Diarrhea: DDx

Question 1

What are the causes of Acute Diarrhea?

Answer 1

1. Gastroenteritis:
   - Hep A: Mexico, no vaccine
   - E. Coli: Travel
   - Giardia: Travel, campers
   - Staph: Church picnics/mayonnaise
2. Clostridium Diff: Antibiotics

Question 2

Causes of bloody diarrhea?

Answer 2

1. Gastroenteritis
2. IBD
3. Bleeding peptic ulcer

Question 3

What are the causes of Chronic Diarrhea?

Answer 3

1. Hyperthyroidism
2. Stress (IBS)
3. Infectious: travel
4. HIV
5. Diet: celiac, lactose
6. Medications: Atbs, stool softeners
7. Rheumatic disease: red eyes, mouth ulcers
8. IBD
9. Malignancy

Question 4

Order in HIstory taking approach?

Answer 4

1. Pre op: DDx
2. Intro
3. CC
   - OCD: How many times? During the night?
   - COCCA +-B/M
   - What increases or decreases?
4. Associated
   - Pain?
   - Vomiting
   - Alternation with constipation
5. Impact:
   - Dehydration?
   - Weight loss?
6. Red flags:
   - Constitutional Symptoms
   - Cancer: Age, history of Ca in family, calibre of stools, type of diet
7. DDx
8. PMH
9. FH
10. SH

Question 5

Diarrhea: Most common organism

Answer 5

Campylobacter

Question 6

Diarrhea: Recent atb use

Answer 6

Clostridium difficile

Question 7

Diarrhea: Camping

Answer 7

Giardia

Question 8

Diarrhea: Traveler’s diarrhea

Answer 8

ETEC

Question 9

Diarrhea: Church picnics/mayonnaise

Answer 9

S. aureus

Question 10

Diarrhea: Uncooked hamburgers

Answer 10

E. coli O157:H7

Question 11

Diarrhea: Fried rice

Answer 11

Bacillus cereus

Question 12

Diarrhea: Poultry/eggs

Answer 12

Salmonella

Question 13

Diarrhea: Raw seafood

Answer 13

Vibrio, HAV

Question 14

Diarrhea: AIDS

Answer 14

Isospora, Cryptosporidium, Mycobacterium avium complex

Question 15

Diarrhea: Pseudoappendicitis

Answer 15

Yersinia

Question 16

Watery diarrhea, dehydration, muscle weakness, and flushing

Answer 16

VIPoma (replace fluids and electrolytes, may need to surgically resect tumor, or use ocreotide).