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Physical Assessment > Chapter 12, Module 7; Diarrhea > Flashcards

Chapter 12, Module 7; Diarrhea Flashcards

1
Q

Abrupt onset 6-12 hr after exposure; nonbloody, watery diarrhea; lasts <1 wk; nausea/ vomiting, fever, abdominal pain, tenesmus

A

Viral gastroenteritis (e.g., Norwalk or rotavirus viral agents)

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2
Q

In children can see severe dehydration; hyperactive bowel sounds, diffuse pain on abdominal palpation

A

Viral gastroenteritis (e.g., Norwalk or rotavirus viral agents)

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3
Q

DIAGNOSTIC STUDIES FOR Viral gastroenteritis (e.g., Norwalk or rotavirus viral agents)?

A

PCR testing

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4
Q

Acute onset 12-24 hr after exposure; lasts 3-7 days; large amounts of bloody diarrhea with abdominal cramping and vomiting

A

Shigella (gram-negative rod; fecal-oral transmission; common in day care setting)

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5
Q

Lower abdominal tenderness, hyperactive bowel sounds, no peritoneal irritation

A

Shigella (gram-negative rod; fecal-oral transmission; common in day care setting)

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6
Q

DIAGNOSTIC STUDIES FOR Shigella (gram-negative rod; fecal-oral transmission; common in day care setting)?

A

Fecal leukocytes, positive stool culture; PCR testing

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7
Q

Acute onset 2-6 hr after ingestion; lasts 18-24 hr; large amounts of watery, nonbloody diarrhea; cramping and vomiting

A

Staphylococcus aureus food poisoning (gram¬ positive cocci; from improperly stored meats or custard-filled pies)

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8
Q

Hyperactive bowel sounds

A

Staphylococcus aureus food poisoning (gram¬ positive cocci; from improperly stored meats or custard-filled pies)

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9
Q

DIAGNOSTIC STUDIES FOR Staphylococcus aureus food poisoning (gram¬ positive cocci; from improperly stored meats or custard-filled pies)?

A

Fecal leukocytes, negative stool culture; PCR testing

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10
Q

Acute onset 8-20 hr after ingestion; lasts 12-24 hr; large amounts of watery, nonbloody diarrhea; abdominal pain and cramping

A

Clostridium perfringens food poisoning (gram-positive rod; from contaminated food)

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11
Q

Hyperactive bowel sounds, diffuse pain on abdominal palpation

A

Clostridium perfringens food poisoning (gram-positive rod; from contaminated food)

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12
Q

DIAGNOSTIC STUDIES FOR Clostridium perfringens food poisoning (gram-positive rod; from contaminated food)?

A

Fecal leukocytes, negative anaerobic culture of stool; PCR testing

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13
Q

Acute onset 3-5 days after exposure; lasts 3-7 days; moderate amounts of bloody diarrhea

A

Salmonella food poisoning (gram-negative bacilli; ingestion of contaminated food, poultry, eggs)

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14
Q

Fever, lower quadrant abdominal pain

A

Salmonella food poisoning (gram-negative bacilli; ingestion of contaminated food, poultry, eggs)

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15
Q

DIAGNOSTIC STUDIES FOR Salmonella food poisoning (gram-negative bacilli; ingestion of contaminated food, poultry, eggs)?

A

Fecal leukocytes, positive stool culture; PCR testing

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16
Q

Acute onset 8-24 hr after ingestion of contaminated food; lasts 3-5 days; large amounts of nonbloody, watery, painless diarrhea; can be mild or fulminate

A

Vibrio choterae (gram¬ negative rod; fecal-oral transmission; ingestion of contaminated water, seafood, or food)

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17
Q

Cyanotic,scaphoid abdomen, poorskin turgor, thready peripheral pulses,voice faint

A

Vibrio choterae (gram¬ negative rod; fecal-oral transmission; ingestion of contaminated water, seafood, or food)

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18
Q

DIAGNOSTIC STUDIES FOR Vibrio choterae (gram¬ negative rod; fecal-oral transmission; ingestion of contaminated water, seafood, or food)?

A

Fecal leukocytes, negative stool culture; PCR testing

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19
Q

Acute onset 8-18 hr after ingestion of contaminated food/water; lasts 24-48 hr; moderate amounts of nonbloody diarrhea; pain, cramping, abdominal pain; adults in United States generally do not develop illness from enterotoxic E. coli

A

Enterotoxic Escherichia coli (gram-negative rod; fecal-oral transmission; ingestion of contaminated water or food)

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20
Q

No fever; dehydration is major complication

A

Enterotoxic Escherichia coli (gram-negative rod; fecal-oral transmission; ingestion of contaminated water or food)

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21
Q

DIAGNOSTIC STUDIES FOR Enterotoxic Escherichia coli (gram-negative rod; fecal-oral transmission; ingestion of contaminated water or food)?

