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David's lecture > Diarrhoea > Flashcards

Diarrhoea Flashcards

1
Q

What does peristalsis do?

A

-It moves contents through the GI tract

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2
Q

What occurs when there is an increased transit time?

A

-Leads to increased absorption of water which leads to constipation

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3
Q

What occurs when there is decreased transit time?

A

-Decreased water and nutrient absportion which leads to diarrhoea

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4
Q

The lower the motility, the longer it takes for goods to move from mouth to anus. TRUE OR FLASE?

A

TRUE

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5
Q

What is diarrhoea?

A

A failure of fluid handling in a normal adults small intestine

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6
Q

How much fluid is input into the colon per day?

A

1.5-2.0 litres

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7
Q

How much fluid is output in faeces?

A

100-200 ml/ per day

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8
Q

What is the major function of the colon?

A

To absorb fluids

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9
Q

What are the two major types of diarrhoea?

A
  • Osmotic

- Secretory

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10
Q

What occurs in osmotic diarrhoea?

A

-Excess of osmotically active particles in the gut lumen

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11
Q

What occurs in secretory diarrhoea?

A

-Bowel mucosa secretes excess water into the lumen

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12
Q

What causes osmotic diarrhoea?

A
  • Osmotic laxatives
  • Excessive solutes in the lumen
  • Inflammation within the mucosa
  • Motility disorders
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13
Q

What occurs in secretory diarrhoea?

A
  • Cholera toxin
  • Other infective causes
  • Specific electrolytes transport defects
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14
Q

How can osmotic diarrhoea be treated?

A

-By removing the source of the osmotically active particles e.g fasting

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15
Q

In secretory diarrhoea, fasting does not alter the mechanisms and therefore does not halt diarrhoea. TRUE OR FALSE?

A

TRUE

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16
Q

Diarrhoea is defined as the increase in stool frequency or water content. TRUE OR FALSE?

A

TRUE

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17
Q

Give examples of some of the agents that cause infections leading to diarrhoea?

A

-Shigella, salmonella , E.Coli

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18
Q

How does infection cause diarrhoea?

A
  • They damage the mucosa e.g rotavirus

- The toxins produced by the infectious agent e.g cholera

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19
Q

What does CFTR stand for?

A

Cystic fibrosis transmembrane conductance regulator

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20
Q

What occurs in cystic fibrosis?

A

-The protein is mutated

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21
Q

CFTR is the only ATPase that pumps ions downhill. TRUE OR FALSE?

A

TRUE

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22
Q

Clostridium difficile is the major cause of diarrhoea and colitis in patients exposed to antibiotics. TRUE OR FALSE?

23
Q

Describe the stages of infection from C. difficile?

A
  • Alteration of normal colonic flora
  • Colonic colonization
  • Growth and production of toxins
  • Infection can lead to fromation of colitis
24
Q

How can an infection from C. Difficle be treated?

A
  • Discontinue offending antibitotics
  • Metronidazole (contraindicated in paients with liver or renal impairment
  • Vancomycin (contraindicated with patients with renal impairment)
25
Q

Diarrhoea can be good, as it removes irritating substances for gut. TRUE OR FALSE?

26
Q

Diarrhoea can lead to significant fluid and salt loss which can be lethal. TRUE OR FALSE?

27
Q

What are treatment measures to treat diarrhoea?

A
  • identify cause of diarrhoea
  • Restore fluids/electrolytes by oral rehydration therapy
  • Elimination of infection may be necessary e.g by using abosrbent agents such as kaolin and anti-diarrhoeal drugs
28
Q

When are antidiarrheal drugs indicated?

A
  • Severe or prolonged diarrhea
  • Severe diarrhea in young children and older adults
  • When specific causes of diarrhoea have been determined
  • In chronic inflammatory diseases of the bowel e.g ulcerative colitis and crohn’s disease
  • In ileostomies
29
Q

What are the contraindications for the use of antidiarrhoeal drugs and what can occur if this is given to patients?

A

-When diarrhoea is caused by
- toxic materials
-Microorganisms that penetrate intestinal mucosa
-Antibiotic - associated colitis
Antidiarrheal agents that slow peristalsis may aggravate and prolong diarrhoea

30
Q

Opiates (morphine and codeine) are contraindicated in chronic diarrhoea because of possible opiate dependence. TRUE OR FALSE?

31
Q

Difenoxin and loperamide are not contraninidcated in children younger than 2 years of age. TRUE OR FALSE?

32
Q

How do anti-motiltiy agents work?

A

-They reduce persistalsis by stimulating opiod receptors in the bowel, which decreases GI motility and increase absorption of water from the bowel

33
Q

Adsorbents and bulk forming drugs can be useful in some form of low grade chronic diarrhoea. TRUE OR FALSE?

34
Q

What are adsorbents such kaolin not recommended for?

A

Acute diarrhoea

35
Q

Describe the mechanism of action of opiods?

A
  • Intestinal motility of micro receptors
  • Intestinal secretion of delta receptors
  • Intestinal absorption of micro and delta receptors
36
Q

Commonly used opiod receptors act via peripheral receptors. TRUE OR FALSE?

37
Q

Loperamide is 40-50 times more potent than morphine as an anti-diarrheal drug. TRUE OR FALSE?

38
Q

How does loperamide (imodium) work?

A
  • Increase the small instine and mouth to cecum transit time, increases anal sphincter tone
  • Contains anti secretory activity against cholera toxin and some forms of E. Coli toxin
39
Q

What is the half life of Loperamide?

40
Q

What are some of the ADRs for Imodium?

A

-Adbominal cramping, dizziness, drowsiness

41
Q

Codeine is a weak opiate that is metabolised to morphine. TRUE OR FALSE?

42
Q

What are the ADRs for codeine?

A

-Drowsiness, long list of opoid related minor side effects can cause physical dependence

43
Q

What are the contranindications for codeine?

A

-Acute respiratory depression, paralytic ileus

44
Q

Morphine is not a strong opiate and is not used as kaolin and morphine mixture. TRUE OR FALSE?

45
Q

Morphine has a greater risks for dependence than codeine. TRUE OR FALSE?

46
Q

What is Co-Phenotrope a combination of and which one is the opiate?

A
  • Diphenoxylate and atropine

- Diphenoxylate - opiate

47
Q

Atropine is not a antiperistaltic. TRUE OR FALSE?

48
Q

Co-Phenotrope can cross BBB which can lead to euphoria, respiratory depression, drowsiness, diziness. TRUE OR FALSE?

49
Q

What group of patients should be not be given Co-Phenotrope?

A

-Patients with acute inflammatory disease of the bowel (ulcerative colitis, crohn’s disease) can cause acute toxic megacolon

50
Q

Adsorbents are not recommended for use in acute diarrhoea. TRUE OR FALSE?

51
Q

Adsorbents non selectively absorbs intestinal fluid. TRUE OR FALSE?

52
Q

What do adsorbents do?

A
  • Regulates stool texture and viscosity

- Bind bacteria toxins and bile salts

53
Q

What do probiotics do?

A
  • They replace normal colonic microflora

- restores instenial function and supresses the growth of pathogenic bacteria

54
Q

Provide some examples of probiotics?

A
  • Diary products e.g lactose

- Lactobacillus acidophilus

David's lecture (13 decks)

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