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ICM - Infectious Disease > Diarrhea > Flashcards

Diarrhea Flashcards

1
Q

Normal stool volume

A
  • 3 to 7 BM/day

-

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2
Q

Normal stool volume

A
  • 3 to 7 BM/day

-

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3
Q

Acute infectious diarrhea

A
  • 20 to 30 BM/day

- up to 20 liters of stool per day

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4
Q

Diarrhea reflects an increase in what?

A

Water

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5
Q

Reasons for increased water in stool from?

A
  1. Increased intestinal secretion of water

2. Decreased intestinal reabsorption of water

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6
Q

Acute diarrhea duration

A

-

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7
Q

Acute diarrhea duration

A
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8
Q

Persistent diarrhea

A

14-30 days

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9
Q

Chronic diarrhea

A

> 30days

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10
Q

Watery types of diarrhea

A

Secretory, Osmotic, Functional

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11
Q

Secretory description of diarrhea

A
  • nocturnal, persists despite fasting

- microscopic colitis, stimulant laxatives; Senna

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12
Q

Osmotic description of diarrhea

A
  • related to intake

- osmotic laxative; Miralax, Olestra

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13
Q

Functional description of diarrhea

A
  • hypermotility, improves with fasting

- Irritable bowel syndrome

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14
Q

Fatty types of diarrhea

A

Malabsorption, Maldigestion

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15
Q

Malabsorption description of diarrhea

A
  • bloating, gas, steatorrhea

- giardiasis, celiac disease

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16
Q

Maldigestion description of diarrhea

A
  • loss of digestive function; meat fibers

- chronic pancreatitis, cystic fibrosis

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17
Q

Inflammatory types of diarrhea

A

IBD, Invasive, Neoplasia

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18
Q

IBD description of diarrhea

A
  • white blood cells, pus, blood

- Ulcerative colitis, Crohn’s disease

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19
Q

Neoplasia description of diarrhea

A
  • associated weight loss, abdominal pain

- colon carcinoma

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20
Q

Neoplasia description of diarrhea

A
  • associated weight loss, abdominal pain

- colon carcinoma

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21
Q

Acute infectious diarrhea

A
  • 20 to 30 BM/day

- up to 20 liters of stool per day

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22
Q

Diarrhea reflects an increase in what?

A

Water

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23
Q

Reasons for increased water in stool from?

A
  1. Increased intestinal secretion of water

2. Decreased intestinal reabsorption of water

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24
Q

Differentiate diarrhea from

A
  1. Pseudodiarrhea
  2. Fecal incontinence
  3. Overflow incontinence
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25
Q

Acute diarrhea duration

A

-

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26
Q

Protozoa of the colon

A

-E.histolytica

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27
Q

Chronic diarrhea

A

> 30days

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28
Q

Watery types of diarrhea

A

Secretory, Osmotic, Functional

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29
Q

Secretory description of diarrhea

A
  • nocturnal, persists despite fasting

- microscopic colitis, stimulant laxatives; Senna

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30
Q

Osmotic description of diarrhea

A
  • related to intake

- osmotic laxative; Miralax, Olestra

31
Q

Functional description of diarrhea

A
  • hypermotility, improves with fasting

- Irritable bowel syndrome

32
Q

Fatty types of diarrhea

A

Malabsorption, Maldigestion

33
Q

Malabsorption description of diarrhea

A
  • bloating, gas, steatorrhea

- giardiasis, celiac disease

34
Q

Maldigestion description of diarrhea

A
  • loss of digestive function; meat fibers

- chronic pancreatitis, cystic fibrosis

35
Q

Inflammatory types of diarrhea

A

IBD, Invasive, Neoplasia

36
Q

IBD description of diarrhea

A
  • white blood cells, pus, blood

- Ulcerative colitis, Crohn’s disease

37
Q

Invasive description of diarrhea

A
  • infectious causes

- Cdiff

38
Q

Neoplasia description of diarrhea

A
  • associated weight loss, abdominal pain

- colon carcinoma

39
Q

Causes of acute diarrhea in healthy adults in developed countries

A
  1. usually viral
  2. more severe diarrhea is more likely bacterial
  3. protozoa are least common causes
40
Q