A

Fecal leukocytes, negative anaerobic culture of stool; PCR testing

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22
Q

Acute onset 12-24 hr after ingestion of contaminated food or water; large amounts of bloody diarrhea; abdominal cramping and vomiting

A

Entamoeba histolytica parasite (cysts in food and water, from feces)

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23
Q

Right lower quadrant abdominal pain; in small number of cases hepatic abscess forms

A

Entamoeba histolytica parasite (cysts in food and water, from feces)

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24
Q

DIAGNOSTIC STUDIES FOR Entamoeba histolytica parasite (cysts in food and water, from feces)?

A

IHA: antibodies to E. histolytica; positive titer is >1:128; PCR testing

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25
Q

Mild, watery diarrhea; crampy abdominal pain

A

Antibiotic-induced diarrhea (begins after taking antibiotics)

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26
Q

Diffuse abdominal pain on palpation, fever absent

A

Antibiotic-induced diarrhea (begins after taking antibiotics)

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27
Q

DIAGNOSTIC STUDIES FOR Antibiotic-induced diarrhea (begins after taking antibiotics)?

A

Usually not needed

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28
Q

Induced by antibiotics, most commonly ampicillin, clindamycin, or cephalosporins; symptoms range from transient mild diarrhea to active colitis with bloody diarrhea, abdominal pain, fever

A

Pseudomembranous colitis (antibiotic-induced Clostridium difficile)

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29
Q

Lower quadrant tenderness, fever

A

Pseudomembranous colitis (antibiotic-induced Clostridium difficile)

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30
Q

DIAGNOSTIC STUDIES FOR Pseudomembranous colitis (antibiotic-induced Clostridium difficile)?

A

CBC: leukocytes; sigmoidoscopy/ colonoscopy; C. difficile toxin assay or stool culture; C. difficile toxin; PCR testing

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31
Q

Children age <4 yr with history of gastroenteritis; history of bloody diarrhea, fever, and irritability

A

Hemolyticuremic syndrome (HUS) (primary cause of HUS in United States is E. coli 0157:H7)

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32
Q

Fever, irritability; can have oliguria or anuria

A

Hemolytic uremic syndrome (HUS) (primary cause of HUS in United States is E. coli 0157:H7)

33
Q

DIAGNOSTIC STUDIES FOR Hemolytic uremic syndrome (HUS) (primary cause of HUS in United States is E. coli 0157:H7)?

A

CBC, platelet count, renal function tests, peripheral blood smear; negative stool culture; PCR testing

34
Q

Premature or low-birth-weight infant who presents with feeding intolerance

A

Necrotizing enterocolitis

35
Q

Vomiting, abdominal distention, lethargy, loose stools with blood and mucous

A

Necrotizing enterocolitis

36
Q

DIAGNOSTIC STUDIES FOR Necrotizing enterocolitis?

37
Q

Gl bleeding 2-3 days postnatal; history of lack of vitamin K injection; history of mother on anticonvulsants prenatally

A

Hemorrhagic disease of the newborn

38
Q

Bruising, ecchymoses, mild to moderate bleeding

A

Hemorrhagic disease of the newborn

39
Q

DIAGNOSTIC STUDIES FOR Hemorrhagic disease of the newborn?

A

Laboratory studies typically show mark¬ edly elevated PT and PTT with depressed levels of vitamin K-dependent factors

40
Q

Intermittent diarrhea alternating with constipation; mucus with stool; seldom occurs at night or awakens patient; commonly present in morning; can have rectal urgency; episodes usually triggered by stress or ingestion of food; affects women three times as often as men

A

Irritable bowel syndrome (IBS)

41
Q

Tender colon on palpation; can have abdominal distention; no weight loss; afebrile

A

Irritable bowel syndrome (IBS)

42
Q

DIAGNOSTIC STUDIES FOR Irritable bowel syndrome (IBS)?

A

Diagnosis of exclusion; sigmoidoscopy, proctoscopy

43
Q

History of severe diarrhea with gross blood in stools, no growth retardation; few reports of pain; age of onset second and third decades with small peak during adolescence; positive family history

A

Ulcerative colitis (distal colon is most severely affected and rectum is involved)

44
Q

Overt rectal bleeding; initially no fever, weight loss, or pain on palpation of abdomen; moderate colitis: weight loss, fever, abdominal tenderness

A

Ulcerative colitis (distal colon is most severely affected and rectum is involved)

45
Q

DIAGNOSTIC STUDIES FOR Ulcerative colitis (distal colon is most severely affected and rectum is involved)?

A

CBC shows leukocytosis or anemia, ESR elevated; stool cultures to rule out other causes of diarrhea; colonoscopy

46
Q

History of chronic bloody diarrhea with abdominal cramping, tenderness, and rectal bleeding; in children a history of growth retardation, weight loss, moderate diarrhea, abdominal pain, and anorexia

A

Crohn disease (associated with uveitis, erythema nodosum)

47
Q

Weight loss; rare gross rectal bleeding; fistulas common

A

Crohn disease (associated with uveitis, erythema nodosum)

48
Q

DIAGNOSTIC STUDIES FOR Crohn disease (associated with uveitis, erythema nodosum)?

