Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI > Constipation & Diarrhea > Flashcards

Constipation & Diarrhea Flashcards

(107 cards)

Start Studying
1
Q

Define Constipation

A

Passage of stool infrequently or with difficulty

Stool frequency of less than three per week (straining, hard stool, incomplete evacuation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Etiology of Constipation

A

Inadequate fiber in diet
Inadequate hydration
Inactivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Medications that can cause Constipation

A 
Opiates/narcotics
Antidepressants
CCB
Antipsychotic
Antiparkinsonian agents
Anticholinergics
Calcium, iron supplements
Antispasmodics
Antacids (calcium & aluminum)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Structural Abnormalities Causing Constipation

A 
Carcinoma
Ischemia
Volvulus
Megacolon
Anorectal Disorders (prolapse, rectocele, pelvic floor dysfunction)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is present with ischemia of the bowel?

A

Usually present with pain

Rebound tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pelvic Floor Dysfunction

A

ANS neuropathy
Pregnancy
Males with surgeries near the perineum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Metabolic Issues Causing Constipation

A 
Hypokalemia
Hypomagnesemia
Hypothyroidism
Hyperparathyroidism
Porphyria- genetic hemoglobin disorder
Addison's disease
Hypercalcemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Neurological Issues Causing Constipation

A 
Parkinson's
MS
Automonic neuropathy
Hirschsprung disease
Chugs disease
Spinal cord lesions
Cerebrovascular disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hirschprung Disease

A

Myenteric plexus affected

Lack of cells at birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Systemic Issues Causing Constipation

A

Amyloidosis
Scleroderma
Polymyositis
Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define Amyloidosis

A

Sclerotic fibers embedded in tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define Scleroderma

A

Tightening of all outside tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Surgical Issues Causing Constipation

A

Abdominal
Pelvic
Colonic
Anorectal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Psychiatric Issues Causing Constipation

A

Depression

Eating disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment of constipation in patients less than 50 years old with no alarm symptoms

A

Empiric treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Further treatment should be performed on patients with any of the following:

A 
Over age 50
Severe constipation
Signs of an organic disorder
Hematochezia
Weight loss
Positive FOBT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Evaluation of Constipation

A

KUB
Barium enema
Colonoscopy
Blood Tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Blood Tests for Constipation

A 
Glucose
CBC
Thyroid
Calcium
Magnesium
Phosphorous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define Colonic Transit Study

A

Observe transit time in patients with refractory constipation not responding to conservative measures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Management of Constipation

A

Prevention

Patient Education

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Patient Education for Constipation

A

Exercise
Fluid intake
Fiber intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does exercise do for bowel movements?

A

Stimulus to colon peristalsis and defecation

Encourage and enable patient to be mobile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Fluid intake

A

Constipated stools are low in water content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Fiber intake

