GIT

Question 1

what is diarrhea?

Answer 1

Diarrhea is increased frequency or volume of stool per day acute or chronic

Question 2

most common causes of diarrhea

Answer 2

1. infectious,
2. antibiotic-associated, or 3.lactose-intolerance etiology,
3. irritable bowel syndrome, and
4. carcinoid syndrome.

Question 3

clinical presentation

Answer 3

1. .hypotensive,
2. febrile, and
3. experiencing abdominal pain

Question 4

Diagnosis…

Answer 4

1. evaluation of diarrhea is to see if there is hypovolemia

2. etiology

Question 5

TTT

Answer 5

1. give IV fluids and antibiotics.

2. Blood >use antibiotic

Question 6

majorty of Infectious Diarrhea

Answer 6

viral and self-limited

Question 7

the most common cause of bacterial diarrehea

Answer 7

Campylobacter and Salmonella, especially in patients with sickle cell and achlorhydri

Question 8

1. chines food and vomiting
2. reactive arthritis and GBS
3. contaminated hamburger and HUS
4. infilterd water on camping lackes and mountain
5. chicken and egg
6. ingestion of raw shellfish
7. nausea and vomiting + salad

Answer 8

1. Bacillus cereus
2. Campylobacter
3. E-coli
4. giardia
5. sallmonela
6. vibrio parahaemolyticus
7. staph

Question 9

diagnosis….

Answer 9

1. stool culture
2. Cryptosporidiosis diagnosis requires a unique test—a modified acid-fast test
3. Giardia diagnosis is best made with an ELISA stool antigen test

Question 10

TTT

Answer 10

1. resolve spontaneously
   and will not need antimicrobial
   2.pain ,blood, fever use anti(empiric :ciprofloxacin)
   3.Scombroid poisoning is treated with antihistamines
   4.Giardia is still
   treated primarily with metronidazole
   5.Cryptosporidiosis is treated with nitazoxanide

Question 11

pathgenesis: C. difficile-Associated Diarrhea(common nosocomial)

Answer 11

1.any antibiotic can lead to difficlie
2.Clindamycin may have one of the highest frequencies
of association, as do fluoroquinolones and cephalosporins

Question 12

clinical presentation:

Answer 12

1.mild diarrhea to fulminant colitis

Question 13

diagnosis:

Answer 13

1. after using antibiotics, evaluate for C. diff
2. ELISA), based on toxin detection in the stool
3. or PCRand LAMP detect toxins

Question 14

TTT:

Answer 14

1. Metronidazole is the drug of choice (contra with pregnancy and allergy) if recurrent use IV
2. oral vamcomysin
3. fidaxomicin reduce number of recurrent

Question 15

Lactose intolerance

Answer 15

single most common potential cause of diarrhea because of

the enormously high prevalence of lactase deficiency

Question 16

clinical

Answer 16

diarrhea produced is associated with gas and bloating, but never contains blood or
leukocytes. Despite the malabsorption of lactose, weight loss does not occur

Question 17

diagnosis

Answer 17

1.increased stool osmolality and increased osmolar gap
2.remove milk, cheese, ice cream,
and other dairy products

Question 18

TTT

Answer 18

1. dietary changes are the best
   therapy.
2. The patient can use lactase supplements

Question 19

etiology of Irritable Bowel Syndrome

Answer 19

predominantly a pain syndrome of unknown etiology

Question 20

clinical presentation

Answer 20

1. diarrhea alternating with constipation
2. pain
3. no nucturnal sym
4. no fever, weight loss,, anorexia,anemia

Question 21

Diagnosis

Answer 21

1.first step is to exclude lactose
intolerance, IBD, celiac disease, carcinoid, Giardia infection, and anatomic defects of the bowel
as the cause.
2. Rome criteria, must occur for at least 3 months

Question 22

TTT

Answer 22

1. High-fiber diet to increase bulk of the stool
2. Antidiarrheal agent such as loperamide
3. Osmotic laxative polyethylene glycol for IBD-C
4. Do not use alosetron due to risk of ischemic coliti

Question 23

what is Carcinoid Syndrome

Answer 23

tumors of the neuroendocrine system. They are most often

located in the appendix and ileum and with increased serotonin

Question 24

highly symptoms is by

Answer 24

serotonin produced is

released directly into the circulation without being detoxified in the liver.

Question 25

clinical presentation

Answer 25

1.diarrhea, flushing, tachycardia, and
hypotension
2.rash may develop from niacin deficiency
3.Endocardial fibrosis
also occurs because of a constant exposure of the right side of the heart to the serotonin(tricuspid and pulmonic stenosis)

Question 26

diagnosis

Answer 26

urinary 5-hydroxyindolacetic acid level

5-HIAA

Question 27

TTT

Answer 27

1. controlling the diarrhea with octreotide,
2. localized >resected
3. Surgery is also used to relieve obstruction of the bowel.