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Gastroenterology > Diarrhea > Flashcards

Diarrhea Flashcards

1
Q

Antibiotic-Associated Diarrhea Dx

A

best initial test: stool C. diff toxin test or PCR.***
=”nucleic amplification assay”
Blood and white blood cells may be present in the
stool

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2
Q

Antibiotic-Associated Diarrhea tx

A

1° Oral vancomycin** OR oral metro +barato
not working? tapered dose of vanco OR fidaxomicin.
not PO possible? EV metronidazol

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3
Q

After multiple recurrences of Antibiotic-Associated Diarrhea, tx

A

fecal transplantation.

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4
Q

What is fulminant C. diff?

A

High WBC
Metabolic acidosis
High lactate
High creatinine

onlinemed:”fever+leukocytosis+megacolon+renal fail”

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5
Q

fulminant C. diff Tx

A

use both vancomycin po and

metronidazole IV

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6
Q

fat Malabsorption Rare causes

A

tropical sprue and Whipple disease.

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7
Q

Vitamin D Deficiency Manifestation

A

Hypocalcemia, osteoporosis

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8
Q

Vitamin K Deficiency Manifestation

A

Bleeding, easy bruising

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9
Q

Vitamin B12 Deficiency Manifestation

A

Anemia, hypersegmented neutrophils, neuropathy

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10
Q

Celiac disease comes along with this disease _____in 10% of cases.

A

dermatitis

herpetiformis

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11
Q

Whipple Disease CXFx

A 
also presents with:
Cardiac symptoms*
Arthralgias*
Ocular findings
Neurologic abnormalities (dementia, seizures)*
Fever
Lymphadenopathy
Diarrhea* trots
"CANT"
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12
Q

Whipple Disease Tx

A

ceftriaxone followed by TMP/SMX

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13
Q

Malabsorption Diagnostic Tests

A

iron deficiency: suggest celiac. kinda r/o chronic pancreatitis

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14
Q

Celiac disease: first test

A

Anti-tissue transglutaminase (TTG). This is the best!!!!!!!.
Then u can use
Antiendomysial antibody
IgA antigliadin antibody

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15
Q

most accurate diagnostic test for celiac disease

A

small bowel biopsy: flattening of the villi

also important to exclude lymphoma

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16
Q

Whipple disease and tropical sprue dx

A

most accurately diagnosed with a bowel wall biopsy showing the specific
organism.
Klebsiella, E coli and Enterobacter.
T. whippelii

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17
Q

Chronic Pancreatitis most accurate diagnostic test.

A

Secretin stimulation testing: pancreas will release a large volume of bicarbonate-rich fluids after the intravenous injection of secretin

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18
Q

Chronic Pancreatitis Dx also

A

Abdominal x-ray:
Abdominal CT scan:
calcification of the pancreas

D-xylose testing: normal results

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19
Q

Chronic

pancreatitis tx

A

Enzyme replacement

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20
Q

Celiac disease tx

A

Avoid gluten-containing foods such as wheat, oats, rye, or barley

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21
Q

Whipple disease tx

A

Ceftriaxone, trimethoprim/sulfamethoxazole

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22
Q

Tropical sprue tx

A

Trimethoprim/sulfamethoxazole, tetracycline

23
Q

Carcinoid Syndrome CxFx

A

Diarrhea
Flushing
Wheezing
Cardiac abnormalities of the right side of the heart

24
Q

Carcinoid Syndrome best initial diagnostic test

A

urinary 5-hydroxyindoleacetic acid (5 HIAA) test

25
Q

Carcinoid Syndrome tx

A

octreotide (a synth. somatostatin)

26
Q

Lactose Intolerance cx fx

A

No weight loss
no deficiency in calories not vits
>f in asians

27
Q

Lactose Intolerance dx

A

stool osmolality is increased, but the usual way to make
the diagnosis is simply to remove all milk-containing products from the diet and
wait a single day for resolution of symptoms.

28
Q

Lactose Intolerance tx

A

Avoiding milk products except yogurt

oral lactase replacement

29
Q

acute and chronic diarrhea diff

A

<2 w Ac
here is subacute.
>4wk chro

30
Q

Dx test if it’s not C diff.
Wath in the workup labs can guide you to find out whether it is invasive or enterotoxic, and how would you interpret that?

A

stool WBC, Reds,}both + in invasive

and Lactoferrin:+ for invasive. - for enterotoxic

31
Q

if invasive diarrhea suspected, what to do?

A

culture + colonoscopy

32
Q

Hemolytic-uremic Sx (HUS) Pathogen + CxFx + source of infection

A

on the spectrum of thromocytopenic thrombotic purpura. PATH: EHEC O157:H7
Blody diarrhea after eating uncooked meat+ anemia + renal failure

33
Q

Hemolytic-uremic Sx HUS patho

A

microangiopatic hemolitic anemia

34
Q

HUS Dx

A

blood smear: schistocytes

shiga like toxine assay

35
Q

HUS Tx

A

supportive
plasma exchange

Avoid antibiotics and antimotility agents

Dialysis if AKI

36
Q

Secretory Diarrhea labs

A

labs are normal! particularly they just have positive nocturnal symp. “even when slept its secreting!”

37
Q

inflammatory chronic diarrhea labs findings

A

+RBC +WBC + mucose

Co

38
Q

what to do if secretory diarrhea is suspected?

A

get a Endoscopy, C Diff testing, and hormones?

39
Q

what to do if chronic inflammatory diarrhea is suspected?

A

colonoscopy + bx

40
Q

VIPoma Dx

A

VIP level

41
Q

VIPoma Tx

A

Resection

42
Q

Carcinoid patho

A

5ht secretor tumor of the intestines. Usually that 5ht in metabolized by the liver and all ok. tho sometimes it can metastize to hepatic vein, right side of the heart. TOTALLY dif, to the carcinoma of the lung who goes to left heart. both fibrose and make valve disease.

43
Q

Carcinoid Cx Fx

A

Right sided cardiac fibrosis
diarrhea
flush

44
Q

Carcinoid Dx

A

5HIAA urine test

45
Q

Carcinoid Tx

A

resection if resectable, if not: somatostatin

46
Q

Duodenum malabsorption problems lead to missing what nutrients, and diseases

A

Folate: macrocytic
Iron: mycrocitic
Calcium: osteoporosis
carbohidrates: bolating, flatos.

47
Q

terminal ileum malabsorption problems lead to missing what nutrients, and diseases

A 
b12
A
D
E
K
48
Q

Vitamin E Deficiency Manifestation

A

nystagmus

49
Q

some important test you could do at first when suspecting malabsorption

A

-100g fat load 72 hours
-d xylose absorption.
Usually no one does this duh

50
Q

Tropical sprue dx

A

endoscopy + bx

51
Q

Tropical sprue epidem

A

caribean farmer

52
Q

biopsy of whipple
tropical sprue
celiac dissease

A

biopsy of whipple= electron mycrocsope, tons of dots for macrophages.

tropical sprue= Villous atrophy, elongated crypts, presence of inflammatory cells
celiac dissease=+-loss villi

53
Q

S3 sound

A

s3, cierre de aortica y pulmonar because of the movement of the blood: increased blood in heart : ICC, hypertyroidism, Insuf Aortica, anemia, pregnancy, ., niños benigno

54
Q

s4

A

justo antes de s1, hipertrofia ventricular.

Gastroenterology (23 decks)

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