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Section 9: Gastrointestinal Disorders > Chapter 73: Disorders Presenting Primarily With Diarrhea > Flashcards

Chapter 73: Disorders Presenting Primarily With Diarrhea Flashcards

1
Q

Amount to tell if acute diarrhea?

A

10ml/kg/d

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2
Q

What is diarrhea?

A

An increased frequency of defecation, usually greater than 3 bowel movements per day for a daily stoll weight exceeding 250grams

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3
Q

In normal conditions, how many ml fluids is lost in the stool per day?

A

<100ml

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4
Q

Intestinal absorption occurs through the ____, and secretion occurs through the ____

A

Intestinal absorption occurs through the villi, and secretion occurs through the crypts

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5
Q

Two mechanism of fluid absorption and which of this is affected with toxin?

A

Passively with the transport of sodium which are afffected with toxin and actively with the absorption of glucose

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6
Q

In diarrheal states, enterotoxins, inflammation, or ischemia. Which are more affected, villi or crypt?

A

Villi so decrease absorption. Cryspts are more resilient after injury

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7
Q

Diarrheal illness is primarily a?

A

Diarrheal illness is primarily a viral infection (norovirus)

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8
Q

This drug stimulates small bowel motility

A

Clavulanate

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9
Q

How can you say if it acute or chronic diarrhea?

A

Acute (<3 weeks) whihc are of greatest concern or chronic (>3 weeks)

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10
Q

Patient with diarrhea had seizure episode. What is your diagnosis?

A

Shigellosis
Theophylline toxicity
Hyponatremia

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11
Q

After rural hiking, patient had diarrhea. What is your diagnosis?

A

Giardiasis

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12
Q

Reiter’s syndrome, the triad of arthritis, conjunctivitis, and urethritis or cervicitis

A

Salmonella, Shigella, Campylobacter, or Yersinia infection

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13
Q

An elderly patient presented at ED with bloody diarrhea and abdominal pain that is out of propoprtion. What will you suspect?

A

Mesenteric ischemia

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14
Q

The most common cause of antibiotic-associated or nosocomial diarrhea

A

Clostridium difficile

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15
Q

Patient had diarrhea and cough. Upon xray shows pneumonia. What is the cause?

A

Legionella

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16
Q

Fluid of choice for diarrhea patient that can tolerate oral feeding

A

Glucose- containing, caffeine-free beverages are the fluids of choice example is Gatorade

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17
Q

The major bacteria responsible are the toxin- and non–toxin-producing diarrhea is

A

E. coli

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18
Q

What symptoms need microbiologic studies to rule out bacterial or amoebic infection?

A
  • Severe abdominal pain
  • Fever
  • Bloody stool
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19
Q

It is recommended treatment for all patients believed to have an infectious diarrhea

A

Ciprofloxacin

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20
Q

Complication of shiga toxin-producing E.coli in children

A

Hemolytic uremic syndrome

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21
Q

First choice for use in South and Southeast Asia. Safe for children and pregnant women

A

Azithromycin 1000mg as single dose

22
Q

Treatment for E. histolytica diarrhea?

A

Metronidazole 750 milligrams PO three times a day for 10 days AND paromomycin 10 milligrams/kg three times a day PO for 7 days

23
Q

Implicated in reducing the inci- dence of C. difficile infection if taken concomitantly with antibiotics but have no role in treating active or recurrent disease

A

Probiotics

24
Q

Treatment for Salmonella non-typhi diarrhea?

A

Ciprofloxacin 750 milligrams PO twice a day for 5 days

Azithromycin 500 milligrams PO once a day for 7 days

25
Q

Treatment for Shigella diarrhea?

A

Ciprofloxacin 750 milligrams PO twice a day for 3 days

Azithromycin 500 milligrams PO once a day for 3 days

26
Q

How many days after start of antibiotic will diarrhea start in C. difficile infection?

A

7 to 10 days

27
Q

Gold standard in diagnosis of C. difficile infection?

A

Cell culture cytotoxicity using selective growth medium

28
Q

It is diagnostic procedure use if patient cannot produce a stool specimen due to ileus or negative assay

A

Colonoscopy

29
Q

Primary treatment for C. difficile infection

A

Fidaxomicin (macrolide antibiotic) 200 milligrams PO twice a day for 10 days

30
Q

Mild C.difficile (WBC <15,000mm3) diarrhea can be treated with

A

Vancomycin 125 milligrams PO four times a day for 10 days

31
Q

What part of the GI is most commonly involved in crohn’s disease?

A

Ileum

32
Q

The peak incidence of crohn’s disease occurs at what age group?

A

15-22 y/o

33
Q

It worsens the crohn’s disease

A
  • Smoking
  • Oral contraceptive use
  • NSAIDs
34
Q

The most important pathologic feature of Crohn’s disease is?

A

The involvement of all the layers of the bowel and extension into mesenteric lymph nodes

35
Q

What are the 3 general types of Crohn’s presentation?

A
  • Inflammatory
  • Stricture
  • Penetrating
36
Q

Crohn’s disease should also be considered in the differential diagnosis of patients with ____

A

Crohn’s disease should also be considered in the differential diagnosis of patients with fever of unknown etiology

37
Q

This laboratory use to monitor disease activity

A

CRP and ESR

38
Q

The best modality for imaging perianal fistulae in crohns disease

A

pelvic MRI

39
Q

The diagnostic modality of choice for biliary complications in crohns disease

A

Ultrasound

40
Q

How to confirm diagnosis of crohns disease?

A

Colonoscopy

41
Q

Treatment for mild to moderate crohn’s disease

A

Sulfasalazine 3-5gm/day

42
Q

If patient with crohns disease is medically resistant. What to give?

A

Anti-tumor necrosis factor antibodies

  • infliximab
  • adalimumab
  • certolizumab gel
43
Q

Complications of biologics drug for crohns disease?

A

Tuberculosis and hepatitis B

44
Q

The most common reason for emergent surgery in Crohn’s disease

A

Obstruction. The distal small bowel is the most common site

45
Q

The characteristic symptom of ulcerative colitis is ____

A

Bloody diarrhea

46
Q

Part of GI that involved in the vast majority of ulcerative colitis patient

A

Rectosigmoid area

47
Q

Can be effective in fulminant colitis nonresponsive to IV corticosteroids

A 
IV cyclosporine (4 milligrams/kg per day)
Infliximab (5 to 10 milligrams/kg per dose)
48
Q

The only biologic indicated for ulcerative colitis

A

Infliximab (5 milligrams/kg per dose)

49
Q

Most common complication of ulcerative colitis?

A

Blood loss from sustained hemorrhage

50
Q

Plain radiograph of abdomen in toxic megecolon. You can see what?

A
  • Air-filled colon greater than 6 cm in diameter

- Loss of colonic haustra and thumb printing

Section 9: Gastrointestinal Disorders (17 decks)

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