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GI Final > Diarrhea (Quiz 2) > Flashcards

Diarrhea (Quiz 2) Flashcards

1
Q

acute diarrhea is defined as lasting how long

A
  • less than 2 weeks
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2
Q

common etiology of acute diarrhea

A
  • infectious
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3
Q

chronic diarrhea is defined as lasting how long

A
  • more than 4 weeks
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4
Q

etiology of chronic diarrhea

A
  • multiple etiologies

- often non-infectious

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5
Q

pathophysiology of osmotic/malabsorption diarrhea

A
  • increased osmotic load in intestine

- retains fluid in lumen of bowel

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6
Q

treatment of osmotic diarrhea

A
  • resolves or decreases with fasting
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7
Q

pathophysiology of secretory diarrhea

A
  • excess secretion of electrolytes and water into intestinal lumen
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8
Q

secretory diarrhea characterized by

A
  • elevated stool volumes

- hypokalemia

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9
Q

result of fasting with secretory diarrhea

A
  • continues despite fasting
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10
Q

how to calculate stool osmotic gap

A

290 - (2 x (Stool Na + Stool K)

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11
Q

stool osmotic gap > 100 suggests

osmotic gap < 50 suggests

A
  • osmotic diarrhea

- secretory diarrhea

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12
Q

pathophysiology of inflammatory diarrhea

A
  • mucosal destruction leads to increased permeability

- inflammatory mediators stimulate secretion and inhibit reabsorption

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13
Q

clinical features of inflammatory diarrhea

A
  • WBC and blood in stool
  • fever
  • tenesmus
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14
Q

what is tenesmus

A
  • urgency to have a bowel movement
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15
Q

two divisions of microscopic colitis

A
  • lymphocytic colitis

- collagenous collitis

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16
Q

which microscopic colitis affects women more

which one affects both equally

A
  • collagenous - women

- lymphocytic - men and women affected equally

17
Q

what does the colon look like with endoscopy and radiographically in microscopic colitis

A
  • normal appearing colon
18
Q

how to diagnose microscopic colitis

A
  • colonic mucosal biopsies
19
Q

biopsy of lymphocytic colitis shows

A
  • infiltration of colonic epithelium with lymphocytes
20
Q

biopsy of collagenous colitis shows

A
  • thickening of sub epithelial collagen band

- some increase in intraepithelial lymphocytes

21
Q

treatment of microscopic colitis

A
  • Budesonide
22
Q

genetics of celiac disease

importance of this test

A
  • lack of HLADQ2/8 forms autoantibodies (TTG, EMA)

- patient’s don’t necessarily have celiac if they are negative for these HLAs but they could have it

23
Q

presentations of celiac disease

A
  • ADEK deficiencies
  • iron deficiency anemia
  • dermatitis herpetiformis
24
Q

histologic findings for celiac disease

A
  • blunting of villi (crypt:villus ratio 3:1 instead of 1:3)
  • increased lymphocytes and plasma cells in lamina propria of epithelium
  • fusion of microvilli
25
Q

pancreatic exocrine insufficiency - malabsorption does not occur until exocrine secretions are decreased by

A
  • 90%
26
Q

pancreatic exocrine insufficiency what you see in clinical studies

A
  • fat in stool

- decrease in ADEK vitamins

27
Q

pathophysiology of bacterial overgrowth

A
  • decreased transit resulting in overgrowth of bacteria in the small bowel
28
Q

how to diagnose bacterial overgrowth

A
  • small bowel X-rays
  • hydrogen breath test
  • empiric antibiotic trial
29
Q

exogenous agents that can cause osmotic diarrhea

A
  • sorbitol
  • lactose in those deficiency in lactase
  • fructose in those deficient in GLUT5
30
Q

pathophysiology of motility diarrhea

A
  • rapid transit through colon
31
Q

what is IBS

A
  • functional bowel disorder

- abdominal pain associated with defecation or change in bowel habit

32
Q

4 IBS subtypes

A
  • IBS constipation
  • IBS diarrhea
  • IBS mixed
  • IBS unspecified
33
Q

pathophys of IBS

A
  • heightened visceral hypersensitivity
  • altered gut-brain axis
  • abnormal CNS processing of visceral stimuli
  • due to infection
34
Q

red flags for IBS

A
  • onset after age 50
  • worsening symptoms
  • weight loss
  • nocturnal diarrhea
  • family history of colon cancer, celiac, IBD
  • rectal bleeding or melena
  • iron deficiency anemia
35
Q

treatment of motility diarrhea

A
  • improves with fasting
36
Q

what are the criteria for IBS

A
  • Rome IV criteria

GI Final (27 decks)

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