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Flashcards in Diarrhea Deck (28)
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1
Q

definition

A

> 3 loose stools daily for 2-3 consecutive days

nocturnal symptoms (ANY nocturnal liquid BM suggests diarrhea)

2
Q

non-inflammatory Diarrhea

A

non-bloody, copious diarrhea (infectious and non infectious_

3
Q

infectious non inflammatory Diarrhea

A

acute, watery, non-bloody diarrhea with bloating, nausea, vomiting and periumbilical pain

suggests toxin

4
Q

diagnosis of non inflammatory Diarrhea

A

stool culture (consideration of C Diff, giardiasis, virus)

fecal fat, stool osmol gap

stool sample = little to no WBC

5
Q

non inflammatory diarrhea management

A

supportive care, underlying cause

aggressive rehydration

antidiarrheal agents (if not concerned for C DIFF)

6
Q

inflammatory diarrhea

A

acute watery, bloody diarrhea, fever with bloating, presence of WBC in stool, periumbilical pain

7
Q

common bacterial causes of inflammatory diarrhea

A
E. coli
Shigella
campylobacter
salmonella
yersinia
8
Q

inflammatory diarrhea management

A

worse outcome

consider empiric abx while awaiting stool culture (cipro + metronidazole, amoxicillin w.augmentin)

9
Q

acute gastroenteritis symptoms

A

nausea with vomiting progressive to diarrhea with abdominal cramping

begin within 24 hrs of ingestion

10
Q

diagnosis of acute gastroenteritis

A

stool culture and ova parasite testing (non resolving symptoms)

11
Q

tx of acute gastroenteritis

A

supportive

if pt is healthy, no bloody diarrhea, no C Diff concern = supportive only

12
Q

food poisoning

A

n/v/d accompanied by fever in setting of recent ingestion of food

13
Q

food poisoning with mostly vomiting etiologies

A

staph aureus
bacillus cerus
norovirus

14
Q

food poising with mostly diarrhea etiologies

A

clostridium perfringens
enterotoxigenic E. coli
cryptosporidium/cyclospora

15
Q

staph aureus

A

symptoms begin within hrs

16
Q

bacillus cerus

A

contaminated rice (I.e. Chinese restaurants)

secretes enterotoxin

17
Q

Rotovirus

A

infants, young children

fecal-oral

watery, non bloody diarrhea + low grade fever

supportive tx and vaccination

18
Q

norovirus

A

outbreaks of gastroenteritis type symptoms due to fecal contaminated water or food, contamination of surfaces, person-person contact

diagnosis stool PCR

cruise ships

19
Q

intestinal parasites

A

diagnosis with stool O and P

transmission thru ingestion of contaminated food or water with feces

protozoa = metronidazole

helminth = mebendazole pr praziquantel

20
Q

first two things to consider when evaluating diarrhea

A
  1. acute (< 2 weeks) or chronic (>4 weeks)
  2. inflammatory or non inflammatory

consider stool culture

21
Q

chronic diarrhea etiologies

A
  1. osmotic
  2. fatty/steatorrhea
  3. secretory
  4. inflammatory
22
Q

fecal fat/stool osmol gap

A

fecal fat measured and suggests malabsorption issue

distinguishes between osmotic and secretory diarrhea

23
Q

secretory diarrhea

A

occurs at night, large volume

use stool osmol gap

24
Q

melanosis coli

A

hyper pigmentation of the colon wall

occurs 2/2 to overuse of laxatives

tx is to stop laxatives

25
Q

giardiasis

A

infectious diarrhea due to GI lambilia

metronidazole

non blood, watery, stomach cramps

“drinks water from a creek”

26
Q

pancreatic insufficiency

A

hx of pancreatic resection or recurrent pancreatitis,

decreased pancreatic enzyme secretion into gut is decreased resulting in malabsorption and chronic diarrhea

27
Q

tx of pancreatic insufficiency

A

supplementation with pancreatic enzymes orally

28
Q

inflammatory diarrhea workup

A

stool culture
stool O/P
consideration of endoscopy

  • chronic blood diarrhea in young adult