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ICM - Infectious Disease > Diarrhea > Flashcards

Diarrhea Flashcards

(73 cards)

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1
Q

Normal stool volume

A
  • 3 to 7 BM/day

-

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2
Q

Normal stool volume

A
  • 3 to 7 BM/day

-

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3
Q

Acute infectious diarrhea

A
  • 20 to 30 BM/day

- up to 20 liters of stool per day

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4
Q

Diarrhea reflects an increase in what?

A

Water

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5
Q

Reasons for increased water in stool from?

A
  1. Increased intestinal secretion of water

2. Decreased intestinal reabsorption of water

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6
Q

Acute diarrhea duration

A

-

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7
Q

Acute diarrhea duration

A
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8
Q

Persistent diarrhea

A

14-30 days

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9
Q

Chronic diarrhea

A

> 30days

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10
Q

Watery types of diarrhea

A

Secretory, Osmotic, Functional

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11
Q

Secretory description of diarrhea

A
  • nocturnal, persists despite fasting

- microscopic colitis, stimulant laxatives; Senna

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12
Q

Osmotic description of diarrhea

A
  • related to intake

- osmotic laxative; Miralax, Olestra

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13
Q

Functional description of diarrhea

A
  • hypermotility, improves with fasting

- Irritable bowel syndrome

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14
Q

Fatty types of diarrhea

A

Malabsorption, Maldigestion

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15
Q

Malabsorption description of diarrhea

A
  • bloating, gas, steatorrhea

- giardiasis, celiac disease

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16
Q

Maldigestion description of diarrhea

A
  • loss of digestive function; meat fibers

- chronic pancreatitis, cystic fibrosis

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17
Q

Inflammatory types of diarrhea

A

IBD, Invasive, Neoplasia

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18
Q

IBD description of diarrhea

A
  • white blood cells, pus, blood

- Ulcerative colitis, Crohn’s disease

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19
Q

Neoplasia description of diarrhea

A
  • associated weight loss, abdominal pain

- colon carcinoma

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20
Q

Neoplasia description of diarrhea

A
  • associated weight loss, abdominal pain

- colon carcinoma

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21
Q

Acute infectious diarrhea

A
  • 20 to 30 BM/day

- up to 20 liters of stool per day

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22
Q

Diarrhea reflects an increase in what?

A

Water

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23
Q

Reasons for increased water in stool from?

A
  1. Increased intestinal secretion of water

2. Decreased intestinal reabsorption of water

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24
Q

Differentiate diarrhea from

A
  1. Pseudodiarrhea
  2. Fecal incontinence
  3. Overflow incontinence
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25
Acute diarrhea duration
-
26
Protozoa of the colon
-E.histolytica
27
Chronic diarrhea
>30days
28
Watery types of diarrhea
Secretory, Osmotic, Functional
29
Secretory description of diarrhea
- nocturnal, persists despite fasting | - microscopic colitis, stimulant laxatives; Senna
30
Osmotic description of diarrhea
- related to intake | - osmotic laxative; Miralax, Olestra
31
Functional description of diarrhea
- hypermotility, improves with fasting | - Irritable bowel syndrome
32
Fatty types of diarrhea
Malabsorption, Maldigestion
33
Malabsorption description of diarrhea
- bloating, gas, steatorrhea | - giardiasis, celiac disease
34
Maldigestion description of diarrhea
- loss of digestive function; meat fibers | - chronic pancreatitis, cystic fibrosis
35
Inflammatory types of diarrhea
IBD, Invasive, Neoplasia
36
IBD description of diarrhea
- white blood cells, pus, blood | - Ulcerative colitis, Crohn's disease
37
Invasive description of diarrhea
- infectious causes | - Cdiff
38
Neoplasia description of diarrhea
- associated weight loss, abdominal pain | - colon carcinoma
39
Causes of acute diarrhea in healthy adults in developed countries
1. usually viral 2. more severe diarrhea is more likely bacterial 3. protozoa are least common causes
40
Bacteria of the small bowel
-Salmonella, E.coli, C.perfringens, S.aureus, A.hydrophila, B.cereus, V.cholerae
41
Virus of the small bowel
-Rotovirus, Norovirus
42
Protozoa of the small bowel
-Cryptosporidium, Microsporidium, Isospora, Cyclospora, Giardia
43
Problems resulting in the anus
- anal fissure - sentinel pile - fistula - anorectal ulcers
44
Virus of the colon
-Cytomegalovirus, adenovirus, herpes simplex
45
Protozoa of the colon
-E.histolytica
46
Stuff that results in dysentery
-salmonella, E.coli, campylobacter, shigella, E.histolytica
47
Stuff that has a preformed toxin
-C.perfringens, S.aureus, B.cereus
48
Stuff that has an entertoxin
-V.cholerae
49
Stuff that has an enteroadherent
-Giardia
50
Stuff that has a cytotoxin
-C.difficile, E.coli 0157
51
Review three slides with tables
Go to packet
52
History of diarrhea
1. Onset.....of abnormal bowel movements 2. Frequency 3. Presence....of blood, mucus 4. Awoken...in the night for BM 5. Associated....symptoms 6. Exposures 7. Antibiotic...use recently
53
Bristol stool chart Type 1
Separate hard lumps, like nuts
54
Description of C.difficile
- toxin mediated colitis caused by overgrowth of C diff in colon - pseudomembranous colitis
55
Bristol stool chart Type 3
Like a sausage but with cracks on the surface
56
Bristol stool chart Type 4
Like a sausage or snake, smooth and soft
57
Bristol stool chart Type 5
Soft blobs with clear-cut edges
58
Bristol stool chart Type 6
Fluffy pieces with ragged edges, a mushy stool
59
Bristol stool chart Type 7
Watery, no solid pieces. Entirely liquid
60
Physical exam
1. vital signs 2. general 3. abdominal exam 4. musculoskeletal 5. skin 6. rectal exam
61
Muscles surrounding the anus and rectum
- pelvic floor muscle - internal anal sphincter - external anal sphincter
62
Problems resulting in the anus
- anal fissure - sentinel pile - fistula - anorectal ulcers
63
Role of testing in acute diarrhea
1. routine stool culture 2. ova/parasites 3. endoscopy
64
Role of testing in acute diarrhea for ova/parasites
- persistant diarrhea - persistant diarrhea following travel to Russia, Nepal - persistant diarrhea with exposure to infants in daycare centers - diarrhea in a man MSM or AIDS - a community waterborne outbreak - blood diarrhea with few or no fecal leukocytes
65
Oral rehydration
0.5 tsp salt 0.5 tsp baking soda 4 tblsp sugar Per liter of water
66
Symptomatic Therapy
- Anti motility agents - loperamide(Imodium) - Diphenoxylate(Lomotil) - Bismuth subsalicylate(Pepto-bismol)
67
Probiotics
-Align, Culturelle
68
Dietary alterations
- avoid dairy(temporary loss of lactase) | - low residue diet(white foods, cooked vegetables, low fat meats)
69
Empiric antibiotics
- fluoroquinolone | - metronidazole
70
Description of C.perfringens
- enterotoxin produced by bacteria in small intestine | - acute gastroenteritis symptoms
71
Description of C.botulinum
- paralytic neurotoxin formed by bacteria present in anaerobic environment - weakness, diplopia, progresses to paralysis
72
Description of C.tetani
- excitatory neurotoxin formed by bacteria present in wounds | - "lockjaw"
73
Description of C.difficile
- toxin mediated colitis caused by overgrowth of C diff in colon - pseudomembranous colitis

ICM - Infectious Disease (4 decks)

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