Bacteria of the small bowel

A

-Salmonella, E.coli, C.perfringens, S.aureus, A.hydrophila, B.cereus, V.cholerae

41
Q

Virus of the small bowel

A

-Rotovirus, Norovirus

42
Q

Protozoa of the small bowel

A

-Cryptosporidium, Microsporidium, Isospora, Cyclospora, Giardia

43
Q

Problems resulting in the anus

A
  • anal fissure
  • sentinel pile
  • fistula
  • anorectal ulcers
44
Q

Virus of the colon

A

-Cytomegalovirus, adenovirus, herpes simplex

45
Q

Protozoa of the colon

A

-E.histolytica

46
Q

Stuff that results in dysentery

A

-salmonella, E.coli, campylobacter, shigella, E.histolytica

47
Q

Stuff that has a preformed toxin

A

-C.perfringens, S.aureus, B.cereus

48
Q

Stuff that has an entertoxin

A

-V.cholerae

49
Q

Stuff that has an enteroadherent

A

-Giardia

50
Q

Stuff that has a cytotoxin

A

-C.difficile, E.coli 0157

51
Q

Review three slides with tables

A

Go to packet

52
Q

History of diarrhea

A
  1. Onset…..of abnormal bowel movements
  2. Frequency
  3. Presence….of blood, mucus
  4. Awoken…in the night for BM
  5. Associated….symptoms
  6. Exposures
  7. Antibiotic…use recently
53
Q

Bristol stool chart Type 1

A

Separate hard lumps, like nuts

54
Q

Description of C.difficile

A
  • toxin mediated colitis caused by overgrowth of C diff in colon
  • pseudomembranous colitis
55
Q

Bristol stool chart Type 3

A

Like a sausage but with cracks on the surface

56
Q

Bristol stool chart Type 4

A

Like a sausage or snake, smooth and soft

57
Q

Bristol stool chart Type 5

A

Soft blobs with clear-cut edges

58
Q

Bristol stool chart Type 6

A

Fluffy pieces with ragged edges, a mushy stool

59
Q

Bristol stool chart Type 7

A

Watery, no solid pieces. Entirely liquid

60
Q

Physical exam

A
  1. vital signs
  2. general
  3. abdominal exam
  4. musculoskeletal
  5. skin
  6. rectal exam
61
Q

Muscles surrounding the anus and rectum

A
  • pelvic floor muscle
  • internal anal sphincter
  • external anal sphincter
62
Q

Problems resulting in the anus

A
  • anal fissure
  • sentinel pile
  • fistula
  • anorectal ulcers
63
Q

Role of testing in acute diarrhea

A
  1. routine stool culture
  2. ova/parasites
  3. endoscopy
64
Q

Role of testing in acute diarrhea for ova/parasites

A
  • persistant diarrhea
  • persistant diarrhea following travel to Russia, Nepal
  • persistant diarrhea with exposure to infants in daycare centers
  • diarrhea in a man MSM or AIDS
  • a community waterborne outbreak
  • blood diarrhea with few or no fecal leukocytes
65
Q

Oral rehydration

A

0.5 tsp salt
0.5 tsp baking soda
4 tblsp sugar
Per liter of water

66
Q

Symptomatic Therapy

A
  • Anti motility agents
  • loperamide(Imodium)
  • Diphenoxylate(Lomotil)
  • Bismuth subsalicylate(Pepto-bismol)
67
Q

Probiotics

A

-Align, Culturelle

68
Q

Dietary alterations

A
  • avoid dairy(temporary loss of lactase)

- low residue diet(white foods, cooked vegetables, low fat meats)

69
Q

Empiric antibiotics

A
  • fluoroquinolone

- metronidazole

70
Q

Description of C.perfringens

A
  • enterotoxin produced by bacteria in small intestine

- acute gastroenteritis symptoms

71
Q

Description of C.botulinum

A
  • paralytic neurotoxin formed by bacteria present in anaerobic environment
  • weakness, diplopia, progresses to paralysis
72
Q

Description of C.tetani

A
  • excitatory neurotoxin formed by bacteria present in wounds

- “lockjaw”

73
Q

Description of C.difficile

A
  • toxin mediated colitis caused by overgrowth of C diff in colon
  • pseudomembranous colitis

ICM - Infectious Disease (4 decks)

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