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GI Exam 1 > Diarrhea > Flashcards

Diarrhea Flashcards

1
Q

Describe these features of Osmotic Vs. Secretory diarrhea:

  1. Effect of Fasting
  2. Fecal Volume
  3. Fecal pH
  4. Fecal Osmolality
  5. Osmotic Gap
A

Osmotic:

  1. diarrhea stops
  2. greater than 1 L/day
  3. less than 6
  4. 280-400 mOsm/L
  5. greater than 40-60 mOsm/L

Secretory

  1. diarrhea continues
  2. less than 1 L/day
  3. greater than 7
  4. 260-300 mOsm/L
  5. less than 20-40 mOsm/L
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2
Q

How is the osmotic gap calculated for stool water?

A

Stool Osmolality - 2[Sodium + Potassium]

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3
Q

What are the major causes of osmotic diarrhea?

A

Lots of unabsorbed nutrients: mostly sugars and salts.

Medications like laxatives

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4
Q

What are the major causes of secretory diarrhea?

A

Bacterial toxins (cholera, giardiasis)

hormone secreting tumors that increase motility or intestinal irritation (ZE tumor).

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5
Q

Name the 3 major culprits in invasive and infectious diarrhea.

A
  1. Campylobacter jejuni (Major)
  2. Shigella
  3. Salmonella
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6
Q

How is left sided diarrhea different from right sided diarrhea?

A

Left:
frequent, small volume
tenesmus (feeling like you have to go all the time) and urgency
blood and mucous are common

Right:
infrequent, large volume
no tenesmus nor urgency
no blood

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7
Q

Which diarrhea-causing organisms do not produce fecal leukocytes?

A

Non-invasive microbes

  1. Amoeba
  2. ETEC
  3. Giardia
  4. Viruses
  5. V. cholerae
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8
Q

Which organisms would you be looking for in diarrhea caused by seafood?

A

Vibrios

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9
Q

Which organism would you be looking for in diarrhea caused by heavy antibiotic use?

A

C. difficile

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10
Q

Which organisms can cause abdominal pain that mimics appendicitis?

A

Salmonella

Yersinia

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11
Q

What is important to remember when treating bloody diarrhea?

A

Don’t use anti-diarrhea meds which can lead to stasis of blood and microorganisms in the colon. It is best to use quinolones to fight off the infecting organism.

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12
Q

What is a common source for salmonella?

A

Raw chicken or raw eggs, pet reptiles

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13
Q

What condition predisposes people to contracting salmonella?

A

Ulcerative Colitis

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14
Q

Most common cause of food poisoning.

A

Staph aureus

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15
Q

2 most common causes of viral diarrhea.

A
  1. Norwalk (cruise ships)

2. Rotavirus (kids, daycare)

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16
Q

Most common source of Giardia lamblia.

A

Water downstream of a beaver dam.

17
Q

Treatment for Giardiasis

A
  1. Metronidazole

2. Paramomycin (pregnant patients)

18
Q

Main causative agent of pseudomembranous colitis.

A

C. diff

Often occurs in the ICU in patients on long term antibiotics

19
Q

Main disorder that is associated with bacterial overgrowth in the intestines.

A

Scleroderma: decreased motility leads to more bacterial growth and diarrhea

20
Q

Most likely cause of travelers diarrhea.

A

ETEC

GI Exam 1 (18 decks)

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