17. diagnostic approach to diarrhea. principles of treatment

Question 1

types of diarrhea

Answer 1

osmotic diarrhea
secretory diarrhea
exudative diarrhea
dysmotility

Question 2

osmotic diarrhea

Answer 2

undigested nutrient in lumen - water follows

overeating, maldigestion, malabsorption

Question 3

secretory diarrhea

Answer 3

enterocytes produce increased amount of fluids

effect of toxins, bacteria

Question 4

exudative diarrhea

Answer 4

increased permeability of mucosa

fluid, RBC, WBC, protein leak into lumen

Question 5

dysmotility

Answer 5

paralysis, atony of intestines - silent gut

secondary to dysbiosis, neoplasm, inflammation

Question 6

classification of diarrhea

Answer 6

duration: acute - chronic
etiology: intestinal - extraintestinal
location: Small bowel - large bowel - diffuse
severity: self limiting - life threatening

Question 7

SI vs LB

Answer 7

volume: SI high, watery. - LB small, dense
mucous: si rare - lb common
blood: si melena - lb fresh
fat: si sometimes - lb no

Question 8

extra intestinal causes

Answer 8

disorder of other organ: EPI, liver, bile
toxic effet: liver - kidney fail, endotoxemia
systemic: distemper, leptospirosis

Question 9

lab test - extra intestinal causes

Answer 9

routine lab: liver, kidney, pancreas

specific lab: endocrine

Question 10

lab test - severity

Answer 10

PCV, TP, lactate

dehydration, electrolytes

Question 11

lab test - SI function

Answer 11

malabsorption, PLE? hypoalbuminemia

Question 12

lab test - location in SI

Answer 12

cobalamin test: decreased conc in distal SID

folate test: decreased conc in proximal SID

Question 13

general treatment

Answer 13

fluid therapy 
diet 
adsorbent, protectant 
prebiotic 
AB 
Immunosuppression