7. DIARRHEA Flashcards

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1
Q

Definition

Cut off ng acute & chronic

A

Acute – lasting for a few hours or days

Chronic (persistent) – lasting for >2 weeks

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2
Q

PATHOGENESIS or MECHANISMS OF DIARRHEA
S.O.M.I.

Secretory

A

Secretagogue (e.g. Cholera toxin) binds to receptor on the surface of the epithelium of the bowel to stimulate

—> intracellular accumulation of cAMP or cGMP

—> leading to excessive secretion of Chloride or Bicarbonate with decreased absorption of Sodium and Water

(+) watery, large volume fecal outputs, painless

PERSISTS WITH FASTING

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3
Q

PATHOGENESIS or MECHANISMS OF DIARRHEA
S.O.M.I.

Osmotic

A

Ingestion of osmotically active or poorly absorbed solute which draw enough fluid into the lumen to exceed the reabsorptive capacity of the colon

(+) watery acidic stools

LAXATIVES, LACTULOSE

Resolves with fasting

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4
Q

PATHOGENESIS or MECHANISMS OF DIARRHEA
S.O.M.I.

Motility

A

Inc. Intestinal Motility meaning decreased ang intestinal transit time which is normally 72 hours (up to 72 hours)

IBS, Thyrotoxicosis, Postvagotomy Dumping Syndrome

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5
Q

PATHOGENESIS or MECHANISMS OF DIARRHEA
S.O.M.I.

Inflammatory

A

Inflammatory mediators can DESTROY MUCOSAL LINING DECREASING ABSORPTIVE SURFACE leading to osmotic diarrhea & allow passage of RBCs and WBCs.

Mediators can also trigger a secretory type of diarrhea by increasing net secretion

infections: Infectious: Salmonella, shigella, amebiasis, Yersinia etc

Non-infectious: IBD, autoimmune, Crohn’s disease, Ulcerative colitis

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6
Q

Dysentert

A

Shigella

TMP + SMX

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7
Q

Zinc

A

<6 mos 10 mg more than six months give 10 mg

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