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Year 3 - Medicine and Surgery book > Diarrhoea > Flashcards

Diarrhoea Flashcards

1
Q

What are the causes of diarrhoea

A
  1. Infection of bowel
  2. Inflammation of bowel e.g. IBD, diverticular disease
  3. Increased bowel motility (e.g. hyperthyroidism, anxiety, IBS)
  4. Malabsorption of nutrients (coeliac disease, pancreatic insufficiency)
  5. Obstruction overflow
  6. Medications
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2
Q

What are ddx for diarrhoea

A 
Young: 
Infective diarrhoea 
IBS
Coeliacs
Crohns
UC
Medications

In elderly - neoplastic disease, diverticular disease, overflow diarrhoea secondary to constipation, ischaemic colitis, microscopic colitis and bacterial overgrowth more common

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3
Q

How can you tell if a metabolic acidosis is being compensated for?

A

If acidotic with low HCO3-, suggests that bodies trying to compensate for acidosis to shift eqm to left

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4
Q

Mucoid/jelly like stools suggests?

A

Classically suggests Salmonella or villous polyps in the colon

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5
Q

Foul smelling and floating stools suggests

A

Malabsorption due to coeliacs, pancreatic duct obstruction or biliary insufficiency

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6
Q

Unusually pale faeces suggests?

A

Lack of bile salts to to biliary or pancreatic duct obstruction (e.g. chronic pancreatitis, gallstones)

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7
Q

Blood on paper when they wipe indicates?

Blood mixed in with stools suggests?

A

Anal pathology - anal fissure, haemorrhoids

UC, dysentery, colorectal carcinoma

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8
Q

Urgency to pass stools indicates?

A

Infectious diarrhoea or IBD

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9
Q

Tenesmus (incomplete emptying) suggests?

A

SOL in rectum (e.g. carcinoma)

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10
Q

Varying bowel habit between diarrhoea, normal stools and constipation suggests?

A

IBS if young patient

Colorectal cancer in elderly

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11
Q

infectious diarrhoea typically presents how often?

A

Once

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12
Q

What does diarrhoea with vomiting suggest?

A

Infectious Gastroenteritis

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13
Q

Diarrhoea with RIF pain could indicate?

A

Terminal ileum inflammation (e.g. Crohns)

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14
Q

Pain in LIF with diarrhoea indicates?

A

Diverticular disease

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15
Q

Pain relieved by passing motions suggests?

A

IBS

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16
Q

Eye problems, joint pains or skin rashes indicates?

A

Associated with IBD (UC and Crohns)

17
Q

Antibiotics and PPIs can cause diarrhoea due to which organism

A

C difficile

18
Q

Clubbing is a sign for which conditions

A

Crohns
UC
Hyperthyroidism

19
Q

Iritis, episcleritis and scleritis are signs of which 2 diseases

A

Crohns

UC

20
Q

Mouth ulcers are a sign of which condition

A

Crohns

21
Q

Erythema nodosum is a sign of which pathologies

A

Crohns and UC

COCP can also cause erythema nodosum

22
Q

Dermatitis herpetiformis is often found along the extensor surfaces of limbs. What is it a sign of

A

Coeliac disease

23
Q

In Crohns disease, where is a mass often found?

A

RLQ

Masses in LLQ could indicate malignancy

24
Q

Anal ulcers and fistulae are signs of which disease?

A

Crohns

25
Q

What blood tests are done in someone with diarrhoea

A
  1. FBC - coeliacs, Crohns, UC all cause anaemia
  2. ESR - elevated ESR = Crohns or UC
  3. CRP - raised in infectious diarrhoea, UC or Crohns
  4. TTG and IgA levels - coeliac disease test
  5. TFTs
  6. U&Es
  7. Albumin - will be low if patient has chronic diarrhoea and malabsorption
  8. Capillary glucose
26
Q

What faeces tests would you do in someone with diarrhoea

A
  1. Faeces microscopy and culture - nb pus cells indicate IBD
  2. C difficile toxin test - especially if patient has recent abx
  3. FOBT - detectable blood points towards UC or infection
27
Q

Which 2 disease fall under IBD

A

Coeliacs and Crohns

Crohns includes RLQ pain and weight loss
UC may have bloody diarrhoea and diffuse pain

28
Q

What investigations are done for suspected Crohns?

A
  1. AXR - bowel inflammation? Severe UC patients are also at risk for toxic megacolon which can perforate
  2. Colonoscopy
  3. DCBE radiograph - rarely used
29
Q

Which medications may be given for Crohns patients

A

Methotrexate
Azathioprine
Infliximab

30
Q

IBS is linked to which psychological triggers

A

Stress. anxiety and depression

31
Q

What is given to treat C difficile infections

A

Metronidazole

Give vancomycin if severe

32
Q

Painless, bloody diarrhoea with a clear cutoff between abnormal and normal bowel (on investigations) indicates what?

A

UC

UC has a strong association with primary sclerosing cholangitis (obstructive jaundice and liver failure) and cholangiocarcinoma

33
Q

What medication is given for UC

A

Methotrexate, azathioprine, salicylate derivatives, corticosteroids, anti-TNF antibodies

Consider surgical resection

34
Q

Which antibody is raised in Graves disease

A

Anti-TPO

Year 3 - Medicine and Surgery book (29 decks)

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