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Exam 1 > Diarrhoea > Flashcards

Diarrhoea Flashcards

1
Q

Diarrhoea first line

A

Loperamide - opioid agonist

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2
Q

Diarrhoea resolve after milk & products removed?

A

Coeliac disease - gluten, lactose

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3
Q

Hypomagnesaemia leads to?

A

high intestinal loses eg IBD, diarrhoea

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4
Q

Duration of diarrhoea why?

A
  • longer = higher chance of dehydration

* differentiation of acute or chronic. Bacterial or viral.

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5
Q

Other association in Diarrhoea?

A
  • blood in stool = IBS, UC, cancer
  • bright red = burst blood vessel less concerning
  • dark tar-like, coffee ground blood = UC, CD
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6
Q

Mucus in stool - diarrhoea?

A

• bacterial food poisoning, E-coli, shingella, salmonella

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7
Q

Actue diarrhoea duration?

A

<14 days

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8
Q

Chronic diarrhoea duration?

A

> 14 days

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9
Q

What is diarrhoea?

A
  • change in normal bowel habit, => increased frequency of bowel movements & passage of salt watery stools
  • osmotic pressure forces water into gut
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10
Q

Infants with diarrhoea - refer?

A

• refer to GP if >1 day due to dehydration risk

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11
Q

Children with diarrhoea - refer?

A

• refer to GP if >2 days - dehydration risk

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12
Q

older children/adults with diarrhoea - refer?

A

• refer to GP if >3 days

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13
Q

Referral for diarrhoea despite taking loperamide?

A

• 24h & it didn’t work

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14
Q

Bacteria causes diarrhoea by?

A

• invasive - attacks mucosal cells, cause diarrhoea with blood & pus

  • non-invasive - doesn’t directly damage the gut, endotoxins produced disrupting secretion.
  • more common
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15
Q

Recent travel & diarrhoea

A

abroad - unfamiliar bacteria, diff hygiene standards

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16
Q

diarrhoea caused by drugs?

A

antibiotics, NDAIS, Fe therapy, metformin. laxative misuse, alcohol increases bowel movement

17
Q

Red flags in diarrhoea?

A

• sudden, unexplained kg loss

18
Q

dehydration from diarrhoea symptoms

A
  • skin spring back after pinch?
  • dry mouth
  • passing urine okay?
  • urine output, colourless?
  • dizziness
  • confusion
  • heart rate increase
  • breathing rate increase
  • unconscious
19
Q

Mr XY, a 29-year-old male, visits your community pharmacy and asks if she can buy something for diarrhoea. Discuss the additional information you require from Mr XY explaining the rationale to aid your differential diagnosis.

A
  • duration - acute, chronic, dehydration risk
  • other association eg blood, mucus
  • bacterial or viral - invasive or non-invasive
  • travel?
  • drugs - NSAIDs, antibiotics, Fe therapy, metformin
  • drug abuse - alcohol, laxative
  • food intolerance
  • sudden kg loss - red flag
  • dehydration - dry mouth, dizziness, confusion.
20
Q

A simple case of acute diarrhoea following a BBQ at the weekend, what pharmacological and non-pharmacological advice you would give.

A

Pharma:
• Oral Rehydration Therapy - satches after passing stool
• electrolytes
• loperamide 4mg if they feel it would help, max 16mg

Non-pharma
• drink water, rest, hygiene
• dont share towels
• wash hands
• avoid spicy foods, caffeine, carbonated drinks, giving stomach more work
• give it a few days to pass. >week = consult GP
• stay off work 48h
• plain carbs, BRAT - banana, rice, apples, toast
• cook meat properly

21
Q

Non - pharmacological advice in diarrhoea

A
  • drink water, rest, hygiene
  • dont share towels
  • wash hands
  • avoid spicy foods, caffeine, carbonated drinks, giving stomach more work
  • give it a few days to pass. >week = consult GP
  • stay off work 48h
  • plain carbs, BRAT - banana, rice, apples, toast
  • cook meat properly
22
Q

Severe hydration therapy?

A

IV fluids & hospitalisation

23
Q

Opioid pharmacology in diarrhoea

A
  • acute diarrhoea
  • short term use
  • slows does peristalsis & opens anus to help store faeces better & decrease sensitivity
24
Q

Loperamide pharmacology in diarrhoea

A
  • reduce peristalsis & increase intestinal transit time

* decrease gut secretions & increase anal sphincter tone

25
Q

Loperamide dose, time?

A
  • 4mg initially
  • 2mg for up to 5 days after
  • 16mg max
26
Q

Oral rehydration example

A
  • Dioralyte - contains rice to make stool harder
  • mixed with water
  • 200ml in child
  • 200-400ml in adult
27
Q

If loperamide first line ineffective?

A
  • codeine 30mg QDS

* loperamide & codeine combination therapy

28
Q

children w diarrhoea treatment?

A
  • normal milk
  • plenty of fluid
  • ORT
  • prevent spread
  • avoid school 48hours
  • avoid swimming for 2 weeks
29
Q

Diarrhoea causes

A
  • infection
  • drug SE
  • acute IBD or IBS
  • Mg2+ - laxative antacids
30
Q

RED FLAGS in diarrhoea

A
  • rectal bleeding
  • unexplained kg loss
  • persistent
  • systemic illness
  • newly started antibiotic/treatment
  • travel

Exam 1 (11 decks)

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