Brainscape's Knowledge GenomeTM

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


See full index

Year 3 Gastro > Diahorrea > Flashcards

Diahorrea Flashcards

1
Q

How can diarrhoea be defined?

A

Three or more loose or liquid stools per 24 hours, and/or

Stools that are more frequent than what is normal for the individual lasting <14 days, and/or

Stool weight greater than 200 g/day.

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

How can diarrhoea be classified?

A

Acute (≤14 days)
Persistent (>14 days), or
Chronic (>4 weeks)

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

Describe the basic pathophysiology of diarrhoea?

A

10L of fluid enters GI tract daily

Small intestine responsible for reabsorbing (99%)

0.1L excreted in faeces

In diarrhoea there is decreased reabsorption or increased secretion

Or increase in bowel motility

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

From where is fluid secreted into the GI tract?

A 
Food 
Drink
Salivary glands
Stomach
Pancreas
Bile ducts
Duodenum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two types of diarrhoea?

A

Inflammatory

Non-inflammatory

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

What can cause inflammatory diarrhoea?

A

Material
Viral
Parasitic

Or early bowel ischaemia, radiation injury or IBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the associated symptoms of inflammatory diarrhoea?

A

Mucoid and bloody stool
Tenesmus
Fever
Severe crampy abdominal pain

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

What are the main features of the diarrhoea in inflammatory diarrhoea?

A

Small in volume

Frequent bowel movements

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

What are the most common causes of inflammatory diarrhoea?

A

Campylobacter, Salmonella, Shigella, Escherichia coli, or Clostridium difficile

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

In who is virus related diarrhoea common in?

A

Children who attend day care centres

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

What are the most 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
12
Q

What findings might be found in inflammatory diarrhoea?

A

Examination of the stool may show leukocytes, and tests for faecal occult blood may be positive.

The test for faecal leukocytes is plagued by a high rate of false-negative results leading to low sensitivity, but a positive test is very informative.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why does fluid enter enterocytes?

A

There are lots of solutes in enterocytes

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

What happens in inflammatory diarrhoea (enterocytes)?

A

Destruction of the epithelium due to inflammation

Enterocytes cannot absorb fluids

Excess fluid in lumen

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

What drug could help inflammatory?

A

Anti-cytokines e.g. Anti-TNF

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

What do you acutely want to do for all types of diarrhoea?

A

Rehydration

e.g. Oral rehydration solution

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

How does ORS work?

A

SGLT-1 = sodium glucose linked transporter

Give 1 glucose and 2 sodium takes both in

Pump into enterocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why does diarrhoea kill?

A

Dehydration

ORS essential especially in children

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

What is chronic diarrhoea?

A

Symptoms for more than 6 weeks

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

What is IBS?

A

Functional cause of diarrhoea

No known structural changes

Symptoms are unexplained

Non-progressive and will not kill patient

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

What are the symptoms of IBS?

A 
Tiredness
Stomach pain
Bloating
Diarrhoea
Constipation 
Mucus in stool
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the symptoms of IBD?

A

Abdominal pain
Diarrhoea
Fatigue

Weight loss
Fever
Blood in stool

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

What are some organic causes of diarrhoea?

A

IBD
Coeliac
Bowel Cancer

Organic = we can find a cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the two types of blood in stool?

A

Blood on toilet paper

Blood mixed in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What further investigation should be conducted?

A 
Faecal Occult Blood 
Stool antigen 
Faecal calprotectin
Colonoscopy 
LFTs
26
Q

What stool tests should be conducted?

A

Eggs + Cysts (associated with parasites) shed intermittently in the stool
3 separate stool samples, 2 days apart

Faecal calprotectin

27
Q

What stool tests should be conducted?

A

Eggs + Cysts (associated with parasites) shed intermittently in the stool
3 separate stool samples, 2 days apart

Faecal calprotectin - indicated migration of neutrophils into intestinal mucosa

Non-specific but looks for evidence of inflammation

28
Q

What tells us it is Crohn’s disease?

A 
Non- continuous 
Cobbelstone appearance
Caecum to splenic flexure
Granulomas - collection of neutrophils 
Changes to mucosa, submucosa, muscularis and serosa (transmural changes)
29
Q

What would ulcerative collitis look like on a colonscopy?

A 
Continuous areas of inflammation
Starts at rectum and continues 
Does not extend beyond large bowel (illeum potentially in severe disease)
Crypt processes 
Affects only mucosa and submucosa
30
Q

What are some complications of Crohn’s?

A

Can get a whole (fistula) forming due to transmural involvement

31
Q

What are some complications of UC?

