F3: Fecalysis (Part 1: Intro-Mechanisms of Diarrhea)

Question 1

Familiarize the importance of fecalysis

Answer 1

For detection of
* Bleeding in the GIT
* Disorders in the liver and biliary duct
* Maldigestion/malabsorption syndromes
* Pancreatic diseases
* Inflammation in the GIT
* Causes of diarrhea and steatorrhea
* Infestation by bacteria, viruses, and parasites

Question 2

IMPORTANCE OF FECALYSIS

Which is/are false regarding importance of fecalysis

a. Bleeding in the GIT
b. Disorders in the liver and heart
c. Maldigestion/malabsorption syndromes
d. Heart diseases
e. Inflammation in the GIT
f. Causes of diarrhea and steatorrhea
g. Infestation by bacteria, viruses, and parasites

Answer 2

b. Disorders in the liver and heart
d. Heart diseases

Question 3

IMPORTANCE OF FECALYSIS

• Tests which detects bleeding in the GIT
• Detects minor amount of blood in the stool

Answer 3

Fecal occult blood test (FOBT)

Question 3

This organ produces bile, it is responsible for the digestion of fats

Answer 3

Liver

Question 4

IMPORTANCE OF FECALYSIS

T or F

In case of biliary obstruction, stercobilin and urobilinefficiently comes out

Answer 4

F (In case of biliary obstruction stercobilin & urobilin cannot come
out)

Question 5

IMPORTANCE OF FECALYSIS

2 pigments that gives the stool its characteristic color

Answer 5

Stercobilin, Urobilin

Question 6

IMPORTANCE OF FECALYSIS

In biliary obstruction, since there is absence oef sertcobilin and urobilin, the stoll appears as ?

what specific term

Answer 6

Acholic

absence of substance that produces pigment ( pale, yellow, grayish)

Question 7

IMPORTANCE OF FECALYSIS

Absence of substance that produces stool pigment

Answer 7

Acholic

Question 8

IMPORTANCE OF FECALYSIS

Stool color produced in biliary obstruction

Answer 8

pale, yellow, grayish

Question 9

IMPORTANCE OF FECALYSIS

• Due to pancreatic insufficiency
• Food are not breakdown easily
• Not fully digested and not fully absorbed

Answer 9

Maldigestion

Question 10

IMPORTANCE OF FECALYSIS

T or F

If not fully digested = not fully absorbed

Answer 10

T

Question 11

IMPORTANCE OF FECALYSIS

Refers to large amounts of fats in the stool

Answer 11

Steatorrhea

Question 12

COMPOSITION

Familiarize the following composition of stool

Answer 12

• Bacteria
• Cellulose and other undigested foodstuffs
• Gastrointestinal secretions
• Bile pigments
• Cells from the intestinal walls
• Electrolytes
• Water

Question 13

COMPOSITION

(1) Food enters the mouth and is incorporated with what making it into a bolus

Answer 13

Incorporated with saliva

Question 14

COMPOSITION

(2) What is the product formed when food is incrporated with saliva?

Answer 14

Bolus

Question 15

COMPOSITION

(3) After formation of bolus, it travels down to where

Answer 15

Esophagus

esophageal sphincter will open and let the bolus into the stomach

Question 16

COMPOSITION

(4) Esophageal sphincter in esophagus allows bolus to enter in what organ of the body?

Answer 16

Stomach

Question 17

COMPOSITION

The acidity of the stomach is by the action of?

Answer 17

Hydrochloric acid

Question 18

COMPOSITION

(5) The bolus will incorporate with the digestive juices (stomach fluid) will result to formation of?

Answer 18

Chyme

Question 19

COMPOSITION

(6) After mixing with jucies in stomach, it will proceed to what next organ? and what part of that organ?

Specific

Answer 19

Small intestine (Duodenum)

Question 20

• First part of the small intestine
• Responsible for breaking down of food

What organ is this

Answer 20

Duodenum

Question 21

COMPOSITION

(7) After passing through duodenum, what other 2 sections of the small intestine does it pass through?

Answer 21

Jejunum, Ileum

Question 22

COMPOSITION

2 parts of the small intestine that is responsible for the absorption of nutrients to the bloodstream

Answer 22

Jejunum, Ileum

Question 23

COMPOSITION

(8) After the small intestine, it would go to the large intestine, which consists of what (4) parts?

clue: A T D S

Answer 23

Ascending, Transverse, Sescending and Sigmoid colon

Question 24

# COMPOSITION (9) Organ where further absoportion of water takes place

Answer 24

Colon

Question 25

# COMPOSITION (10) After the colon, it would be transmitted to the (blank) and eventually will enter (blank)

Answer 25

Rectum Anus

Question 26

# COMPOSITION T or F When the ascending colon is filled with fecal matter, it will be stimulated to enter the rectum, then the anus

Answer 26

F (When the **descending colon** is filled with fecal matter, it will be stimulated to enter the rectum, then the anus)

Question 27

# COMPOSITION (11) Is considered to be last part of digestion

Answer 27

Anus

Question 28

# COMPOSITION While the food is in the small intestine, these (2) other organs will release enzymes to further break down the food

Answer 28

* Liver * Pancreas

Question 29

# COMPOSITION Length of small intestine?

Answer 29

20 ft long

Question 30

# FECAL FORMATION Volume of secretions that enter the GIT/day

Answer 30

9000 mL (8-10L)

Question 31

# FECAL FORMATION Volume of secretion that reaches the large intestine

Answer 31

500mL to 1,500mL

Question 32

# FECAL FORMATION Volume of secretion that large intestine can absorb

Answer 32

up to 3000mL

Question 33

# FECAL FORMATION Normal stool volume?

Answer 33

100-150mL

Question 34

# FECAL FORMATION T or F The reason why initial volume (9000ml) is reduced to 500-1500 mL is due to excretion of nutrients and substances

Answer 34

F (The reason why initial volume (9000ml) is reduced to 500-1500 mL is due to absorption of nutrients and substances)

Question 35

# FECAL FORMATION Abnormal condition where: * Increased frequency of defecating (>3 times a day) * Increased liquidity (watery stool) * > 200g/day

Answer 35

Diarrhea

Question 36

# CLASSIFICATIONS OF DIARRHEA What are the (4) parameters in classifying diarrhea

Answer 36

* Illness duration * Mechanism * Severity * Stool characteristics

Question 37

# CLASSIFICATIONS OF DIARRHEA Classification of diarrhea that determines if diarrhea is either acute or chronic

Answer 37

Illness duration

Question 38

# CLASSIFICATIONS OF DIARRHEA Acute or Chronic Diarrhea? * sudden onset * < 4 weeks

Answer 38

Acute Diarrhea | Illness duration

Question 39

# CLASSIFICATIONS OF DIARRHEA What are the 3 mechanisms of diarrhea | Mechanism ## Footnote clue: SOA

Answer 39

* Scretory * Osmotic * Altered motility

Question 40

# CLASSIFICATIONS OF DIARRHEA Severity of diarrhea can either be? | dalawa

Answer 40

Mild or Severe

Question 41

Mechanism of diarrhea referring to hypermotility

Answer 41

Altered motility

Question 42

# MECHANISM OF DIARRHEA * Increased secretion of water * Bacterial, viral and protozoan infestation produce increased secretion of water and electrolytes * Caused by organisms that produce toxin * Stools are water and voluminous * Contributes even when there is no oral food intake * It is caused by microorganism toxin

Answer 42

Secretory Diarrhea

Question 43

# MECHANISM OF DIARRHEA In secretory diarrhea, this causes electrolyte channel to prolong its opening (Specifically chloride channel since the toxins make the channels prolong their opening, the chloride will keep on going out) | SECRETORY DIARRHEA

Answer 43

Toxins produced by the microorganisms

Question 44

# MECHANISM OF DIARRHEA Toxins produced by microorganisms microorganisms cause a. Electrolyte channel to prolong closing b. Potassium channel is affected, hence sodium then water will follow c. both d. NOTA | SECRETORY DIARRHEA

