Diarrhea Flashcards
Which of the following is NOT a cause of chronic diarrhea (duration?)? A. Omsmotic B. Secretory C. Medications D. Inflammatory E. Maldigestive/malabsorptive
Duration: > 4 weeks
C. Medication is a cause of acute infection.
Who requires the most urgent evaluation?
A. 20 y/o male with N/V, diarrhea, low grade fever for the past 12 hours after returning from a picnic
B. 40 y/o female with watery diarrhea ad milde dehydration since returning from a cruise vacation
C. 70 y/o female with recent history of UTI treatment with diarrhea that has some blood streaks, abdominal pain and fever
D. 30 y/o female with watery diarrhea since returning from a camping trip
C. Pt has C dif. inflammatory diarrhea
A. Staph, samanella
B. Norovirus
D. Giardia
Pair the microbe with the correct high risk groups: A. Travelers B. Public water/outdoor C. Cruise ships/enclosed facilities D. Picnic/contaminated foods E. Heathcare facilities
- Norovirus
- Giardia, cryptosporidium
- E. coli, staph aureus, salmonella, bacillus cereus
- E. coli, campylobacter
- C. difficile
A: 4 B: 2 C: 1 D: 3 E: 5
Indications for evaluating diarrhea include all EXCEPT: A. Dehydration/volume depletion B. Lasting >24 hours C. Bloody stools D. Elderly E. Immunocompromised
B. Lasting > 48 hours
Which of the following ischaracteristicofnonenterotoxigenicdiarrhea: A. Bloody stool B. Fever, dehydration C. Short duration D. Symptomatic therapy + stool studies
C.All other characteristics are ofenterotoxigenicdiarrhea
Acute, bloody diarrhea associated with pain and mucus in a patient
inflammatory or infectious
Acute, bloody diarrhea associated with pain and mucus in a patient >50 y/o is most likely ____
diverticulitis, ischemic colitis
All of the following are characteristic ofosmoticdiarrhea EXCEPT? A. Watery B. Resolves w/ fasting C. Bloody stool D. Weight loss E. Bloating
C, D
Which of the following isNOT a causeofosmoticdiarrhea?
A. Magnesium: laxatives, antacids, supplements
B. Carbohydrate malabsorption
C. Celiac Disease
D. Medications
D
Osmotic gap > ___ suggests osmotic diarrhea.
125
Which of the following is NOT a characteristic ofsecretorydiarrhea?
A. No blood in stool
B. Recurrent dehydration
C. Watery larger volume of stools than osmotic
D. Nocturnal diarrhea
E. Relieved w/ fasting
E. Continues with fasting.
Which type(s) of diarrhea resolves with fasting?
Osmotic
Malabsorption/maldigestion
Which of the following is NOT a cause ofsecretorydiarrhea? A. Toxins B. Inflammation C. Medications D. Neuroendocrine tumors E. Inflamatory bowel disease
E. Inflammatory bowel disease is a cause of malabsorption, maldigestion diarrhea
Fecal Na+ and K+
secretory
Which of the following is NOT associated withmalabsorption/maldigestiondiarrhea? A. Continues with fasting B. Associated with steatorrhea C. Associated with weight loss D. Celiac disease
A. Resolves with fasting
Tissue transglutaminase IgA is used to test for ___
Celiac disease
Evaluation of small bowel mucosa endoscopically is used to diagnosis _____
Malabsorption/maldigestion diarrhea
r/o Celiac disease + Crohn’s disease
52 y/o woman complains of diarrhea for the past 3 months. Diarrhea is loose to watery with urgency and tenesmus (urgency to evacuate bowels). She reports vague RLQ pain and a 5 lb weight loss. PE shows RLQ tenderness. CBC shows mild microcytic anemia. Stool culture is negative, but is hemoccult positive. What is the next best step?
A. Treat empirically for C dif colitis
B. Start fiber and re-evaluate in 1 month
C. Perform colonoscopy
D. Perform quantitative fecal fat analysis
C
Which of the following is NOT a characteristic ofinflammatorydiarrhea? A. Abdominal pain B. Blood in stool C. Associated w/ weight loss D. Urgency w/ tenesmus E. Watery stool
E
Which of the following is NOT used in testing for inflammatorydiarrhea? A. Stool leukocytes B. Fecal occult blood test C. Transglutaminase IgA D. O&P culture E. Upper endoscopy F. Colonoscopy
D
29 y/o woman reports diarrhea for the past 5 years. Stools are loose and mushy. She reports frequent bloating and LLQ pain that improves with defecation. No weight loss, nocturnal symptoms or blood in stool. What is the most appropriate next step?
A. Send stool for Giardia antigen
B. Start fiber and re-evaluate in 1 month
C. Perform EGD for small bowel biopsies
D. Perform colonoscopy
B
Chronic, young, no weight loss, no red flags
What’s the next step?
Acute diarrhea w/ toxicity –>
stool culture
What’s the next step?
Acute diarrhea w/ toxicity and abx use –>
C diff PCR
What’s the next step?
Chronic diarrhea w/ blood in stool –>
Colonoscopy
What’s the next step?
Chronic diarrhea w/ malabsorption/maldigestion
Evaluate small bowel and pancreas
What’s the next step?
Chronic diarrhea w/o red flags or alarm symptoms –>
conservative management(bulking agent, antispasmodics)
T/F: Opiates is an effective way to decrease peristalsis/motility and can be used to treatany kind of diarrhea.
False. Avoid in infection and IBD
Octreatide is used to ____
decrease secretion
Cholestyramine is used to ____
bind bile salts
Celiac Disease is an indication for use of ____ for evaluation.
Endoscopy
Enterography is used to evaluate ____ (2)
Small bowel imaging:
IBD
Tumors
