Diarrhoea Flashcards
Definition of diarrrhoea
Strictly speaking, diarrhoea is an increase in the amount of stool passed daily to
over 300 g of stool per day. Th is is usually accompanied by increased frequency and
loosening of the stools
What is haematochezia
bright red stools from frank blood
Which medications can cause diarrhoea
g. laxatives, digoxin, metformin, thiazides, some antibiotics
T/F immune-related diseases are less likely to present for the first time in older adults
T…… but curiously, Crohn’s disease has a second incidence peak at ages 50−80.
What do you always start your management with
Airway, Breathing, and Circulation (ABC): always, always, always start the
management of a patient with ABC. Whilst the ABCs will be obviously normal in a large number of patients presenting in a non-emergency setting, you
should always keep it in mind when admitting patients to hospital. Note that
hypotension is a late and worrying sign in young patients.
• Dehydration: in a patient with a 3-day history of diarrhoea,
What is a normal anion gap and how is it calculated
(Na+K − Cl − HCO3) should be <18 mM
Skin/eye/joint problems associated with UC and Crohn’s?
Uveitis (painful
red eye with loss of vision)
Scleritis (painful red eye with no loss of vision),
Episcleritis (uncomfortable red eye with no loss of vision),
Enteric arthritis,
Erythema nodosum (painful, dark red nodules on shins),
and
Pyoderma gangrenosum (ulcers with a surrounding purple halo) are all associated with IBD (UC and Crohn’s disease)
Common cause of erythema nodosum in young women
Combined oral contraceptive pill
but in this case Crohn’s/UC as they are systemic inflammatory conditions
Coeliac disease is often associated with which rash. Where is the rash found
Coeliac disease is often associated with an
itchy rash known as dermatitis herpetiformis.
The rash is typically found
over the extensor surfaces of the limbs and over the scalp. The rash is very
itchy, so its papules are usually raw or crusted from the patient scratching
them.
3 causes of anaemia due to coeliac/crohns/UC?
- Malabsorption of iron/b12/folate
- GI blood loss (especially UC)
- Chronic disease process per se
What makes UC more likely
Bloody diarrhoea
What blood test tests for coeliac with high specificity and sensitivity
Tissue transglutaminase (TTG)
But you have to go an IgA with it.
Because IgA deficiency can cause false -ve results
When do you do a feacal occult blood test
T/F coeliac would expect to have a +ve FOBT
the patient may not have overt blood in
the faeces, but may have blood detectable using a FOBT.
F.
A +ve FOBT points you towards infection or UC, and away from hyperthyroidism, coeliac disease, and
IBS.
What must you do before requesting a feacal occult blood test
Should only be requested after stopping any drugs that can
cause bleeding (e.g. aspirin, warfarin), as these will give a false positive result.
If they cannot be stopped, a positive result does not help the diagnosis and
therefore you should not order the test.
What might ESR/CRP help you in differentiating a GI infection with an inflammatory condition
While both are biomarkers for inflammation, ESR and CRP should be interpreted differently.
CRP is a more sensitive and accurate reflection of the acute phase of inflammation than is the ESR.
In the first 24 hours of a disease process, the ESR may be normal and CRP elevated
