Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SAM 2 > Diarrhea > Flashcards

Diarrhea Flashcards

1
Q

What is diarrhea?

A

Passing of loose or liquid stool secondary to disorders of the GI system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the normal physiology of the small intestine?

A
  • Site of absorption of almost all nutrients
  • Food has been broken down into very small partially digested particles
  • Bile and pancreatic enzymes facilitate breakdown into smaller molecules which facilitates transport across the epithelium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are three very important balances maintained by proper GI physiology?

A

Acid base balance
Water balance
Nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the result of disruption of the osmosis functions of the GIT?

A
  • Malabsorption of water dependent solutes

- Water remaining in the lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the result of disruption of secretory functions of the GIT?

A
  • Increased secretion of water into the lumen

- Bacterial toxins and other agents open channels to allow water loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What effect does infection have on the GIT?

A
  • Disruption and destruction of epithelium
  • Malabsorption of water and nutrients
  • Exudation of serum and blood with destruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What effect does inflammation have on the GIT?

A
  • Secretory issues

- High rate of loss of epithelium leading to malabsorption and osmotic disruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What effect does increased motility have on the GIT?

A

Increased transit time leads to decreased chance of absorption of nutrients and water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some clinical signs/presenting concerns for an animal with diarrhea?

A

Diarrhea, tenesmus, hematochezia, melena, dyschesia, inappetence, systemic signs of illness, abdominal distension, borborygmi, flatulence, vomiting, weight loss, ravenous appetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What characterizes diarrhea as acute versus chronic?

A

Acute 3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some differentials for a patient with diarrhea?

A

Metabolic disorders, toxin/drug, primary intestinal disease, foreign body, environmental, organ failure, pancreatitis or EPI, neoplasia, infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the questions to ask that can help narrow down your differential list?

A

Onset, duration, appearance and content, frequency, relationship to food, diet change, current diet/encironment/medication, medical history, weight loss, vomiting, appetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some causes of melena?

A

Coagulopathies, immune mediated thrombocytopenia, ingestion of blood, GI erosion/ulceration, foreign body, neoplasia, drug/toxin causing bleeding, vascular anomaly, paraneoplastic, metabolic, inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are common physical exam findings in a patient with melena?

A

Dehydration, abdominal pain and distension, edema, coat colour change, muscle wasting, enlarged LNs, signs of systemic illness, thickened intestines

May be totally normal- always perform a rectal exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What should diagnostics be prioritized based on?

A

Severity, breed, age, environment, exam findings, history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T/F: Acute and stable diarrhea typically responds to empiric treatment.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Presence of what three things with diarrhea require more aggressive treatment?

A

Weight loss, inappetence, dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What kind of diarrhea demands a more complete work up?

A

Chronic diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

T/F: Acute non-ill diarrhea is typically self-limiting, has unremarkable findings, and requires little to no symptomatic therapy.

A

True

Dietary change, psyllium, or metronidazole can be tried if needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the typical causes of acute diarrhea in an otherwise healthy animal?

A

Dietary indiscretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What diagnostic tests can you run as minimum database for an animal that is systemically well with diarrhea?

A

Big 4 and fecal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How is a patient with chronic diarrhea with no systemic illness worked up?

A

Big four and fecal- typically unremarkable

Must differentiate between large and small bowel diarrhea to aid in diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are some common presentations of an animal with diarrhea, acute or chronic, that is systemically unwell?

A

Pain or FB on abdominal palpation
Hematochezia or melena
Dehydration and weight loss

Must provide systemic support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What diagnostics should be done on an animal with diarrhea that is systemically unwell?

A

QATS, BP, bloodwork, UA, fecal, radiographs

25
Q

What is treatment dependent upon?

A

Cause of the diarrhea

Surgical or medical management possible

26
Q

What is the benefit of doing more extensive labwork on a systemically unwell patient with diarrhea?

A

Rule out non-GI disease or learn about extent of primary GI disease

Cortisol levels or ACTH stim, anti-thrombin, Ca panel with vit-D

27
Q

What are some common CBC findings of a systemically unwell patient with diarrhea?

A

Anemia, thrombocytopenia, leukopenia or cytosis

May be normal

28
Q

What are some common chem findings of asystemically unwell patient with diarrhea?

