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Gastroenterology > Diarrhea > Flashcards

Diarrhea Flashcards

1
Q

what constitutes diarrhea? (2)

A

increased stool frequency over 3x per day
OR
loose/watery stools

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2
Q

what is the most common cause of acute diarrhea in adults?

A

infectious

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3
Q

diarrhea for 14 days or fewer

A

acute

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4
Q

diarrhea for more than 14 days but less than 30 days

A

persistent

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5
Q

diarrhea for more than 30 days

A

chronic

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6
Q

what will be different between inflammatory and noninflammatory diarrhea?

A

inflammatory diarrhea results in bloody stools, fecal leukocytes, and fevers

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7
Q

what is the most common cause of nausea, vomiting, and diarrhea in the US?

A

viral gastroenteritis

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8
Q

what is the most common cause of the stomach flu?

A

norovirus

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9
Q

what virus is most likely found in infants and young kids?

A

rotaviruses

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10
Q

protozoa found in untreated water while camping with beavers, spreads quickly within families

A

giardia

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11
Q

protozoa found in untreated water while camping, affecting immune suppressed individuals

A

cryptosporidium

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12
Q

preformed enterotoxin found in meats eggs, diary products; causes N/V, diarrhea, and cramping

A

staph aureus

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13
Q

preformed enterotoxin found in starchy foods left at room temperature

A

bacillus cereus

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14
Q

preformed enterotoxin found in beef, poultry, and gravy; causes diarrhea and cramping

A

clostridium perfringes

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15
Q

enterotoxin found in undercooked ground beef, unpasteurized milk/juice, and water. causes diarrhea and cramping.

A

E. coli

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16
Q

enterotoxin found in fecal contamination of food and water; causes profuse watery diarrhea (rice-water stools)

A

vibrio cholerae

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16
Q

virus that is more common in immunocompromised patients

A

cytomegalovirus

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16
Q

parasite from untreated water

A

entamoeba hystolytica

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17
Q

found in contaminated oysters or shellfish with onset of 2-24 hours

A

vibrio parahaemolyticus

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18
Q

opportunistic infection when normal flora has been reduced, caused by antibiotic usage

A

C. difficile

19
Q

found in sandwiches, salads, and raw food that come into contact with infected person

A

shigella

20
Q

causes fever, stiff neck, confusion and vomiting

A

listeria

21
Q

what 6 labs should be ordered for acute diarrhea?

A

CBC/CMP
stool leukocytes/culture
stool assay for C. diff
PCRs

22
Q

what diagnostic should be ordered for acute diarrhea that is present over 10 days?

A

stool O&P

23
Q

what 4 S&S indicate dehydration?

A

tachycardia
hypotension
orthostatic hypotension
dry mucous membranes

24
Q

what 3 S&S indicate inflammatory disease?

A

fever
bloody stools
severe abd pain/tenderness

25
Q

what is the treatment for acute diarrhea? (2)

A

BRAT diet + hydration
loperamide: only for mild-moderate
probiotics

26
Q

for acute diarrhea, when should empiric antibiotics be considered? (7)

A

fever
> 6 stools/day
bloody stools
immunocompromised pts
clinical dehydration
> 70 yo
comorbidities

27
Q

what are the empiric antibiotics that can be used?

A

azithromycin x 3 days
ciprofloxacin x 3-5 days

28
Q

increased stool frequency of more than 3/day, stool weight over 200 g/day, and decreased fecal consistency over a 4-week period

A

chronic diarrhea

29
Q

what is the most common cause of osmotic diarrhea (increased stool osmotic gap)?

A

malabsorption syndromes

30
Q

characterized by abdominal distention, bloating, and flatulence d/t increased gas production

A

malabsorption of carbs

31
Q

how to diagnose malabsorption syndrome? (2)

A

elimination trial x 2-3 weeks
hydrogen breath test

32
Q

high volume of stool, with normal stool osmotic gap

A

secretory diarrhea

33
Q

what causes secretory diarrhea? (2)

A

endocrine tumors
bile salt malabsorption

34
Q

what is the most common cause of chronic diarrhea in young adults?

A

IBS

35
Q

abnormal motility and malabsorption without pain or abnormal findings

A

functional diarrhea

36
Q

what inflammatory processes cause chronic diarrhea? (2)
what symptoms present? (2)

A

ulcerative colitis
crohn disease

blood
pus

37
Q

what lab is recommended for signs of malabsorption?

A

IgA-tTG

38
Q

what positive test suggests malabsorption?

A

fecal fat

39
Q

what diagnostic is recommended to rule out IBD and cancers?

A

colonoscopy w/ mucosal biopsy

40
Q

what diagnostic is recommended for suspected small intestinal malabsorption conditions?

A

upper endoscopy

41
Q

what are 4 antidiarrheal options for chronic diarrhea?

A

loperamide
codeine + opium
clonidine
octreotide

42
Q

what med can be used for secretory diarrhea?

A

octreotide

43
Q

diarrhea beginning 2-10 days into travel; commonly a bacterial infection

A

traveler’s diarrhea

44
Q

what are 3 most common etiologies of traveler’s diarrhea?

A

E. coli
shigella
campylobacter

45
Q

a patient presents with 7-10 stools/day, abdominal cramping, and nausea +/- vomiting. Dx?

A

traveler’s diarrhea

46
Q

what is the treatment for mild traveler’s diarrhea? (3)

A

hydration
bismuth subsalicylate
loperamide (use caution)

47
Q

what is the treatment for moderate-severe traveler’s diarrhea? (3)

A

hydration

+/- antibiotics if fever, bloody stools, or worsening abdominal pain:
azithromycin x 3 days
OR
ciprofloxacin x 3-5 days

Gastroenterology (26 decks)

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