Constipation and Diarrhea

Question 1

definition of diarrhea for dx

Answer 1

more than 3 Bm/day or increase in liquid, ocifal dx stool weighs more than 200-300 g per 24 hours

Question 2

Treatment for fecal impaction

Answer 2

enema or digital extraction

Question 3

If diarrhea for less than 7 days what is work up if there are sx of inflammatory problem?

Answer 3

check stool bacteria, WBC, ova, and parasite

Question 4

if d for less than 10 days what history/ data do you need/

Answer 4

oral anal sex?, travel?, amebiasis, send 3 stool samples for O and P

Question 5

treatment for mild diarrhea

Answer 5

fluids, BRAT

Question 6

mild to mod diarrhea

Answer 6

loperamide, peptobismol, (NOT for pts with high fever, systemic toxicity)

Question 7

severe

Answer 7

admit and give IVFs or oral hydration

Question 8

when would treat diarrhea with empiric abx?

Answer 8

non hosopital acquired, moderate to severe fever, tenesumus, blod or pt who is immocompromised or severely dehydrated

Question 9

6 reasons to admit a pt with diarrhea

Answer 9

1. severe and need IVF (abd pain, mental status change etc)
2. severe bloody d
3. severe abd pain, toxic colitis, IBD, intestinal ischemia, surgical abd
4. sx severe infection or sepsis more than 39.5, leukocytosis, rash
5. pts over 70 with worsening sx
6. HUS sx

Question 10

3 major sx of HUS

Answer 10

acute kidney failure, thrombocytopenia, hemolytic anemia

Question 11

treatments for chronic diarrhea 7

Answer 11

1. underlying cause first
2. Loperamide
3. diphenoxylate with atropine
4. opiods
5. clonidine
6. octreotide
7. cholestyramine