Chronic Diarrhea- Case conference

Question 1

quantify the amount of liquid being screted as gastric juice

Answer 1

2.5 L/d

Question 2

amount of liquid created

Answer 2

7 L/d

Question 3

amount of fluid that enters the GI system

Answer 3

9-Aug

Question 4

the small bowel reabsorbs ____of fluid

Answer 4

6-7 L/d

Question 5

the large bowel reabsorbs ____of fluid

Answer 5

1-2 L/d

Question 6

how much fluid is sereted in stool

Answer 6

1%, 100mL/d

Question 7

list the 4 important types of chronic diarrhea

Answer 7

osmotic, secretory/watery, inflammatory, fatty

Question 8

ions such as magnisum ans sulphate cause ______type of diarrhea. State another substance that causes the same effect

Answer 8

osmotic, phosphate

Question 9

sugars/ alcohol sugars i.e. mannitol,sorbitol lactase deficiency cause __________type of diarrhea

Answer 9

osmotic

Question 10

disordered electrolyte transportation describes this type of diarrhea

Answer 10

secretory

Question 11

after any gastroenteritis theres a transiet lactase deiciency, state the type of diarrhea that follows

Answer 11

osmotic

Question 12

which type of diarrhea stops during fasting

Answer 12

osmotic

Question 13

malabsorption or secretion of electoyles is characteristic of this type of diarrhea

Answer 13

secretory

Question 14

diarrhea thatÕs persistant during fasting

Answer 14

secretory

Question 15

which is more severe, osmotic or secretory diarrhea, state the stool gap both each

Answer 15

secretory has larger volume, it has normal stool osmotic gap no inflammation. Osmotic has high stool osmotic gap, positive for leukocytes and is less severe than secretory

Question 16

state two inflammatory causes of secretory diarrhea

Answer 16

microscopic colotis, intestinal ischemia

Question 17

state different tyoes of infalmatoy diarrhea

Answer 17

IBD, ischemic colotis, malignancy

Question 18

state 4 different infectious causes of inflammatory diarrhea

Answer 18

invasive bacterial/ parasitic, pseudomemranous colotis, ulcerating viral infections

Question 19

state two bacterial causes for inflammatory diarrhea

Answer 19

yersinia, TB

Question 20

state two inflammatory diarrhea causes that are parasitic in origin

Answer 20

amebiasis, stronglyoids

Question 21

pseudomembranous colotis is a cause of

Answer 21

c diff

Question 22

the only parasite that can cause chronic diarrhea and may cause fatty diarrhea

Answer 22

giardia

Question 23

celiac sprue, and whipple disease are both causes of

Answer 23

malabsorption thus fatty diarrhea

Question 24

name two pathologes od increased motility

Answer 24

IBS, hyperthyroidism

Question 25

peripheral neruopathy and easy brusiing is suggestive of whicch tpy wof diarrhea?

Answer 25

fatty

Question 26

blood, ,mucus, pus and small volume are all signs of

Answer 26

inflammatory chronic diarrhea

Question 27

medications must be stiooed for _____to rule out the cause

Answer 27

2 weeks

Question 28

3 causes of clubbing related to this block

Answer 28

liver cirrhosis, IBS, celiac disease

Question 29

dermatitis herpetiformis is a skin lesion that suggests

Answer 29

celiac disease

Question 30

erythema nodsum/ pyoderma gangrenosum are suggestivve of

Answer 30

IBD

Question 31

hyperpigmentation is a sign of

Answer 31

addisions disease

Question 32

whats pathognomic for celiac disease

Answer 32

anti-transglutaminase IgA Ab, anti-endomyseal IgA Ab

Question 33

other than leykocytes whats another marker for infllmation

Answer 33

calprotectin

Question 34

fecal occult blood, what is uspected?

Answer 34

Crohns disease

Question 35

if fat is suspected, which tet is usally performed

Answer 35

sudan

Question 36

musosal atrophy is characterisitic of

Answer 36

celiac disease

Question 37

T or F, empiritc course of antibotics is helpful in chronic diarrhea

Answer 37

not usefull, false

Question 38

if antibiotics are diven in chronic diarrhea, a complication might be

Answer 38

Hemolytic uremic syndrome

Question 39

bile acidting resins are used in pts with

Answer 39

liver disease

Question 40

clonidine is used in pts with

Answer 40

diabetic diarrhea

Question 41

name a somatostatin analogue used in carcinoid syndrome, dumping syndrome, AIDS diarrhea

Answer 41

octreotide

Question 42

whats the best marker for amalbsorption

Answer 42

albumin

Question 43

Abnormal small intestine mucosa due to intestinal reaction to _________is known as celiac disease

Answer 43

gliadin

Question 44

whats the only autoimmune disease in which androgen alpha gliadine recognized

Answer 44

celiac

Question 45

celiac disease is also associated with other diseases like

Answer 45

thyroid and DM type 1

Question 46

important markers for celiac disease, which is better?

Answer 46

HLA DQ2 HLADQ8, 2 is more important

Question 47

celiac disease is most severe this part of the bowel, and result in defiency 3

Answer 47

proximal, Fe,Ca, folic acid

Question 48

if pt isn't compliant on a gluten free diet, state the prognosis of such a pt

Answer 48

lymphoma, carcinoma of the bowl

Question 49

deep ulcers on biopsy may suggest

Answer 49

chrons disease

Question 50

state another symptom of this disease , then mention what it is1. foully fatty stoolÓ steatorrhea 2. Acanthocytosis (spiked RBCs) 3. Low cholesterol

Answer 50

abetalipoproteinemai, ataxia

Question 51

state 3 definitions for diarrhea

Answer 51

_ Increased stool water content / fluidity _ Increased stool weight: > 200 gm/d _ 3 or more BMs daily than usual stool habit.

Question 52

how much fluid us ingested

Answer 52

1-2 L/d