CSI Crohns/Diarrohea

Question 1

how much water do you ingest?

Answer 1

1-2 L

Question 2

How much water is secreted?

Answer 2

6-7L

Question 3

How much water is excreted?

Answer 3

0.1ml

Question 4

define diarrohea

Answer 4

3+ loose stools per 24hr

acute >1/7
persistant >14/30
chronic > 1/12

Question 5

pathology causes of diarrohea:

Answer 5

• increase in secretion
• decrease in absorption
• increase bowel motility

Question 6

divisions of diarrohea:

Answer 6

inflam (pathogens causing dysfunction)
non inflam-> secretory (more scereted eg cholera toxin) & osmotic (less solutes to take water across/ suck more water in) –> maldigestion (lactose intolerance or pancreatic exocrine insufficency, slutes cannot cross so water sucked in/cannot follow) & malabsorption (epsom salts).

Question 7

Stool size in secretory vs osmotic

Answer 7

small in inflammatory and big in non inflammatory

Question 8

Test to distinguish secretory from osmotic

Answer 8

Osmotic Stool Gap Test

Question 9

Osmotic stool gap test: explain, equation

Answer 9

concentration of Na +K in lumen. 290 - 2(Na + K). In secretory it is less than 50 since more solutes will follow water as it is secreted. So bigger 2(Na + K). In osmotic, 2(Na + K) is less since water is drawn in through indigestable solutes which dilutes.

Question 10

What happens in inflam diarrohea?

Answer 10

endothelial dysfunction because of the pathogens. WBcs ROS incraese inflam, so less absorption

Question 11

What happens in secretory inflam?

Answer 11

incraesed secretion and less absorption. eg chloera. cholera toxin incraeses adenylate cyclase -> increase amp and incraese opening of chloride ions for longer time. more water secreted

Question 12

what is osmotic? 2 types

Answer 12

osmotic: less absorption from lack of solutes/enzymes
maldigestion: intolerance and pancreatic enzyme insufficency.
malabsorption: lack of ions/epsom salts, short bowel syndrome, bacterial overgrowth.

Question 13

Drugs for specific types of diarrohea

Answer 13

SGLT1 transporters -> incraesed absorption.
NSAIDs for inflam
maldigestion: enzyme supplements
malabdorptione: rehydration therapy

Question 14

IBS VS IBD

Answer 14

IBS: Group of symtoms with iritable bowel with triggers. “ mucus, constipation+diarrohea, bloated”
IBD: group of infalammatory disorders “ blood in poo, weight loss,fever “
both: fatigue, pain,faecal inconsistency

Question 15

investgations for diarrohea

Answer 15

Blood FBC, CRP, U&E, LFT, COELIAC SEROLOGY :TTG (tissue transglutaminase antibody)
Stool sample: FIT, microculture, faecal calprotectin (inflam in bowel)

CT Abdo + colonoscopy/biopsy

Question 16

4 differences in uc VS crohns

Answer 16

Crohns:
* non-continuous vs continous
* cobblestone vs pusedosysts
* down into muscularis vs mucosa
* non-caeseating vs crpyt abcesses

Question 17

treatment levels:

Answer 17

1) steroids
2) immunosupressants: methotrexate or prednesiolone
3) biologicals: - ends in mab
4) surgery eg bowel resection
5) enteral nutrition/liquid diet (kids and oyung people)

Question 18

extended risks:

Answer 18

Cancer, damage

Question 19

what can diagnose Crohns

Answer 19

colonoscopy + biopsy

Question 20

risk factors (5)

Answer 20

enviormental, diet, smoking, genes, immune system

Question 21

Symptoms:

Answer 21

• Diarrhoea
• Stomach aches and cramps
• Bloody stools
• Fatigue
• Weight loss
• Pyrexia
• Nausea and vomiting
• Joint pain
• Sore, red eyes
• Patches of painful, red, and swollen skin, usually on legs
• Mouth ulcers

Question 22

2 main complications of corhns

Answer 22

bowel damage: ulcer, fistula, stricture
cancer

Question 23

seea doctor if

Answer 23

blood in stools
not growing
diarrohea for more than 7 days
- frequent stomach aches or cramps
- unexplained weight loss

Question 25

What diarrhoea fixes after fasting

Answer 25

Non inflammatory osmotic diarrhoea