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Flashcards in kiddy diarrhea Deck (35):
1

def dia

increased stool fluid content above normal
- over 3 loose/lquid stools per day

2

location of villi

small and large bowel

3

how much fluid enters colon and how much is absrobed

1.5-2L/day - 90% absrobed

4

most important ion for flow

Na

5

main pump and 3 main mech that pull H2o into body

Na/K pump
1. SGLT-1 - glucose/Na cotransporter pulls Na and glucose in from lumen
2. Na comes in from electro selective Na channels
3. Anion co-exchanger (Cl/CO3)

6

Main secretory channel

CFTR - pushes Cl into lumen and Cl and Na come into enterocyte - pushes NA out

7

what is net water movement

follows the gradient that has been created

8

4 mech that affect electrolytre movement

1. enteric nervous system
2.lamina propria cells
3. mucosal epi cells - somatostatin
4. blood

9

what is important molecule that increases absorbtion

aldosterone - increases Na absorbtion via Na/K pump

10

how do most substances affect gut levels

via secretion

11

what are 3 main messangers involved in secretons

1. cAMP
2. cGMP
3. Ca/kinase

12

how do they work (2)

1. inhib. Na/CL influx
2. increase Cl efflux

13

what part of lumen is most absorbtion and secretion

absorb - villi
secrete -crypt
- since there are more villi than crypt, get fluid absorbtion1

14

2 types of villous problems with absorbtion

1. too little time to absorb
2. not enough ville (destructions)

15

def osmotic diarrhea

too much solute pulls water into gut
- proportional to intake of solute
- stool ion gap high
- not usually too bad

16

3 things that might cause osmotic

1. carbs
2, fat
3. protein

17

2 possible cause of them being there and one possible outcome

1. lack of disgestion
2. lack of absorbtion
- can ferment and cause gas

18

what are only carbs that can be absorbed without digestion

glucose and fructose

19

what happens to fats

1. emulsified by bile to micelles
2. hydrolized to fatty acids
3. absorbed via passive diffusion

20

what happens to chol.

special transport protein

21

what happens to protein

hydrolyzed by various proteases then taken up as di/tri peptides or AAs

22

def secretory diarrhea

increase in enterocyte secretion

23

features of secretory

large volume
- no response to fasting
- colon responses vary

24

2 mech of sectetory

1. increased secondary messangers
2. loosening of the tight junctions

25

3 cause of diarrhea

motility

26

main cause of acute diarrhea

infection
- enteric or extraintestinal

27

def. chronic diarrhea

>14 days

28

what is main question to ask

are they still growing?
- if so, probably not bad

29

7 "zebra" causes

1. protein indegestiokn
2. fat assimilation
3. bile acid disorders
4. general malabsorb
5. pancreatic insuff.
6. immune based
7. defects in electrolyte transport

30

9 common causes (other than infection)

1. diet - sorbitol
2. meds
3. pancreatic insuff. -CF, inflammation
4. bile acid disorders - too little or too much
5. carbo malabsorbtion
6. immune based - celiac, IBD,
7. motility disorders - hirschprung, thyrotoxicosis
8. neoplastic
9. surgical

31

important questions on Hx

1. age of onset
2. duration freq
3. birth Hx
4. diet
5. stool
6. med and fam Hx

32

5 exam points

1. growth and demeanor
2. clubbing
3. nasal polyps
4. skin integrity
5. perianal appearance

33

3 most common cause in finfants

1. formula intolerance
2. CF
3. immunodef. states

34

3. most common causes in toddlers

1. post-infetious enteritis
2. diet related
3. celiac

35

3 most common in older

1. celiac
2. lactose
3. IBD

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