A

Colonoscopy with biopsies

49
Q

Bloating, flatus, diarrhea exacerbated by ingestion of certain disaccharides (e.g., lactose, milk, milk products); can follow viral gastroenteritis

A

Carbohydrate malabsorption

50
Q

Diffuse abdominal pain

A

Carbohydrate malabsorption

51
Q

DIAGNOSTIC STUDIES FOR Carbohydrate malabsorption?

A

Trial elimination of offending foods

52
Q

Greasy, fatty, malodorous stools; associated with deficiencies of vitamins K, A, and D; cystic fibrosis

A

Fat malabsorption

53
Q

Rectal prolapse, poor weight gain, abdominal distention

A

Fat malabsorption

54
Q

DIAGNOSTIC STUDIES FOR Fat malabsorption?

A

72-hr fecal fat, sweat test

55
Q

Three or four stools/day; some contain mucus; rare past age 4-5 yr

A

Toddler’s diarrhea

56
Q

Physical examination and growth normal

A

Toddler’s diarrhea

57
Q

DIAGNOSTIC STUDIES FOR Toddler’s diarrhea?

A

Clinical diagnosis

58
Q

Increased stool frequency, looseness, paleness, and bulkiness of stool within 3-5 mo of dietary onset; children are lethargic, irritable, and anorectic; peak frequency 9-18 mo

A

Celiac sprue/protein hypersensitivity (reaction to protein in wheat, rye, barley, and oats)

59
Q

Failure to thrive, abdominal distention, irritability, muscle wasting

A

Celiac sprue/protein hypersensitivity (reaction to protein in wheat, rye, barley, and oats)

60
Q

DIAGNOSTIC STUDIES FOR Celiac sprue/protein hypersensitivity (reaction to protein in wheat, rye, barley, and oats)?

A

IgA anti tTG antibodies Clinical findings, improvement on gluten- free diet, CBC, anemia, folate deficiency, radiography, biopsy

61
Q

Watery, foul diarrhea; common in day care, among travelers

A

Giardia species parasite (primary cause of chronic diarrhea in children)

62
Q

Low-grade fever, weight loss; chronic form: fatigue, growth retardation, steatorrhea

A

Giardia species parasite (primary cause of chronic diarrhea in children)

63
Q

DIAGNOSTIC STUDIES FOR Giardia species parasite (primary cause of chronic diarrhea in children)?

A

Giardia antigen test; PCR testing

64
Q

Recurrent episodes; variable amounts watery, nonbloody diarrhea; amounts can be massive

A

Cryptosporidium species/ Isospora belli protozoan parasites (fecal-oral transmission; ingestion of contaminated water or direct oral-anal contact)

65
Q

Weight loss, severe right upper quadrant abdominal pain with biliary tract involvement

A

Cryptosporidium species/ Isospora belli protozoan parasites (fecal-oral transmission; ingestion of contaminated water or direct oral-anal contact)

66
Q

DIAGNOSTIC STUDIES FOR Cryptosporidium species/ Isospora belli protozoan parasites (fecal-oral trans¬ mission; ingestion of contaminated water or direct oral-anal contact)?

A

Stool for O&P Antigen Test; PCR testing

67
Q

Following Gl surgery, diarrhea occurs after meals because of increased transit of food through colon

A

Postgastrectomy dumping syndrome

68
Q

Diaphoresis and tachycardia

A

Postgastrectomy dumping syndrome

69
Q

DIAGNOSTIC STUDIES FOR Postgastrectomy dumping syndrome?

A

Upper Gl series

70
Q

Nocturnal diarrhea, postprandial vomit¬ ing, fatty stools from malabsorption

A

Diabetic enteropathy

71
Q

Findings associated with diabetes

A

Diabetic enteropathy

72
Q

DIAGNOSTIC STUDIES FOR Diabetic enteropathy?

A

Diagnosis of exclusion in diabetic people

73
Q

Insidious onset, recurrent large amounts of nonbloody diarrhea, mild to moderate nausea/vomiting

A

HIV enteropathy (direct infection of mucosa and neuronal cells in Gl system)

74
Q

Findings associatedwith HIVinfection

A

HIV enteropathy (direct infectionofmucosaand neuronal cells in Glsystem)

75
Q

DIAGNOSTIC STUDIES FOR HIV enteropathy (direct infection of mucosa and neuronal cells in Gl system)?

A

Testing for HIV

76
Q

Mild to moderately severe nonwatery, nonbloody diarrhea

A

Medication-induced diarrhea

77
Q

No specific findings related to diarrhea

A

Medication-induced diarrhea

78
Q

DIAGNOSTIC STUDIES FOR Medication-induced diarrhea?

A

Usually none needed

Physical Assessment (27 decks)

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