Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CSI > A case of diarrhoea > Flashcards

A case of diarrhoea Flashcards

1
Q

What is the definition of diarrhoea?

A
  • Three or more loose or liquid stools per 24 hours and or
  • Stools that are more frequent than usual for the individual lasting more than 14 days and or
  • Stool weight greater than 200g/day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is diarrhoea classified?

A
  • Acute (<14 days)
  • Persistent (>14 days)
  • Chronic (>4 weeks)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why does diarrhoea occur?

A

When there’s decreased absorption or increased secretion of fluid and electrolytes, or an increase in bowel motility meaning a greater than usual amount of fluid is excreted in the faeces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the two categories of diarrhoea?

A

Inflammatory and non-inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is inflammatory diarrhoea?

A

Diarrhoea caused by the presence of an inflammatory process eg. bacterial, viral or parasitic infection or due to bowel ischaemia, radiation injury or IBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the characteristics of inflammatory diarrhoea?

A
  • Mucoid and bloody stool
  • Tenesmus
  • Fever
  • Severe crampy abdominal pain
  • Small in volume with frequent bowel movements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the most common cause of infectious diarrhoea in the US?

A

Bacterial infection: campylobacter, salmonella, shigella, E.coli, C. difficile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are common causes of acute diarrhoea in developing countries?

A

Protozoa and parasites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What would a stool examination of inflammatory diarrhoea show?

A

Leukocytes, positive faecal occult blood test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What would the histology of the GI tract in inflammatory diarrhoea look like?

A

Abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the characteristics of non-inflammatory diarrhoea?

A
  • Watery
  • Large-volume
  • Frequent stool >10-20 per day
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is not present in non-inflammatory diarrhoea?

A
  • Tenesmus
  • Blood in the stool
  • Fever
  • Faecal leukocytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the GI histology like in non-inflammatory diarrhoea?

A

Preserved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can non-inflammatory diarrhoea be further sub-divided into?

A

Secretory and osmotic diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is secretory diarrhoea?

A

When there’s an altered transport of ions across the mucosa which results in increased secretion and decreased absorption of fluids and electrolytes from the GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Does fasting decrease secretory diarrhoea?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some of the causes of secretory diarrhoea?

A
  • Enterotoxins: infections such as vibrio cholerase, staphylococcus aureus, E.coli, HIV and rotavirus
  • Hormonal agents: vaso-active intestinal peptide, small-cell cancer of the lung, neuroblastoma
  • Laxative use, intestinal resection, bile salts and fatty acids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is osmotic diarrhoea?

A

Unabsorbed or poorly absorbed solute in the intestinal tract that causes an increased secretion of liquids into the gut lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the stool volume like in osmotic diarrhoea?

A

Stool volume is relatively small (compared with secretory diarrhoea) and diarrhoea improves with fasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What can osmotic diarrhoea be further divided into?

A

Maldigestion and malabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is maldigestion?

A

Impaired digestion of nutrients within the intestinal lumen or at the brush boarder membrane of mucosal epithelial cells

Seen in pancreatic exocrine insufficiency and lactase deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is malabsorption?

A

Impaired absorption of nutrients

Seen in small bowel overgrowth, mesenteric ischaemia, post bowel resection (short bowel syndrome) and in mucosal disease (coeliac disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How much fluid should normally be excreted in faeces?

A

0.1L

24
Q

What are the enterocytes?

A

Cells lining the large and small intestines

25
Q

Give an overview of the different forms of diarrhoea and whether they’re enterocyte or luminal issues

A
  • Inflammatory diarrhoea: problem with the enterocytes meaning they’re unable to absorb compounds from the lumen, lots of fluid left in the lumen
  • Secretory diarrhoea: channels in the enterocytes are activated meaning solutes in the enterocytes will cross into the lumen therefore water will be retained in the lumen eg. cholera- cystic fibrosis transmembrane conductance regulator is activated meaning Cl- and Na+ pass into the lumen
  • Osmotic maldigestion: compounds aren’t digested (broken down) meaning they can’t be absorbed eg. lactose intolerance
  • Osmotic malabsorption: compounds aren’t absorbed properly eg. laxative effect of prunes, sorbitol present which isn’t absorbed by enterocytes meaning water is retained in the lumen
26
Q

How does oral rehydration solution work?

