Diarrhea

Question 0

What are 3 major functions performed by the GI tract?

Answer 0

• Propels, mixes and digest food.
• Secretes enzymes and fluids after ingestion.
• Selectively absorbs water, electrolytes and nutrients.

Question 1

Increased stool output, passage of abnormally fluid or unformed stools usually associated with increased frequency and/or volume of feces is known as what?

Answer 1

Diarrhea

Question 2

T/F: There is a constant bidirectional flux of water and ions across the small intestinal mucosa.

Answer 2

True

Question 3

Water moves in response to what?

Answer 3

Osmotic gradients

Question 4

Where does absorption primarily occur?

Secretion?

Answer 4

• Enteric villi

- Intestinal crypts

Question 5

Are villi found in the small intestine, large intestine or both?

Answer 5

Small intestine

Question 6

With diarrhea, does the absorptive process exceeds the secretory process in magnitude, or does the secretory process exceeds the absorptive process?

Answer 6

The secretory process exceeds the absorptive process.

Question 7

Different disease processes can convert portions of the GI tract from a what to a what?

Answer 7

An absorptive organ into a secretory organ.

Question 8

What are 4 pathophysiologic mechanisms of diarrhea?

Answer 8

• Osmotic (malabsorption/maldigestion)
• Secretory
• Increased permeability (exudative)
• Altered motility

Question 9

What type of diarrhea may develop when osmotically active molecules remain in the intestinal lumen (malabsorption)?

Answer 9

Osmotic diarrhea

Question 10

When osmotically active molecules remain in the intestinal lumen, water movement from where to where is promoted?

Answer 10

From plasma to the intestinal lumen .

Question 11

What happens to the absorptive capability of the small and large intestine with osmotic diarrhea?

Answer 11

They are overwhelmed.

Question 12

What is a possible cause of osmotic diarrhea?

Answer 12

Sudden dietary changes.

Question 13

What type of diarrhea can occur when there is interference with digestion and therefore the absorption of nutrients?

Answer 13

Osmotic diarrhea

Question 14

T/F: What is not digested cannot be absorbed.

Answer 14

True

Question 15

Unabsorbed solutes that remain in the intestinal lumen act as what?

Answer 15

Osmotic agents resulting in diarrhea.

Question 16

What are 2 examples of conditions that can lead to osmotic diarrhea?

Answer 16

• Exocrine pancreatic insufficiency in dogs

- TGE in young pigs

Question 17

Why are dogs with exocrine pancreatic insufficiency unable to digest food properly?

Answer 17

Decreased amount of pancreatic enzymes.

Question 18

How do the feces of dogs with exocrine pancreatic insufficiency appear?

Answer 18

Voluminous, place and full of fat (steatorrhea).

Question 19

The presence of excess fat in the stools, usually caused by disease of the pancreas or intestine, is known as what?

Answer 19

Steatorrhea

Question 20

Is secretory diarrhea a result of an active or passive mechanism?

Answer 20

Active mechanism

Question 21

Secretory diarrhea is usually caused by what?

Answer 21

Infectious agents (bacteria, viruses)

Question 22

Pathogens may adhere to the mucosa disrupting the absorptive/secretory processes of enterocytes without causing significant damage to the cells with what type of diarrhea?

Answer 22

Secretory diarrhea

Question 23

With secretory diarrhea, certain bacterial toxins activate the secretion of what?

Answer 23

Sodium, chloride and other electrolytes.

Question 24

T/F: Electrolytes follow water secretion, overwhelming the absorptive capability of the intestine.

Answer 24

False - water follows electrolyte secretion.

Question 25

Disease resulting in mucosal damage and inflammation can lead to what type of diarrhea?

Answer 25

Increased permeability (exudative) diarrhea

Question 26

What does the loss of the normal epithelial lining (tight junctions) seen with increased permeability (exudative) diarrhea lead to?

Answer 26

Passive loss of fluid (serous proteins, blood, etc.)

Question 27

What is an example of a cause of increased permeability (exudative) diarrhea?

Answer 27

Rhodococcus equi-induced enterocolitis in foals

Question 28

Are primary disorders of motility common or uncommon in veterinary medicine?

Answer 28

Uncommon

Question 29

Most causes of diarrhea can lead to what? | What does this contribute?

Answer 29

- Secondary decrease in segmental contractions. | - Contributes to diarrhea due to decrease resistance to the caudal movement of the ingesta.

Question 30

What are the 2 types of movement seen in the GIT?

Answer 30

- Segmental | - Peristaltic

Question 31

Why might intestinal transit be accelerated in many forms of diarrheal states?

Answer 31

Stimulation of peristalsis by increased intraluminal volumes.

Question 32

T/F: Regarding the pathophysiologic mechanisms of diarrhea there is considerable overlap with more than one mechanism involved in a single patient.

Answer 32

True

Question 33

Is diarrhea or vomiting seen as the result of disease within the GI tract considered a primary or a secondary gastrointestinal disease?

Answer 33

Primary

Question 34

Is diarrhea or vomiting seen as a manifestion of disease somewhere else in the body considered a primary or a secondary gastrointestinal disease?

Answer 34

Secondary

Question 35

What are 2 examples of secondary gastrointestinal disease?

Answer 35

- Exocrine pancreatic insufficiency | - Renal disease

Question 36

T/F: Many cases of acute diarrhea are self-limiting.

Answer 36

True

Question 37

What are 2 dietary causes of acute diarrhea?

Answer 37

- Dietary indiscretion | - Dietary intolerance

Question 38

What are 3 examples of infectious causes of acute diarrhea?

Answer 38

- Parvovirus enteritis in dogs - Panleukopenia in cats - Salmonellosis

Question 39

Pancreatitis can lead to what type of diarrhea?

Answer 39

Acute diarrhea

Question 40

Diagnosis of which type of diarrhea often requires a more extensive work-up?

Answer 40

Chronic diarrhea

Question 41

What are 3 examples of causes for chronic diarrhea?

Answer 41

- Inflammatory Bowel Disease (IBD) - Gastro-intestinal neoplasia - Chronic parasitism/fungal infections

Question 42

What are 4 pathophysiologic mechanisms of diarrhea?

Answer 42

- Osmotic (malabsorption/maldigestion) - Secretory - Increased permeability (exudative) - Altered motility

Question 43

Main pathophysiologic mechanism of diarrhea in Johne's disease is what?

Answer 43

Increased permeability (exudative)

Question 44

Classical cause for secretory diarrhea is what?

Answer 44

E. coli

Question 45

What is the main pathophysiologic mechanism of diarrhea seen with porcine proliferative enteropathy caused by Lawsonia intracellularis?

Answer 45

Increased permeability (exudative)

Question 46

Main pathophysiologic mechanism of diarrhea for crypto is what?

Answer 46

Osmotic malabsorption/maldigestion

Question 47

What is the main pathophysiologic mechanism of diarrhea with blackhead disease?

Answer 47

Increased permeability (exudative)