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2a GP > 6. IBD > Flashcards

6. IBD Flashcards

1
Q

what is the diagnostic criteria for diarrhoea ?

A

stools occur more than 3 times a day, and looser than usual.

Diagnostic levels is 200g/24 hr

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2
Q

at what point is diarrhoea considered chronic?

A

over 4 weeks

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3
Q

possible causes of acute diarrhoea?

A

Infections (often viral or toxins, usually self limiting)

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4
Q

possible causes of chronic diarrhoea?

A

organic
- Celiacs disease
- IBD
- infections
- neoplasms

functional
- IBS
- food allergy
- abuse of drugs or alcohol

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5
Q

what is the difference between organic and functional diarrhoea?

A

both are chronic

Organic diarrhoea can be detected or quantified by testing

Functional diarrhoea cannot be detected or quantified from testing

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6
Q

what are the main differentiating features between organic and functional diarrhoea?

A

organic
- duration ranges
- larger volume
- often blood
- often wakes patient up at night

functional
- over 6 months
- smaller volume
no blood
- often in morning

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7
Q

what are the main differentiating features between diarrhoea cased by small bowel and larger bowel problems?

A

Small bowel
- Larger volume
- Lower frequency
- yellow/grey colour

Large bowel
- Small volume
- Higher frequency
- Blood and mucous in stools

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8
Q

what investigations might you order if a patient presents with diarrhoea ?

A

esophageal endoscopy
Colonoscopy
Biopsies

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9
Q

CLASSIFYING DIARRHOEA BASED ON PATHOLOGY

what is osmotic diarrhoea?

A

water in lumen

Caused by malabsorption eg, celiac or osmotic laxatives

Symptoms resolved with fasting

Osmotic gap is often greater than 100 mOSM/kg

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10
Q

CLASSIFYING DIARRHOEA BASED ON PATHOLOGY

what is secretary diarrhoea?

A

Active secretion of water and electrolytes into lumen via activation of adenylyl/guanylyl cyclase

Caused by bacterial endotoxins eg. E coli or cholera

No response to fasting

No osmotic gap

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11
Q

CLASSIFYING DIARRHOEA BASED ON PATHOLOGY

what is Exudative diarrhoea?

A

Extended inflammatory damage
to intestinal mucosa

Blood and mucous seen

IBD - chrons, UC

No response to fasting

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12
Q

CLASSIFYING DIARRHOEA BASED ON PATHOLOGY

what is Diarrhoea due to altered motility ?

A

increase in peristalsis means less time for reabsorption

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13
Q

what are considered associated symptoms of diarrhoea?

A
  • fever
  • abdominal pain
  • vomiting
  • alternating with constapation
  • dehydration

-extraintestinal manifestations of IBD

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14
Q

what are the extraintestinal manifestations of IBD?

A

Red eyes
Mouth ulcers
Skin rash
Nail changes
Back pain
Urethral discharge
History of IBD
Join pain

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15
Q

what are alarming symptoms of diarrhoea?

A

Weight loss if chronic

Dehydration if acute

Does someone they hang around with have the same symptoms ?

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16
Q

name some differential diagnosis of diarrhoea

A

IBS

infection

diet

medications

HIV

colon cancer

17
Q

list some examples of PMH that are relevant when assessing a patent with diarrhoea

A

Bowel resection
Radiation
Any previous medical disease
Medications
surgery/hospital stays
Allergy

18
Q

list some examples of family history questions that are relevant when assessing a patent with diarrhoea

A

has anyone in your immediate family had….

Colon cancer
IBD
Celiac disease

19
Q

list some examples of social history questions that are relevant when assessing a patent with diarrhoea

A

home/work support
Social status
Sexual history
Smoking
alcohol
recreational drugs

20
Q

what is a stoma?

A

an opening made during surgery.

It connects the bowel to the surface of the tummy.

The stoma is round or oval-shaped, and it looks pink and moist.

Having a stoma means poo (stools) will not pass out of the rectum and anus in the usual way.

Instead, it will pass out of the stoma, into a disposable bag that is worn over the stoma.

21
Q

what are the types of stoma?

A

Colostomy = from an opening in the colon

Ileostomy = from an opening in the small bowel (ileum)

Temporary stoma - can be reversed

permanent stoma - for cancer patients, rarer

22
Q

language for bodily excretions:

is wee, urine or pee preferred?

A

pee

then urine

23
Q

language for bodily excretions:

is stool, poo or faeces preferred?

A

poo

then stool

24
Q

language for bodily excretions:

is fart, passing wind or flatulence preferred?

A

fart

25
Q

what is IBD?

A

referes to ulcerative colitis and crohns.

2a GP (6 decks)

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