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Gasto > GI SS 2 > Flashcards

GI SS 2 Flashcards

1
Q

Constipation

A

fewer than three in a week - hard, straining, incomplete

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2
Q

Constipation causes

A

Fiber Hydration Holding it in

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3
Q

Primary Constipation

A

More common - Cannot be attributed to any structural abnormalities or systemic disease

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4
Q

Secondary Constipation

A

More sudden w/out constipation - Caused by systemic disease, medications, obstructing lesions

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5
Q

Constipation S&S

A

History is important to tell Primary/Secondary differences PE -Dullness to percussion in the left quadrants
DRE

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6
Q

Constipation – Further Work Up

A

age 50 years or older
severe constipation
signs of an organic disorders
alarm symptoms

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7
Q

Constipation - Labs

A 
Complete blood count
Serum electrolytes (CMP)
calcium, glucose
Thyroid panel
Radiographs
Endoscopy - Sigmoidoscopy
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8
Q

Constipation Treatment

A

Lifestyle, Diet, Exercise, Medical Changes

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9
Q

Constipation Meds

A

Osmotic Laxative
Stimulant Laxative
Stool Surfactants
Enema

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10
Q

Constipation - Complications

A

Fecal Impaction

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11
Q

Paradoxical diarrhea

A

Liquid stool around impaction

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12
Q

Fecal Impaction

A

Requires manual disimpaction/fragmentation followed by administration of oil-retention enema (mineral oil)

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13
Q

Hemorroids

A

chronic dilation of the veins of the rectum

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14
Q

Constipation - Refer

A

Symptoms are refractory to treatments
Patient has structural abnormality
Evidence of obstruction
Over age 50 or Alarm symptoms

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15
Q

Diarrhea

A

frequent stools (more than three per day)
loose, watery stools
urgency

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16
Q

Acute Diarrhea

A

<2W

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17
Q

Chronic Diarrhea

A

> 4W

18
Q

Persistant Diarrhea

A

2-4W

19
Q

Inflam vs Non-inflam=

A

Bloody vs non-bloody

20
Q

2 important diarrhea consideration

A

Time frame & Inflam(Blood)

21
Q

Accute Non-inflam (organism type)

A

Mild - self limiting - due to noninvasive bacteria Virus - Norovirus / Rotavirus

22
Q

Acute Diarrhea S&S

A 
Loose, watery stools
Up to 10 per day
Abdominal cramps
Bloating
N/v                                                                                        Dehydration
23
Q

Dehyrdation signs

A

Dizziness, light headedness, orthostatic HOTN

24
Q

Acute Inflammatory Diarrhea (organism type)

A

<2W w/ blood or pus & fever Invasive or Toxin producing bacterium - E Coli O157 + others

25
Q

Acute Inflammatory Diarrhea

A 
Loose, bloody stools
Lower in volume
Fever
Severe abdominal cramps (LLQ)
Urgency
Tenesmus - Rectal cramping
26
Q

Acute Inflammatory Diarrhea Eval

A

Prompt evaluation necessary in all cases Fecal Leukocytes - = in non-inflammatory diarrhea
Stool Culture
Ova & Parasites (O&P) - Three samples necessary
C difficile assay (recent antibiotic use)

27
Q

Acute diarrhea treatment - generally

A 
BRAT diet
Avoid high-fiber foods, fats, dairy, caffeine
Rehydration
Frequent PO liquids
Water, Gatorade
Oral rehydration salts if necessary
28
Q

Acute diarrhea treatment - Meds

A 
Not always indicated! – Diarrhea is the body’s method of “flushing the system                                                                                    but - Antidiarrheals to continue mission/work
Antibiotics sometime (invasive organsims even se
29
Q

Acute diarrhea treatment - Empiric

A

Fluoroquinolones DOC for Immunocompromised Severe dehydration Nonhospital acquir

30
Q

Traveler’s Diarrhea - Empiric

A

Fluoroquinolones, Azithromycin, Rifaximin

31
Q

Chronic Diarrhea

A 
Medications - Review & D/C
Osmotic Diarrheas
Secretory Conditions
Inflammatory Conditions
Malbsorptive Conditions
Motility Disorders
Chronic Infections
Systemic Disorders
32
Q

Chronic Diarrhea due to - Medications

A

Review & D/C

33
Q

Chronic Diarrhea due to - Osmotic Diarrhea

A 
Increased stool osmotic gap 
Resolve when fasting
Etiologies:
 Carbohydrate malabsorption
 Laxative abuse
 Malabsorption syndromes
34
Q

Chronic Diarrhea due to - Secretory

A 
Increased intestinal secretion or decreased absorption
High volume, watery stool
Little to no change with fasting
Etiologies:
Endocrine tumors
Bile salt malabsorption
35
Q

Chronic Diarrhea due to - Inflammatory

A

Inflammatory Bowel Disease
Crohn Disease
Ulcerative Colitis
Microscopic Colitis

36
Q

Chronic Diarrhea due to - Motility D/O

A

Irritable Bowel Syndrome

Pain and altered bowel habits w/o evidence of organic disease

37
Q

Chronic Diarrhea due to - Chronic Infections

A

Parasitic infections
Giardia, E histolytica, and Cyclospora
Intestinal nematodes

38
Q

Chronic Diarrhea due to - Systemic Conditions

A

Thyroid disease

Diabetes

39
Q

Chronic Diarrhea – Work Up

A

First exclude most common causes
Evaluation directed at most likely
Lab Tests:
CBC, Chem 17, LFT, Thyroid studies, ESR, CRP
Stool studies:
Culture, Leukocytes, Lactoferrin, Occult blood, O&P, electrolytes

40
Q

24 Hr stool collection

A

Total Weight - total fat

41
Q

Chronic Diarrhea - Treatment

A

Depends on etiology but most often refer

Gasto (6 decks)

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