Test 1: Diarrhea and Dehydration Flashcards Preview

4th Semester: MOD > Test 1: Diarrhea and Dehydration > Flashcards

Flashcards in Test 1: Diarrhea and Dehydration Deck (46):
1

Which type(s) of diarrhea have a net loss of sodium?

Secretory

and

Malabsorptive/Maldigestive

2

All types of diarrhea have net losses of

these three components

Water

Potassium

Bicarbonate

3

Which type of diarrhea DOES NOT

have a net loss of sodium?

Osmotic

4

If your body has low body water or high plasma osmolality, it is experiencing

Dehydration

5

What are the two types of osmoles, and which type can diffuse across membranes?

Effective and Ineffective

Effective can diffuse across membranes

6

The names of the types of dehydration

reflect the tonicity of the ______ after water is lost

ECF

7

What can cause Hypertonic dehydration?

Osmotic diarrhea

M/M diarrhea

8

What can cause Isotonic Dehydration?

Diarrhea

Renal disease

9

What can cause HYPOtonic dehydration?

Secretory diarrhea (like calf scours)

Vomiting

3rd space loss (GI atony or displaced abomasum)

10

What is the most common type of dehydration seen clinically?

HYPOtonic dehydration

(loss of electrolytes > water loss)

11

If you see an increase in PCV (packed cell volume) and TP (total protein)

in conjunction with

an increase in Na+ AND Cl-

what type of dehydration do you have?

HYPERtonic dehydration

12

If you see an increase in PCV (packed cell volume) and TP (total protein)

but serum concentrations of both

Na+ and Cl- do not change

what type of dehydration do you have?

Isotonic dehydration

13

If you see an increase in PCV (packed cell volume) and TP (total protein)

but only Na+ decreases

what type of dehydration do you have?

HYPOtonic dehydration

14

How does the body respond to dehydration?

By releasing stimulating the RAAS to combat hypovolemia

and by releasing ADH to combat the change in

osmolality

15

Describe the mechanism for

hypernatremia in osmotic diarrhea

In osmotic diarrhea, nonabsorbable solutes

accumulate in the gut lumen causing

water to move from the plasma into the gut.

Plasma becomes hypertonic due to hypernatremia

16

Where does absorption primarily occur?

Enteric villi

17

Where does secretion primarily occur?

Intestinal crypts

18

What are the 4 pathophysiologic mechanisms of diarrhea?

Osmotic (malabsorptive/maldigestive)

Secretory

Exudative (Increased Permeability)

Altered Motility

19

What would you expect to see for lab results

in the case of isotonic dehydration?

Osmolality?

Sodium? Chloride?

Urine Specific Gravity?

PCV?

Normal Osm, Na+, Cl-

Increased PCV and USG

20

What would you expect to see for lab results

indicating Hypertonic Dehydration?

Osmolality?

Sodium?

Chloride?

BUN- blood urea nitrogen?

USG?

PCV?

Increase in all of them!

21

What would you expect to see for lab results

indicating HYPOtonic Dehydration?

Osmolality?

Sodium?

Chloride?

USG?

PCV?

Decrease in ALL except PCV, which would be increased

22

How is corrected chloride calculated?

Corrected Cl- =

(Normal average Na+/Measured Na+) x Measured Cl-

23

If chloride and sodium are not at their usual

1:1 ratio,

what does that indicate?

An acid-base disturbance

24

What are the causes of

hypotonic dehydration?

Secretory diarrhea (ETEC calfs, scours)

Vomiting

3rd space loss (GI Atony, Displaced abomasum)

25

What are causes of HYPERtonic dehydration?

Osmotic diarrhea

Maldigestion/Malabsorption

Diabetes

26

What are the causes of Isotonic Dehydration?

Some diarrheas

Some renal diseases

27

In dehydration, fluid from the ___ is lost first,

then ____ fluid is lost

In dehydration fluid from the ECF is lost first,

then intracellular fluid is lost

28

ALWAYS THINK OF CHLORIDE (Cl-)

AS _________

ALWAYS THINK OF CHLORIDE

AS AN ACID

29

What can cause a Metabolic Alkalosis in regards to

chloride?

Loss of chloride rich (acid-rich) fluids:

Vomiting

Ptyalism

 

Sequestration of chloride rich fluids:

Abomasal atony, GDV, Displaced abomasum

30

This type of diarrhea occurs when

excessive amounts of solute are retained in the intestinal lumen. Water moves from the plasma into the lumen and diarrhea results

Osmotic (Malabsorption/Maldigestion)

31

This type of diarrhea

occurs when a chemical (usually produced by a pathogen) prolongs the opening of chloride channels on the enterocytes an allows uncontrolled secretion of water from the crypt cells.

Secretion of water exceeds absorption of water

in the intestinal lumen

SECRETORY diarrhea

32

This type of diarrhea occurs when

there is destruction of the mucosal epithelium.

Inflammation results which causes release of inflammatory mediators and cytokines and secretion is stimulated. In addition, the destruction results in loss of tight junction function increasing permeability

and causing diarrhea

Exudative (increased permeability) diarrhea (inflammatory diarrhea)

33

VILLOUS ATROPHY

is associated with

this type of diarrhea

Osmotic/Malabsorptive

34

How is D-Lactate formed?

In osmotic diarrhea, food is not properly digested or absorbed in the intestines. Because of this, the colon has to try to ferment the undigested food resulting in an acidic colonic environment,

which results in increased activity of lactobacillus.

Lactobacillus produces D-Lactate and the crypt cells increase secretion of water and solute to compensate resulting in diarrhea

35

Damage to VILLOUS TIPS which

causes proliferation of immature crypt cells

is associated with this type of diarrhea

Secretory!

36

What is the only type of diarrhea that

does not cause sodium loss?

Osmotic diarrhea

37

Exocrine pancreas insufficiency and transmissible gastroenteritis in pigs

causes this type of diarrhea

Osmotic/Malabsorption/Maldigestion

Decreased pancreatic enzymes = unable to properly digest food

 

Inflammation causes villous attenuation and blunting = cannot properly absorb nutrients

38

This type of diarrhea stops when the patient is fasted

Osmotic/Malab/Maldig

39

ETEC calves usually have this type of diarrhea

Secretory

40

Rhodococcus equi induced enterocolitis, an

inflammatory disease in foals

presents with this type of diarrhea

Exudative (increased permeability) diarrhea

41

A horse with diarrhea

has severe hyponatremia, hypochloridemia,

and HYPERkalemia.

 

Approximately how many days has this horse had diarrhea for?

These are values for an ACUTE diarrhea

so

less than 6 days

42

What is the most important finding in a horse

with chronic diarrhea (>4 weeks)?

Persistent LOW normal K+ values

43

What tube is best for measurement of lactate?

GRAY TOP Tube for lactate

44

On the bloodwork for an ETEC calf, what should you expect to see?

Dehydration (increased PCV)

Hypoglycemia (due to sepsis)

low pH (acidosis)

Hyper D and L-Lactatemia

Decrease in sodium, chloride, potassium (sometimes) and bicarb

45

What is the BEST test for indentifying

increased serum D-lactate?

LOSS of

PALPEBRAL REFLEX

46

A 2 yr old lab has a history of vomiting and inappetance. There is a disproportionate loss of

chloride compared to sodium.

What type of dehydration.

What is you Dx?

Metabolic alkalosis due to

vomiting and a proximal GI obstruction