
Q

what serology test tests for VIPoma

Study These Flashcards
A

vasoactive intestinal peptide (VIP)

21
Q

what serology test tests for medullary thyroid carcinoma

22
Q

what serology test tests for zollinger ellison syndrome

23
Q

what serology test tests for carcinoid tumor

Study These Flashcards
A

urinary 5-hydroxyindoleacetic acid (5-HIAA)

24
Q

medications that are common offenders in mediation induced diarrhea

Study These Flashcards
A

1) cholinesterase inhibitors
2) SSRIs
3) angiotensin II receptor blockers
4) PPIs
5) NSAIDs
6) metformin
7) allopurinol

25
common pathophysiology of IBS
visceral hyperalgesia to mechanoreceptor stimuli
26
what psychological disturbances are associated with IBS
depression, hysteria, OCD
27
what are the alarm symptoms associated with IBS
1) acute onset of sx 2) nocturnal diarrhea 3) severe constipation or diarrhea 4) hematochezia 5) weight loss 6) fever 7) FMHx of CA
28
ROME IV criteria is used to diagnose what dz
IBS
29
diagnostic criteria for IBS
chronic > 6 months for diagnosis, at least 3 months for it to be on a differential
30
describe the ROME IV criteria for IBS
recurrent abd pain, on average, at least 1 day per week in the last 3 months, associated with 2+ of the following: 1) related to defecation 2) associated w/ change in frequency of stool 3) associated with change in appearance of stool
31
what is the FODMAPS diet for IBS
fermentable oligosaccharides, disacchardies, monosaccharides, and polyols
32
what pathogens are associated with CHRONIC infectious diarrhea
protozoans: giardia, e. histolytica, cyclospora intestinal nematodes: strongyloidiasis stercoralis bacteria: c. diff
33
most common antibiotics that increase risk for C. diff
1) ampicillin 2) clindamycin 3) 3rd gen cephalosporins 4) fluoroquinolones
34
etiologic agents for microscopic colitis
1) NSAIDs 2) PPIs 3) low dose aspirin 4) SSRI 5) ACEI 6) beta-blockers
35
characteristics of malabsorption syndromes
1) weight loss 2) osmotic diarrhea 3) steatorrhea 4) nutritional defiicency
36
SIGNS of malabsorption
1) loss of muscle mass or subq fat 2) pallor due to anemia 3) vitamin K deficiency 4) hyperkeratosis 5) osteomalacia 6) neurologic signs due to vitamin B12
37
sx of malabsorption
1) diarrhea 2) steatorrhea 3) weight loss 4) abd distension 5) weakness 6) muscle wasting
38
elevated fecal fat
malabsorption syndrome
39
extraintestinal features of celiac dz
1) fatigue, depression 2) iron deficiency anemia 3) osteoporosis 4) short stature 5) delayed puberty 6) amenorrhea 7) reduced fertility 8) dermatitis herpetiformis
40
what scan should you do on celiac pts to screen for osteroperosis
dual-energy x-ray densitometry
41
sx of pancreatic insufficiency causing chronic diarrhea
1) steatorrhea 2) weight loss 3) gaseous distention and flatulence
42
causes of bile salt malabsorption
1) bacterial overgrowth 2) massive acid hypersecretion 3) medications that bind bile salts
43
signs of bile salt malabsorption
1) bleeding tendencies 2) osteoporosis 3) hypocalcemia 4) watery secretory diarrhea
44
periodic acid schiff (PAS) test positive for macrophages with characteristic bacillus
whipple dz
45
what type of diarrhea is common in the elderly
overflow diarrhea from fecal impaction
46
describe fecal incontinence
neuromuscular disorder or structural anorectal problems causing involuntary discharge of rectal contents
47
what is pseudodiarrhea
frequent passage of small volumes of stool
48
how to diagnose fecal impaction
DRE
49
chronic use of laxatives can lead to what endoscopic finding
melanosis coli | - benign hyerpigmentation of colon

Maddy - GI II Exam I - some pharm (23 decks)

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