diarrhoea

Question 1

pathology of infectious diarrhoea

Answer 1

direct invasion of pathogen damages intestinal mucosa cells –> causing inflammation and prevents absorption of solutes from intestines –> increases luminal osmotic load –> fluid evacuated in watery stool, taking electrolytes with it
enterotoxins produced by pathogen stimulates fluid and electrolyte secretion –> watery stools

Question 2

pathology and sx of viral gastroenteritis

Answer 2

transmission–> contaminated food, contact with another person
symptoms of watery, non-bloody stools, may be accompanied by N/V and low grade fever, chills, malaise, headache
self limiting

Question 3

pathology and sx of bacterial gastroenteritis

Answer 3

watery and/or bloody diarrhoea with mucus, may be accompanied by fever
self limiting

Question 4

pathology and sx of protozoal diarrhoea

Answer 4

incubation period 1-2 weeks
symptoms: bloating, flatulence, explosive, foul smelling and greasy stools, abdominal cramps, anorexia and nausea
without treatment can persist for weeks to months

Question 5

types of dietary diarrhoea (3)

Answer 5

LACTOSE INTOLERANCE
EXCESSIVE FIBER INTAKE
ENTERAL DIETS THAT IS HIGHLY OSMOTIC

Question 6

types of drug induced diarrhoea

Answer 6

Antibiotics 
chemotherapeutic agents 
acarbose 
magnesium containing antacids 
HIV medications 
digoxin 
Cholchicine 
NSAIDs
caffeine and theophylline 
laxative abuse

Question 7

things to ask patient (diarrhoea)

Answer 7

age 
medical history 
diet, travel, occupational history 
timing of diarrhoea
stool quality and volume 
other associated symptoms (dehydration, abdominal pain, weight loss, fever, n&v)

Question 8

when to refer

Answer 8

<3yo 
>48h and worsens 
presence of blood, mucus and pus in stools 
accompanied by severe vomiting and fever 
signs of severe dehydration 
severe abdominal symptoms 
suspected adverse drug reaction 
individuals who maybe immunocompromised

Question 9

antiperistaltics (2)

Answer 9

loperamide

diphenoxylate + atropine

Question 10

loperamide MOA

Answer 10

acts directly on circular and longitudinal intestinal muscles, through the opioid receptor to inhibit peristalsis and prolong transit time
reduce decal volume, increase viscosity, diminishes fluid and electrolyte loss, demonstrates anti-secretory activity

Question 11

loperamide dose

Answer 11

2mg caps
2 caps stat followed by 1 cap after each unformed stool,/
max 8 caps a day

Question 12

loperamide contraindications

Answer 12

diarrhoea associated with high fever or mucus/blood

Question 13

diphenoxylate + atropine dose

Answer 13

2.5mg/0.025mg tab
1-2 tabs ads or ads
max 8 a day

Question 14

loperamide min age

Answer 14

2yo

Question 15

diphenoxylate min age

Answer 15

13yo