A

Acute constipation low on fiber diet

Chronic constipation responds poorly to fiber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Classes of Medications for Constipation
``` Stool softeners Laxatives stimulant laxatives Opioid-receptor antagonist Digital disimpaction ```
26
Types of Stool Softeners
Colace | Docusate calcium
27
Types of Laxatives
Bulk laxatives | Osmotics
28
Types of Bulk Laxatives
Psyllium Methylcellulose Fibercon (polycarbonophil) Benefiber (wheat dextran)
29
Types of Osmotics
``` Lactulose Sorbitol Polyethylene glycol Magnesium citrate Magnesium sulfate ```
30
Types of Stimulant Laxatives
Bisacodyl | Senna
31
Type of Opioid-receptor Antagonist
Methylnaltrexone
32
What is methylnaltrexone approved for?
Palliative care patients | Patients on chronic opioid treatment
33
Define Diarrhea
Increase in stool liquidity and/or frequency
34
How many stools a day is considered abnormal?
3 times a day
35
Osmotic Diarrhea Pathophysiology
Non-absorbable substance draws out excess water into the intestines & increases stool weight and volume
36
Secretory Diarrhea Pathophysiology
Mucosal secretion of fluid and electrolytes secondary to bacterial enterotoxins, neoplasms, or exotoxins
37
Motility Diarrhea Pathophysiology
Food is not mixed properly, digestion is impaired and motility is increased Secondary to resection of the small intestine, surgical bypass of an area of intestine or diabetic neuropathy
38
Acute Diarrhea Length
39
Persistent Diarrhea Length
More than 14 days in duration
40
Chronic Diarrhea Length
More than 30 days in duration
41
Clinical Manifestations of Acute Diarrhea
Self-limited Fever Cramping pain
42
Clinical Manifestations of Chronic Diarrhea
Secondary to IBS IBD Malabsorption syndromes
43
Clinical Manifestation of Inflammatory Diarrhea
``` Blood Fever Peritoneal signs Weight loss Pus ```
44
Clinical Manifestation of Non-inflammatory Diarrhea
Diarrhea | Self-limited
45
Most common cause of diarrhea in pregnant women
Listeria
46
Most common cause of diarrhea in daycares
Adenovirus | Norovirus
47
Most common cause of diarrhea in drinking water
Giardia
48
Most common cause of traveling diarrhea
E. coli
49
Treatment for Diarrhea
Cipro (go to) | Flagyl (weird bugs)
50
Leukocytes in the stool would be a sign of what type of bugs?
Invasive bugs
51
Viral Agents for Acute Infectious Diarrhea
Norovirus Rotavirus Adenoviruses Astrovirus
52
Bacterial Culprits for Acute Infectious Diarrhea
``` Salmonella Campylobacter (Guillan Barre) Shigella (blood, fever) Enterotoxigenic E. coli C. difficile ```
53
Protozoa Culprits for Acute Infectious Diarrhea
Cryptosporidium Giardia Cyclospora Entamoeba
54
Sources for Salmonella Diarrhea
``` Beef Pork Poultry Eggs Raw milk Ice cream Vegetables Unpasteurized Orange juice Pet ducklings Lizards Rattlesnake meat ```
55
Sources for Campylobacter Diarrhea
Poultry Raw milk Raw cheeses
56
Sources for Shigella Diarrhea
Daycare centers | Vegetables
57
Sources for Vibrio Cholerae Diarrhea
Shellfish from the Gulf of Mexico Inadequately cooked seafood from South America Coconut milk from Thailand Airline outbreaks
58
Sources for C. Difficile Diarrhea
Hospitalization Inpatient or outpatient antibiotics or chemo within last several weeks Daycare centers
59
Sources for Listeria Diarrhea
``` Beef Pork Poultry Milk cheese Coleslaw Hot dogs Potato salad Pregnancy Neonates Immunocompromised patients ```
60
Sources for Rotavirus Diarrhea
Daycare centers Nurseries Australia
61
Sources for Norovirus Diarrhea
``` Schools Nursing homes Cruise ships Camps Military barracks Vegetables waterborne Foodborne Shellfish-associated outbreaks ```
62
Sources for Hepatitis A Diarrhea
``` Overcrowding Lack of clean water Patient & staff of institutions Daycare centers Men who have sex with men IV drug users Travelers Military barracks Shellfish ```
63
Sources for Adenovirus Diarrhea
Infantile diarrhea | AIDS
64
Sources for CMV Diarrhea
HIV-infected homosexual men with AIDS | Organ transplantation
65
Sources for Giardia Diarrhea
Daycare centers Swimming pools Travel Fruit salad
66
Sources for Cryptosporidium Diarrhea
``` Daycare centers Swimming pools AIDS Farm animal exposure City water supply contamination ```
67
Sources for Cyclospora Diarrhea
Raspberries from Guatemala
68
Non-infectious Agents Acute Diarrhea
Drugs Food allergies Thyrotoxicosis Carcinoid syndrome
69
Indications for Diagnostic Evaluation of Acute Diarrhea
