Diarrhea

Question 1

What is pseudodiarrhea?

Answer 1

Can just be increased frequency of bowel movements but not actual diarrhea

Question 2

What is fecal incontinence?

Answer 2

Involuntary discharge of rectal contents (could be neurogenic)

Question 3

What is overflow incontinence?

Answer 3

Happens with constipation. Liquid stool builds up behind hard stool and the liquid stool will leak around the bulk

Question 4

Three main types of acute diarrhea

Answer 4

1. Watery
2. Fatty diarrhea
3. Infectious

Question 5

Secretory diarrhea typically occurs when?

Answer 5

At night

Question 6

What typically causes fatty diarrhea?

Answer 6

1. Maldigestion (giardiasis, etc)

2. Malabsorption (chronic pancreatitis, etc)

Question 7

What is the number one cause of acute diarrhea?

Answer 7

Viral infection

Question 8

Acute, persistent, chronic diarrhea time course?

Answer 8

• Acute < 14 days
• Persistant 15-30 days
• Chronic < 30 days

Question 9

Foods implicated with s. aureus food poisoning?

Answer 9

Cream based things that have sat out

Question 10

Hamburgers at picnics are implicated with what food poisoning?

Answer 10

Non-typhoidal salmonella

Question 11

What foods are implicated with shiga-toxin producing e. coli?

Answer 11

Hamburgers and spinach

Question 12

Sushi food poisoning organism?

Answer 12

Vibrio parahemolyticus (grows in months without an R)

Question 13

What two GI symptoms can c. perferingens cause?

Answer 13

• Toxin mediated GI symptoms

* Necrotizing enteritis “pig bel”

Question 14

What are risk factors for Hep A infection?

Answer 14

• MSM
• Shellfish
• Food workers

Question 15

What are two common finding that might appear on a rectal exam in a PT with diarrhea?

Answer 15

• Anal fissures

* Anal fistulas

Question 16

Watery (osmotic) diarrhea is most often due to what?

Answer 16

What you eat. Olestra, laxatives, etc.

Question 17

Watery (functional) diarrhea is most often due to what?

Answer 17

Hypermotility (IBS)

Question 18

Fatty (malabsorptive) diarrhea is most often due to what?

Answer 18

Giardia, celiac disease (bloating, gas, steatorrhea)

Question 19

Fatty (maldigestion) diarrhea is most often due to what?

Answer 19

Loss of digestive function (chronic pancreatitis, cystic fibrosis)

Question 20

Inflammatory (IBD) diarrhea is most often due to what?

Answer 20

Ulcerative colitis, Crohns (WBCs, pus, blood)

Question 21

Inflammatory (invasive) diarrhea is most often due to what?

Answer 21

C-diff and other infectious causes

Question 22

If an adult has a more severe infectious diarrhea, what would it make you suspicious for?

Answer 22

A bacterial cause instead of a viral cause

Question 23

Five reasons you would want to test for ova and parasites?

Answer 23

1. Persistent D
2. Persistent D following trip to Nepal, Russia
3. Persistent D with exposure to kids at daycare
4. D in MSM or with AIDs
5. Bloody diarrhea with few or no leukocytes

Question 24

What is emperic antibiotic treatment for diarrhea?

Answer 24

1. Fluoroquinolones

2. Metronidazole

Question 25

How can you differentiate large from small intestine on radiograph?

Answer 25

Small intestine has haustra that go all the way across (large has tinea coli)