A

High predisposition to Colon Cancer

32
Q

What treatments can be used for Crohn’s? (conservative)

A

Stopping smoking - referral to cessation clinic
Exercise
Dietary advice to prevent malnourishment
Psychological support - groups

33
Q

What treatments can be used for Crohn’s? (medical)

A

Corticosteroids to induce remission

Azothiprine or bilogica (Mabs) long term to dampen down immune system

34
Q

What treatments can be used for Crohn’s? (surgical)

A

Bowel resection
May need ileostomy for a few months post-op

Mainly due to strictures and fistulas

Leave as late as possible due to the chance of further surgeries

35
Q

When should you see a GP re crohn’s?

A

blood in your poo
diarrhoea for more than 7 days
frequent stomach aches or cramps
lost weight for no reason, or your child’s not growing as fast as you’d expect

36
Q

What causes Crohn’s disease?

A

your genes – you’re more likely to get it if a close family member has it
a problem with the immune system

smoking

a previous stomach bug

an abnormal balance of gut bacteria

37
Q

What are the other symptoms of Crohn’s?

A 
a high temperature
feeling and being sick
joint pains
sore, red eyes
patches of painful, red and swollen skin – usually on the legs
mouth ulcers
children grow more slow than usual
38
Q

How can steroids help with Crohn’s?

A

can relieve symptoms by reducing inflammation in your digestive system – they usually start to work in a few days or weeks

are usually taken as tablets once a day – sometimes they’re given as injections

may be needed for a couple of months – do not stop taking them without getting medical advice

39
Q

What are the side effects of steroids?

A 
weight gain
indigestion
problems sleeping
an increased risk of infections
slower growth in children
40
Q

What immunosuppressants might be taken with Crohn’s?

A

azathioprine, mercaptopurine and methotrexate

41
Q

What can immunosuppressants do in Crohn’s?

A

can relieve symptoms if steroids on their own are not working

can be used as a long-term treatment to help stop symptoms coming back

are usually taken as a tablet once a day, but sometimes they’re given as injections

may be needed for several months or years

42
Q

What are the side effects of Immunosuppressants?

A

feeling and being sick, increased risk of infections and liver problems

43
Q

What biological medicines are used in Crohn’s?

A

adalimumab, infliximab, vedolizumab and ustekinumab

44
Q

What can biological medicines do in Crohn’s?

A

can relieve symptoms if other medicines are not working

can be used as a long-term treatment to help stop symptoms coming back

are given by injection or a drip into a vein every 2 to 8 weeks

may be needed for several months or years

45
Q

What are the side effects of biological medications?

A

increased risk of infections and a reaction to the medicine leading to itching, joint pain and a high temperature

46
Q

When might surgery be recommended?

A

the benefits outweigh the risks or that medicines are unlikely to work

47
Q

What does a resection involve?

A
  1. Making small cuts in your tummy (keyhole surgery).
  2. Removing a small inflamed section of bowel.
  3. Stitching the healthy parts of bowel together.
48
Q

What might you need to careful about with Crohn’s?

A

Triggers

e.g. certain foods
pharmacy medicines

49
Q

What’s the deal with Crohn’s and vaccinations?

A

Flub jab yearly

Avoid live vaccines e.g. MMR

50
Q

What might be more difficult during a flare up?

A

Getting pregnant

51
Q

What might not work as well when you have Crohn’s?

A

Some contraceptives

e.g. the Pill

52
Q

What are possible complications of Crohn’s?

A

Damage to bowel e.g. scarring, narrowing, ulcers, fistulas

Difficulty absorbing nutrients - osteoporosis, iron deficiency anaemia

Bowel cancer

53
Q

How does the risk of bowel cancer change with Crohn’s?

A

after 10 years the risk is about 1 in 50
after 20 years the risk is about 1 in 10
after 30 years the risk is about 1 in 5

54
Q

What should people with Crohn’s do?

A

Have regular colonoscopies

55
Q

What can cause infectious diarrhoea?

A 
Norovirus
E. coli 
Shigella
Campylobacter 
Cholera
56
Q

What are the features of campylobacter infection?

A

Flu-like prodome
Crampy abdo pain
Diarrhoea +/- blood

57
Q

What is the most common cause of infective diarrhoea?

A

E. Coli

Esp amongst travellers
Watery stools
Abdo cramps and nausea

58
Q

How do you treat infective diarrhoea?

A

Rehydration

Correction of electrolyte imbalance

59
Q

What kind of bacteria is E. coli?

A

gram-negative, rod-shaped bacterium

60
Q

What investigations are done for infectious diarrhoea?

A

Stool cultures
FBS
Renal function and electrolytes

Year 3 Gastro (39 decks)

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