A

Insert a solution of 2:1 Na+:glucose into the colon which causes SGLT1 transporters to take the compounds across into enterocytes, leading to movement of water from the lumen into the enterocytes

27
Q

What does SGLT1 stand for?

A

Sodium glucose linked transporter 1

28
Q

Why does diarrhoea lead to death?

A

Due to massive dehydration

29
Q

What is a functional cause of diarrhoea?

A

There are no known structural changes causing the patient’s symptoms aka. IBS
Non-progressive and non-fatal

30
Q

What is an organic cause of diarrhoea?

A

There is a structural change causing diarrhoea eg. IBD, colon cancer, coeliac disease

31
Q

What are the symptoms of IBD?

A
  • Weight loss
  • Fever
  • Blood in the stool
32
Q

What are the symptoms of IBS?

A
  • Alternating constipation and diarrhoea
  • Mucus in stool
  • Bloating
33
Q

What are the symptoms of IBS and IBD?

A
  • Abdominal pain
  • Faecal urgency- feels the need to open their bowels
  • Fatigue
34
Q

What is the function of a FBC?

A

To look for anaemia and signs of inflammation/ infection

35
Q

What is the function of a urea and electrolytes test?

A

To check renal function and electrolyte status

36
Q

What is the function of examining CRP?

A

To look for infection/ inflammation

37
Q

What would red, fresh blood in the stool indicate?

A

A lower GI bleed

38
Q

What would darker blood in the stool indicate?

A

An upper GI bleed, as the blood has been digested

39
Q

How would the bleeding from stomach ulcers manifest?

A

Either in vomit or as darker blood in the stool

40
Q

What is the function of a fecal occult blood test?

A

A test that looks for traces of blood that aren’t visible to the human eye

41
Q

What is the function of a LFT?

A

A liver function test, albumin levels are also obtained: low albumin can indicate an acute inflammatory process, can also be used as a surrogate marker for malnutrition- low albumin suggests malnourishment

42
Q

How can thyroid function affect diarrhoea?

A

Hyperthyroidism can lead to diarrhoea

43
Q

Which antibody is screened for in coeliac disease?

A

Tissue transglutaminase antibody

44
Q

What do stool tests screen for?

A

Microbiology, ova and cysts associated with parasite disease, faecal calproctectin

45
Q

Why should stool samples be repeated even if an initial sample has come back negative?

A

Because ova a cysts are shed intermittently, need to take three samples two days apart

46
Q

What is faecal calproctectin?

A

A surrogate marker for inflammation in the bowel, it indicates migration of neutrophils into the intestinal mucosa

47
Q

When would faecal calproctectin be raised?

A

Coeliac, colon cancer and IBD as it doesn’t detail the site or extent of inflammation- non-specific test

48
Q

What is the difference in location between crohn’s disease and ulcerative colitis?

A

look up pic

Crohn’s can occur anywhere along the GI tract

49
Q

What are granulomas?

A

Collections of neutrophils

50
Q

Which tissue layers does Crohn’s disease affect?

A
  • Mucosa
  • Submucosa
  • Muscularis
  • Serosa
51
Q

Which tissue layers does ulcerative colitis affect?

A

Just the mucosa

52
Q

What can treatments for conditions be split into?

A
  • Conservative
  • Medical
  • Surgical
53
Q

Why does smoking worsen Crohn’s disease?

A

It causes small areas of infarction in the gut

54
Q

Why is smoking protective in ulcerative colitis?

A

It dampens the immune system

55
Q

What is the conservative management for Crohn’s disease?

A
  • Smoking cessation
  • Dietary advice
  • Psychological support
  • Patient support groups
56
Q

What is the medical management for Crohn’s disease?

A

Acute/ flare up:
- Corticosteroids

Long-term:
- Biologics: monoclonal antibodies

57
Q

What is the surgical management of Crohn’s disease?

A

Patients at risk of fistulas and strictures as all layers of the bowel are affected, often not used as a first line treatment as the chance of the patient needing surgery again later on is high
Bowel re-section

CSI (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions