Final Exam - Diarrhea + Constipation

Question 1

___ liters of fluid enters proximal small intestine every day

Answer 1

9

Question 2

if small intestine water absorptive capacity is exceeded, _____ overloads the colon, resulting in diarrhea

Answer 2

chyme

Question 3

acute diarrhea is usually caused by ?

Answer 3

infection

Question 4

what is the most common foodborne cause of diarrhea and vomiting?

Answer 4

norovirus

Question 5

______ diarrhea is characterized by a change in active ion transport

a. exudative
b. secretory
c. osmotic
d. altered intestinal transit

Answer 5

b. secretory

Question 6

_____ diarrhea is caused when poorly absorbed substances are retained in intestinal fluids, and results in influx of water and electrolytes into the lumen

a. exudative
b. secretory
c. osmotic
d. altered intestinal transit

Answer 6

c. osmotic

Question 7

most common bacteria in the US

Answer 7

salmonella

Question 8

what is tenesmus?

Answer 8

straining and painful stooling

Question 9

what does the BRAT diet stand for?

Answer 9

bananas
rice
applesauce
toast

Question 10

_____ _____ may be considered for any traveler to prevent traveler’s diarrhea

Answer 10

bismuth subsalicylate

Question 11

when antibiotic prophylaxis is indicated, _____ is recommended for traveler’s diarrhea prevention

Answer 11

rifaximin

Question 12

true or false: antibiotics are recommended for mild traveler’s diarrhea treatment?

Answer 12

false

(not recommended; loperamide or bismuth subsalicylate)

Question 13

antimotility drugs mech of action

Answer 13

activate the mu opioid receptors in bowel to reduce peristalsis and inc segmentation

Question 14

what is the purpose of atropine in Lomotil (diphenoxylate/atropine)?

Answer 14

the side effects of atropine are a deterrent for abusing it

Question 15

true or false: loperamide has CV risks

Answer 15

true

Question 16

psyllium, polycarbophil, attapulgite, and kaloin-pectin mixture are examples of

a. antimotility agents
b. absorbents
c. antisecretory agents

Answer 16

b. absorbents

Question 17

absorbents mech of action

Answer 17

adsorb nutrients, toxins, drugs and digestive juices

Question 18

what is the GI transit time from mouth to anus?

Answer 18

36 hours

(30-40 is the range)

Question 19

acute constipation is less than ____ bowel movements/week

a. 2
b. 3
c. 5
d. 7

Answer 19

b. 3

Question 20

chronic constipation requires symptoms lasting > ____ weeks

Answer 20

6

Question 21

true or false: diabetes, Parkinson’s, CNS injury, and MS can slow down GI motility

Answer 21

true

Question 22

bulk laxatives mech of action

Answer 22

forms emollient gels which retain water, swells, and stimulates bowel movement

Question 23

true or false: Citrucel should be mixed with hot water

Answer 23

false

(cold water)

Question 24

docusate mech of action

Answer 24

decreases fecal surface tension; stool softener

(does nothing for peristalsis)

Question 25

mineral oil mech of action

Answer 25

lubricates lumen of colon

Question 26

mech of action of saline laxatives (milk of magnesia, Mg citrate)

Answer 26

draws fluid into colon which stimulates motility

Question 27

hyperosmotic agents are excellent for ____ constipation a. acute b. chronic

Answer 27

b. chronic

Question 28

true or false: fluoroquinolones are recommended for prophylaxis of traveler's diarrhea

Answer 28

false (not recommended)

Question 29

antibiotic treatment should be used in ____ traveler's diarrhea a. mild b. moderate c. severe

Answer 29

c. severe

Question 30

antibiotic treatment is not recommended in ____ traveler's diarrhea a. mild b. moderate c. severe

Answer 30

a. mild

Question 31

MOA of stimulant laxatives

Answer 31

Locally stimulates enteric nerves which stimulates contractions and mobility; also increases fluid and Na secretion into the lumen

Question 32

glycerin suppositories a. hyperosmotic agent b. stimulant laxative

Answer 32

a. hyperosmotic agent

Question 33

bisacodyl suppositories a. hyperosmotic agent b. stimulant laxative

Answer 33

b. stimulant laxative

Question 34

lubiprostone is a _____ channel activator

Answer 34

chloride

Question 35

lubiprostone (Amitiza) is indicated for what two conditions?

Answer 35

CIC (chronic idopathic constipation in adults) IBS-C

Question 36

linaclotide (Linzess) and plecanatide (Trulance) MOA

Answer 36

guanylate cyclase-C receptor activator

Question 37

metoclopramide and prucalopride are ______ agents

Answer 37

prokinetics

Question 38

patients on opioids should avoid which laxatives?

Answer 38

bulk laxatives

Question 39

methylnaltrexone (Relistor) and naloxegol (Movantik) MOA

Answer 39

mu opioid receptor antagonist

Question 40

when to take naloxegol (Movantik)

Answer 40

1 hr prior to 1st meal or 2 hours after meal