Diarrhiea Flashcards

1
Q

What are the time frames for acute vs chronic diarrhoea?

A

<1wk acute
2-4wks persistant
>4wks chronic

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2
Q

What’s the most common cause of diarrhoea in kids?

A

Dysmotility e.g. Toddler’s Diarrhoea or IBS

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3
Q

What are the other 2 major types of chronic diarrhoea?

A

Secretory e.g. Acute Infective Diarrhoea or IBD

Osmotic related to malabsorption

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4
Q

What could cause osmotic diarrhoea?

A

Lactose intolerance
Coeliac
Fat Malabsorption (CF, chronic liver disease or cholestasis)

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5
Q

How does secretory diarrhoea come about?

A

Toxins from infective agents –> Cl- secretion out CFTR –> Water follows into bowel

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6
Q

What organisms can cause secretory diarrhoea?

A

Mostly:
- Vibrio Cholerae
- Enterotoxigenic E.Coli

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7
Q

How does Osmotic Diarrhoea come about

A

Malabsorption –> High solute level in the bowel –> H2O moving into the bowel

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8
Q

What do you want to know in a diarrhoea kids H & E?

A

Age
Onset (sudden or gradual)
FH
Nocturnal Defecation (more likely organic cause)

Growth & weight gain

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9
Q

What tests can you do to narrow down diarrhoea?

A

Stool analysis:
- Appearance
- Culture
- Biochemistry

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10
Q

How would you difffernetiate osmotic from secretory diarrhoea?

A

1) Fasting would stop osmotic
2) Stool analysis
- Osmotic gap high in osmotic (lower Na/K)
- Na/K/Cl low in osmotic (dilution)
- Volume smaller in osmotic
- opps of the aboves are true in secretory

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11
Q

What other symptoms/signs in osmotic diarrhoea would point towards coeliac disease?

A

Abdo bloating
FTT
Short stature
Constipation
Tiredness
Dermatitis Herpetiformis
FH

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12
Q

What tests would you run for Coeliac?

A
  • Abs
  • Genetic tests (HLA DQ2 & 8)
  • Duodenal Biopsy
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13
Q

What Abs are tested for in Coeliac?

A

Anti-Tissue Transglutaminase (TTG)
Anti-Gliadin
Anti-Endomysial

also Serum IgA (As 2% of people have IgA deficiency which would make the specific Abs show up as a false -ve)

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14
Q

How can you diagnose coeliac without a biopsy?

A

Only if:
- Symptomatic
- Anti-TTG >10x normal
- +ve Anti-Endomysial Abs
- +ve HLA-DQ2 or 8

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15
Q

How do you treat Coeliac?

A

Gluten free diet for life

If they onset <2yrs you may want to re-challenge and re-biopsy later

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