A

Hypoalbuminemia (PLE, neoplasia, pythiosis)
Hypocholesterolemia
Hypocalcemia
Hypo or hyperkalemia, hypochloremia, hyponatremia

May be normal

29
Q

What is typically the only changes noted on a UA of a systemically unwell patient with diarrhea?

A

Minimally concentrated to dilute with PU/PD

30
Q

What endocrine tests are done in a systemically unwell patient with diarrhea?

A

T4- may be sick euthyroid or hyperthroid

Cortisol can also be run

31
Q

What will fecal analysis tell you in a patient with diarrhea?

A

Parasites and protozoa
Bacteria overgrowth
Inflammatory or neoplastic cells

32
Q

What values do a GI panel give you?

A

B12, folate, TLI, and PLI

33
Q

Where is B12 absorbed?

A

Ileum

34
Q

What cofactor is needed for proper B12 absorption from ileum?

A

Intrisic factor produced from the pancreas

Low levels may result in malabsorption and deficiencies despite adequate levels

35
Q

What does a high and low folate level tell you?

A

High- Intestinal dysbiosis

Low- Malabsorption

36
Q

What TLI levels are consistent with exocrine pancreatic insufficiency?

A

Low levels

37
Q

What condition is an elevated PLI level consistent with?

A

Pancreatitis

38
Q

What does speckling in the mucosa of the intestine on US indicate?

A

Inflammatory disease

39
Q

What does striations in the mucosa of the intestine on US indicate?

A

Lymphangectasia

40
Q

What does loss of layers or thickening of layers indicate on US?

A

That there’s a problem- very nonspecific finding

41
Q

What other things can you find on intestinal US?

A

Masses, intussuseptions, LN enlargement, effusions

42
Q

What can be aspirated when investigating GI disease?

A

Thickened small bowel wall, mass lesions, infiltration lesions

43
Q

T/F: Fecal occult blood testing in infrequently used since it is incredible insensitive.

A

True- must be on a non-meat or cooked vegetable food diet otherwise it will give you a false positive

44
Q

What is fecal alpha proteinase inhibitor and what do we use it for?

A

Increases with GI protein loss due to intestinal barrier compromise and leaking

Useful for differentiating PLE from other causes of low albumin

45
Q

What is pANCAs and what do we use it for?

A

Peripheral antineutrophilic cytoplasmic autoantibody

Maker of inflammation in people with colitis and Chrone’s

46
Q

What is methylmalonic academia and what do we use it for?

A

Precursor to or concurrent result with to B12 deficiency

Has an inverse relationship

47
Q

What is a hallmark of treatment for any patient with diarrhea?

A

FLUIDS

48
Q

What antibiotics can be tried with animals with diarrhea?

A

Metronidazole, unasyn, clavamox, tylosin, oxytetracycline, enrofloxacin

49
Q

What kind of things can you give to increase fiber in the diet?

A

Metamucil, konsil, generic psyllium powder, canned pumpkin

Rx- W/D from hills

50
Q

What are some dietary changes that you can attempt with animals with diarrhea?

A

Novel protein, gran free, hydrolyzed proteins, fat restricted, home cooked diets

51
Q

What two vitamins can be helpful to supplement in patients with diarrhea?

A

Folic acid/folate and B-12

52
Q

Can you try prednisone/solone or dexamethasone for diarrhea?

A

Yes- if inflammatory

53
Q

What is budesonide?

A

Topical steroid that is more potent than prednisolone with less systemic side effects

54
Q

What other immune modulation drugs can you use to treat diarrhea?

A

Cyclosporine
Azathioprine- never in cats
Chlorambucil

55
Q

What is sulfasalazine and what is it used for?

A

MOA isn’t clear but helps with large bowel diarrhea

Has some antibacterial and anti-inflammatory properties

56
Q

What is bismuth subsalicylate and what is it used for?

A

Diarrhea treatment and adjuct therapy for helicobacter

Antimicrobial, weak antacid, anti secretory, and anti-inflammatory properties

Radioopaque and creates dark stool

57
Q

What are probiotics?

A

Dosages of living organisms that promote GI health by improving epithelial barrier function and modulating mucosal immune system

Lactobacilli and bifidobacteria

58
Q

What are prebiotics?

A

Non-digestible dietary carbohydrates to stimulate growth and metabolism of enteric protective bacteria

SAM 2 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions