Diarrhea (Self Care)

Question 1

Acute Diarrhea is classified as

Answer 1

fewer than 14 days of symptoms

Question 2

Persistent Diarrhea is classified as

Answer 2

14 days to 4 weeks

Question 3

Chronic DIarrhea is classified as

Answer 3

More than 4 weeks

Question 4

How is Acute Diarrhea generally treated?

Answer 4

WIth management of fluid and electrolyte replacement, dietary interventions, and nonprescription drug treatment.

Question 5

What may be causes for Acute Diarrhea?

Answer 5

Poisoning, medications, intolerance of certain foods, or various non-GI acute or chronic illness

Question 6

What virus constitutes the most common cause of diarrheal illness in adults and children, with highest incidence in children <5 years of age?

Answer 6

Noroviruses (occurs year-round)

Question 7

What virus causes gastroenteritis in patients all ages; Most common cause of SEVERE diarrhea in infants and young children?

Answer 7

Rotavirus

Question 8

How is Norovirus spread

Answer 8

-Most often transmitted by contaminated water or food
-Also from person to person through contact w/ contaminated environmental surfaces
-

Question 9

How is Rotavirus spread and some adverse effects from it?

Answer 9

-fecal-oral route
-Can cause severe dehydration and electrolyte disturbances, may result in death

Question 10

Where is the suspected site of infection if PTs diarrhea is watery

Answer 10

Small intestine
(caused by toxin-producing pathogens)

Question 11

Where is the suspected site of infection if PTs diarrhea is bloody (dysentery-like)

Answer 11

Large intestine

Question 12

Are any nonprescription therapies available to manage diarrhea caused by protozoa (ex. Entamoeba histolytica)

Answer 12

No, self-management is inappropriate in this case

Question 13

How does someone get Traveler’s diarrhea?

Answer 13

Acquired mainly through ingestion of contaminated water and/or food

Question 14

Bacterial and Viral pathogens have an incubation of ______

Answer 14

6-72 hours
Result in quicker onset of diarrhea

Question 15

Protozoal pathogens have an incubation period of _____

Answer 15

1-2 weeks
Onset of diarrhea rarely seen in first few days

Question 16

List the 4 classifications of diarrhea

Answer 16

-Osmotic
-Secretory
-Inflammatory
-Motor

Question 17

What are the classifications/mechanisms of acute diarrhea?

Answer 17

Osmotic
Secretory

Question 18

What are the classifications/mechanisms of chronic diarrhea?

Answer 18

Motor
Inflammatory

Question 19

Undigested food particles in stool suggest disease of the _____ _______

Answer 19

Small Intestine

Question 20

Black, tary stools may indicate ______

Answer 20

Upper GI Bleeding

Question 21

What does red stool suggest

Answer 21

-Lower bowel or hemrrhoidal bleeding
-Recent ingestion of red foods (beets) or drug products

Question 22

Many small-volume stools suggests ________

Answer 22

Colonic disorder

Question 23

Yellowish stools indicate ______

Answer 23

Presence of bilirubin and potentially serious pathology of the liver

Question 24

Whitish tint to stool suggests _____

Answer 24

Fat malabsorption disease

Question 25

What age range of children are most likely to suffer from complications that require hospitalization

Answer 25

Children 2 years old and younger

Question 26

How many bowel movements within 24 hours can potentially lead to loss of fluids and result in circulatory collapse and renal failure in 2 month old infants

Answer 26

8-10 bowel movements

Question 27

What is the initial self-management with mild to moderate uncomplicated diarrhea? (FIRST-LINE TREATMENT)

Answer 27

Focus on fluid and electrolyte replacement with oral rehydration solutions (ORS)

Question 28

Is self-care during pregnancy appropriate?

Answer 28

No

Question 29

2 phases that oral treatment can be carried out

Answer 29

Rehydration therapy Maintenance therapy

Question 30

True or False: ORSs are proven to provide benefit to adults with mild diarrhea who can maintain an adequate fluid intake ?

Answer 30

False: while they are highly recommended, there is little evidence of support when given to otherwise healthy adults who can maintain an adequate fluid intake

Question 31

Why are premixed products preferred for use in children

Answer 31

They are safe and convenient

Question 32

Which ORS therapy type potentially reduces stool volume by 20%-30% in children with cholera

Answer 32

Cereal-based ORS therapy

Question 33

What medication is recommended to provide protection against travelers' diarrhea

Answer 33

Bismuth subsalicylate (BSS)

Question 34

What ages in children can use nonprescription loperamide

Answer 34

6 years and older

Question 35

Name a non prescription antidiarrheal opioid agonist that provides symptomatic relief of acute, nonspecific diarrhea

Answer 35

Loperamide

Question 36

What are drug interactions reported with loperamide

Answer 36

P-gP inhibitors (quinidine)

Question 37

Agent FDA approve for management of ACUTE diarrhea

Answer 37

Bismuth subsalicylate (BSS)

Question 38

What age range for children is the use of BSS safe

Answer 38

children 12 years and older

Question 39

What is the function of BSS

Answer 39

exerts antidiarrheal effects that reduce fluid and electrolyte losses, frequency of unformed stools, nausea, vomiting

Question 40

Why should the use of BSS in children be cautioned

Answer 40

Possible Reye syndrome

Question 41

What patient population is BSS contraindicated with

Answer 41

Pts with AIDs

Question 42

What drug interactions exist with BSS

Answer 42

-Radiopaque/Radiographic studies -Aspirin -Warfarin (toxicity) -Valproic acid -Methotrexate

Question 43

What are the self-care treatment recommendations for children <5 years old

Answer 43

-ORS therapy -Antidiarrheal agents are NOT recommended

Question 44

What are the self-care treatment recommendations for geriatric patients (>65 years)

Answer 44

-Self-treatment w/ antidiarrheal medications is STRONGLY cautioned against - Patients should be referred if diarrhea is severe

Question 45

What are the self-care treatment recommendations for pregnancy

Answer 45

-Self-treatment w/ non prescription antidiarrheals is INAPPROPRIATE -Referral

Question 46

What is the function of Probiotics

Answer 46

-Release antimicrobial substances in the intestines -Produce acids (ex. lactic acid) and short-chain fatty acids that lower intestinal pH and suppress growth of pathogenic bacteria -Enhance mucosal barrier integrity and immune responses

Question 47

What population can benefit from the use of probiotics

Answer 47

immunocompetent adults and children

Question 48

When are probiotics used/effective

Answer 48

preventing/treating mild acute, uncomplicated diarrhea, in previously healthy infants and children

Question 49

Are probiotics ideal for management of moderate to severe diarrhea

Answer 49

No, not enough evidence to support this

Question 50

How do major adverse effects of probiotics present in older patients

Answer 50

-Systemic Infections (critically ill, immunocompromised patients, patients with bowel diseases)