Profuse watery diarrhea with signs of hypovolemia Passage of small volume stools containine blood and mucus Bloody diarrhea Temperature > 101.3 Passage of >6 unformed stools in 24 hours or a duration of illness >48 hours Severe abdominal pain Hospitalized patients or recent use of antibiotics Diarrhea in the elderly or immunocompromised Systemic illness with diarrhea
70
Etiology of Chronic Diarrhea
``` Medications Osmotic Secretory Inflammatory Malabsorptive Motility disorders Chronic infections ```
71
Examples of Medications in Chronic Diarrhea
``` Cholinesterase inhibitors Metformin SSRI's Flexors ARB's PPI NSAIDs ```
72
Examples of Osmotic Issues in Cause Chronic Diarrhea
Malabsorption Lactose, fructose, sucrose Laxative abuse
73
Examples of Secretory Issues in Chronic Diarrhea
Endocrine tumors | Bile salt absorption
74
Examples of Inflammatory Issues in Chronic Diarrhea
Crohn's | Ulcerative colitis
75
Examples of Malabsorptive Disorders in Chronic Diarrhea
Steatorrhea | Vitamin deficiences
76
Example of Motility Disorders in Chronic Diarrhea
IBS
77
Examples of Chronic Infections in Chronic Diarrhea
DM Carcinoid syndromes Collagen/vascular disorders Thyroid issues
78
Causes of Osmotic Diarrhea
Antacids, lactulose, sorbitol Lactose Intolerance Magnesium: antacids, laxitives
79
Clues for Osmotic Diarrhea
Stool volume decreases with fasting | Increased stool osmotic gap
80
Clues for Secretory Diarrhea
``` Large volume (>1L/day) Little change with fasting Normal stool osmotic gap ```
81
Causes of Secretory Diarrhea
Hormonally: carcinoid, medullary CA of thyroid, Zollinger-Ellison syndrome Factitious: phenolphthalein, cascara, senna Villous adenoma Bile salt malabsorption Medications
82
Clues for Inflammatory Diarrhea
Fever Hematochezia Abdominal pain
83
Causes of Inflammatory Diarrhea
IBD Lymphoma Adenocarcinoma Radiation enteritis
84
Clues for Malabsorption Syndrome Diarrhea
Weight loss Abnormal laboratory values Fecal fat
85
Causes of Malabsorption Syndrome Diarrhea
``` Small bowel mucosal disorders: celiac, tropical sprue, Whipple disease, eosinophilic, gastroenteritis, resection, Crohn's Lymphoma Carcinoid Infectious Kaposisarcoma Sarcoidosis Retroperitoneal fibrosis Pancreatic disease Bacterial overgrowth: motility disorders, scleroderma, fistulas, small intestinal diverticula ```
86
Clues of Motility Disorder Diarrhea
Systemic disease | Prior abdominal surgery
87
Causes of Motility Disorder Diarrhea
``` Post surgical: vagotomy, partial gastrectomy, blind loop with bacterial overgrowth Scleroderma DM Hyperthyroidism IBS ```
88
Causes of Chronic Infection Diarrhea
``` AIDS related: CMV, HIV C. difficile Mycobacterium avid complex Giardia, Entamoeba histolytica Microsporida Cryptosporidium Isospora ```
89
Diarrhea Work-Up
``` History: travel, longevity of symptoms, family hx, food intake and relationship to onset CBC TSH CMP ESR CRP Wet mount of stool Guiac ```
90
What are you looking for in a fecal analysis?
``` Fecal leukocytets Fecal occult blood Fecal fats Enteric pathogen cultures C. difficile toxin Ova & parasites ```
91
What are you looking for on a CMP for diarrhea?
Hypoalbumin- malabsorption | Hyponatremia- secretory
92
What are you looking for on an ESR/CRP?
Crohn's ulcerative colitits
93
What are you looking for on a CBC for diarrhea?
Anemia
94
What does the presence of fecal leukocytes indicate?
Bowel mucosal inflammation Invasive bacterial enteritis Ulcerative colitis
95
What bugs are you looking for in a stool for culture & sensitivity?
Enterococcus E. coli Clostridium
96
What do you treat enterococcus, e. coli, clostridium with?
Cipro
97
What bugs are you looking for in a stool ova & parasite study?
Salmonella Shigella Giardia
98
How does a C. diff toxin assay work?
C. diff multiplies and releases toxin that causes necrosis of the colonic epithelium which causes the diarrhea Yellow, mucus stools
99
Which diseases have fecal fat?
Steatorrhea Sprue Crohn's Whipples disease
100
Colonoscopy with Mucosal Biopsy Excludes
IBD Microscopic colitis Colonic neoplasia
101
What is an upper endoscopy looking for?
Celiac sprue | Whipple disease
102
Further Stool Studies
24 hour stool collection | Other imaging
103
What is the most common reason for a 24 hour stool collection?
Patient with IBS who wants a definitive answer
104
Treatment of Diarrhea
``` Fluid replacement Antibiotic therapy Bismuth subsalicylate Opiate antidiarrheal agents Cholestyramine (Questran) ```
105
What is the best way to replace fluids in children?
Pedialyte
106
What is the best way to replace fluids in adults?
1/2 tsp. salt 1 tsp. baking soda 8 tsp sugar 8 oz. orange juice in 1 L of water
107
Most common antibiotic therapy for diarrhea
Cipro Flagyl Bactrim

GI (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions