diarrhea

Question 0

4 types of diarrhea

Answer 0

osmotic
secretory
inflammatory
dysmotility

Question 1

CAMP

Answer 1

increase in camp–> increase secretion and decreased absorption via phosphorylation of CFTR which prolongs its opening

Ne and SMS (Gi)-_>decrease camp
VIP, PG (Gs)–>incease camp

Question 2

osmotic gap

Answer 2

elevated above 100 in osmotic diarrhea

Question 3

reasons for secretory diarrhea

Answer 3

endocrine tumor (VIPoma, gastrinoma)
laxatives
lubiprostone (apical Cl channel activator)
cholera

Question 4

inflammatory diarrhea

Answer 4

destruction of absorptive cells

bloody mucoid stool, increase in fecal WBC, fever

Question 5

dysmotility diarrhea

Answer 5

decreased intestinal transit time which leads to both an osmotic shift (hypertonic intestinal content) and a secretory (rapid distention of bowel–>VIP–>fluid and extrolyte secretion) component

surgeries, diseases associated with dysmotility (scleroderma, DM)

Question 6

bacterial overgrowth

Answer 6

slows intestinal transit–>bacterial overgrowth–>deconjugate bile–>decreased cholesterol absorption–>steatorrhea

Question 7

mexico/south america

Answer 7

enterotoxic ecoli–traveler’s, ehec

Question 8

asia

Answer 8

invasive salmonella, shigella

Question 9

camping/hikes

Answer 9

giardia

Question 10

fecal leukocyte and culture

Answer 10

positive: bacterial
negative: viral

Question 11

bad part of antidiarrheal agents

Answer 11

can worsen inflammatory disease

Question 12

acute vs chronic diarrhea

Answer 12

less than 3 weeks vs greater than 3 weeks

Question 13

crohns spares the

Answer 13

rectum

Question 14

ulcerative collitis

Answer 14

starts in rectum and cotninues proximally

Question 15

special nonrisk factor in ulcerative collitis

Answer 15

smoking is protective

so is appendectomy

Question 16

infiltration and crypts of UC

Answer 16

restricted to mucosa, do not spread to mucularis

Question 17

crohn’s disease pathology

Answer 17

transmural lesions (all through the serosa)
non-caseating granulomatous inf
cobblestoning

Question 18

CD ddx from IBS

Answer 18

pain awakens frm sleep

Question 19

fistulas are unique to

Answer 19

crohn’s disease

Question 20

5-ASAs

Answer 20

mesalamine

work well for UC but not CD

Question 21

what is best for CD and UC

Answer 21

combo of immunomodulator and bilogic