Answer 44

d. NOTA ## Footnote TO BE CORRECT, IT SHOULD BE: Toxins from microorganisms cause a. Electrolyte channel to prolong **OPENING** b. CHLORIDE channel is affected, hence sodium then water will follow

Question 45

T or F Secretory diarrhea still can happen even if you do not eat anything for a few days because of the toxin in the system

Answer 45

T

Question 46

# MECHANISM OF DIARRHEA Stool result of patient can possibly be positive to what (3) parameters | SECRETORY DIARRHEA

Answer 46

WBC, RBC, mucus

Question 47

# Causes of Secretory diarrhea (3) Microorganisms that cause secretory diarrhea? | clue: VEG

Answer 47

* Vibrio cholerae (eneterotoxigenic toxin) * Enterotoxigenic e. coli * Giardia lamblia

Question 48

# Causes of Secretory diarrhea T or F Invasive diarrhea causes secretory diarrhea

Answer 48

T

Question 49

# Causes of Secretory diarrhea (2) examples of bacteria causing invasive diarrhea which also leads to secretory diarrhea are what?

Answer 49

Salmonella, shigella

Question 50

# Causes of Secretory diarrhea Causes of Secretory diarrhea a. drugs (stimulant laxatives) b. Hormones, inflammatory bowel disease c. both d. NOTA

Answer 50

c. both

Question 51

# Causes of Secretory diarrhea What are the hormnes or inflammatory diseases that cause secretory diarrhea?

Answer 51

* Crohn disease * Ulcerative colitis * Lymphocytic colitis * Diverticulitis

Question 52

Familiarize Causes of Secretory diarrhea

Answer 52

* Vibrio cholerae (enterotoxigenic toxin) * Enterotoxigenic E. coli * Giardia lamblia * Invasive diarrhea * Drugs, stimulant laxatives * Hormones, inflammatory bowel disease

Question 53

# MECHANISM OF DIARRHEA * Results from the presence of osmotically active, poorly absorbed solutes in the bowel lumen that inhibit normal water and electrolyte absorption * Increased retention of water and solute in the large intestine due to an **enzyme deficiency** * Associated with malabsorption and maldigestion * Watery and gaseous stool with NO WBC, RBC, and mucus * Positive for the substance that is not reabsorbed * Presence of undigested food

Answer 53

Osmotic Diarrhea

Question 54

# CAUSES OF OSMOTICALLY ACTIVE SUBSTANCE What are the 2 causes of osmotically active substances

Answer 54

* Maldigestion * Malabsorption

Question 55

# CAUSES OF OSMOTICALLY ACTIVE SUBSTANCE * Enzyme deficiency * Ex. lactose intolerance - deficient of lactase whic breaks down lactose in simple forms

Answer 55

Maldigestion

Question 56

# CAUSES OF OSMOTICALLY ACTIVE SUBSTANCE * Comes together with maldigestion * In order for you to absorb a substance, it should be in the simplest form * If you cannot digest properly, you will not be able to absorb it.

Answer 56

Malabsorption

Question 57

# Causes of Osmotic diarrhea Familiarize the Causes of Osmotic diarrhea

Answer 57

* Disaccharide deficiency (lactose intolerance) * Pancreatic insufficiency: pancreas does not produce that is necessary to breakdown the food Malabsorption (celiac disease, tropical sprue) Poorly absorbed sugars (lactose, sorbitol, mannitol) Laxatives

Question 58

T or F Fasting does not stop osmotic diarrhea

Answer 58

F (Fasting **DOES** stop it)

Question 59

# MECHANISM OF DIARRHEA * Describes conditions of either enhanced motility (hypermotility) or slow motility (constipation) * Can be seen in patients with **irritable bowel syndrome (IBS)**

Answer 59

Altered Motility

Question 60

# MECHANISM OF DIARRHEA * A functional disorder in which the nerves and muscles of the bowel are extra sensitive * Causes cramping, bloating, flatus, diarrhea and constipation * Can be triggered by food, chemicals, emotional stress and exercise | ALTERED MOTILITY

Answer 60

Irritable bowel syndrome (IBS)