Diarrhea

Question 1

how long can acute diarrhea last? what about chronic?

Answer 1

acute is less than 2 weeks and chronic is more than 4

Question 2

what typically causes acute diarrhea?

Answer 2

most commonly infectious

Question 3

name the four types of diarrhea

Answer 3

inflammatory
secretory
osmotic
motility

Question 4

what causes diarrhea in osmotic diarrhea?

Answer 4

increased solutes in the lumen pulls water out and makes the stools runny

Question 5

what causes motility diarrhea?

Answer 5

rapid transit through the colon

Question 6

what can cause osmotic diarrhea to usually resolve?

Answer 6

fasting

Question 7

what is a common infectious cause of secretory diarrhea?

Answer 7

cholera toxin

Question 8

will fasting fix secretory diarrhea? what diarrhea will fasting fix?

Answer 8

no it will not

will fix osmotic though

Question 9

what diarrhea type is associated with hypokalemia?

Answer 9

secretory diarrhea

Question 10

what is the equation for the stool osmotic gap?

Answer 10

290-(2x(Na+K)) in stool

Question 11

is stool osmotic gap greater than 100…what type of diarrhea?

Answer 11

osmotic

Question 12

if stool osmotic gap less than 50 what type of diarrhea?

Answer 12

secretory

Question 13

what type of diarrhea can have an urgency or tenesmus associated with it? why?

Answer 13

inflammatory…because rectum can get inflammed and lead to this issue

Question 14

name three types of inflammatory bowel disease that cause inflammatory diarrhea

Answer 14

ulcerative colitis
crohns disease
microscopic colitis

Question 15

name the four common infectious agents that cause inflammatory diarrhea

Answer 15

enteroinvasive E coli
Shigella
salmonella
clostridia difficile

Question 16

what are the two types of microscopi colitis?

Answer 16

lymphocytic colitis

collagenous colitis

Question 17

what are the symptoms of microscopic colitis?

Answer 17

chronic watery diarrhea with cramping and pain

Question 18

how does the colon appear in microscopic colitis?

Answer 18

totally normal

Question 19

how do you diagnose microscopic colitis?

Answer 19

mucosal biopsy

Question 20

what changes are seen in lymphocytic colitis

Answer 20

infiltration of colonic epithelium with lymphocytes

Question 21

what changes are seen in collagenous colitis?

Answer 21

thickening of subepithelial collagen band

Question 22

what is the treatment for micrscopic colitis types?

Answer 22

budesonide (steroid)

Question 23

name the two genetic factors for celiac disease

Answer 23

HLADQ2 or 8

Question 24

other than genetic factors what else plays into celiac disease development?

Answer 24

environmental factors

Question 25

describe the pathology of celiac disease

Answer 25

epithelium has innate response to gluten and this leads to intraepothelial lymphocytosis and villous atrophy which causes GI and systemic manifestations

Question 26

what are the antibodies to test for with celiacs?

Answer 26

TTG and EMA

Question 27

name the four findings that are common with celiacs

Answer 27

diarrhea malabsorption iron deficiency anemia dermatitis herpetiformis

Question 28

what is the skin finding with celiac? where does it commonly show up?

Answer 28

dermatitis herptiformis | elbows and knees

Question 29

what is treatment for celiacs? does this permanently rid of disease?

Answer 29

remove gluten...antibodies go away but still sensitive and will return if you eat it again

Question 30

what happens to the crypt/villus ration in celiacs?

Answer 30

usually much more villus than crypts but it inverts and there are more crypts than villus...

Question 31

what cells come into the crypt area with celiacs?

Answer 31

lots of lymphocytes

Question 32

what is the change in villi called in celiacs?

Answer 32

villous blunting

Question 33

what is the usual cause of osmotic diarrhea from pancreatiz exocrine insufficiency?

Answer 33

decrease in aamount of lipase

Question 34

what are four causes of pancreatic exocrine insufficiency?

Answer 34

CF alcohol pancreatitis pancreatic ressection pancreatic cancer

Question 35

pancreatic insufficiency will lead to a decrease in what molecules? and what in the stool?

Answer 35

fat in stool...decrease in fat soluble vitamins

Question 36

what cause bacterial overgrowth in the SI?

Answer 36

decreased transit or motility

Question 37

bacterial overgrowth leads to what type of diarrhea?

Answer 37

osmotic diarrhea

Question 38

name two ways to test for bacterial overgrowth being a cause of osmotic diarrhea

Answer 38

hydrogen breath test | empiric trial of antibiotics

Question 39

name two exogenous agents that can cause osmotic diarrhea

Answer 39

sorbitol and non absorbed sugars

Question 40

what is IBS?

Answer 40

abdominal pain and defecation habit changes

Question 41

does IBS always have to be diarrhea? what else can it be?

Answer 41

no...can be only diarrhea or can be mix of extra hard poops and diarrhea or can be only hard poops

Question 42

what is one of the most common findings with people that have IBS? explain what this is

Answer 42

visceral hypersensitvity...this is when balloon distended in rectum ppl with IBS are much more sensitive to pain

Question 43

what is a known cause of IBS/

Answer 43

post infectious