Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PCQ > IBS, Acute Diarrhea > Flashcards

IBS, Acute Diarrhea Flashcards

1
Q

IBS age epidemiology

A

F>M

20-39 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

IBS presentation

A

Chronic/recurrent abdominal pain/discomfort
Cramping, diffuse lower abdominal pain→ variable intensity, periodic exacerbations
+/- dyspepsia, atypical chest pain, vomiting (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

IBS categories:

A

Constipation predominant
Diarrhea predominant
Mixed
Unclassified

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Extraintestinal symptoms of IBS

A 
Sexual dysfunction
dysmenorrhea
Irritative voiding symptoms
Fibromyalgia
somatic or psychological complaints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Rome IV criteria for IBS

A

Recurrent abdominal pain 1 or more days/week in last 3 months + 2 or more:

  1. Related to defecation
  2. Change in stool frequency
  3. Change in stool form
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

IBS, C/D alarm symptoms

A 
Onset >50 years
Severe/progressively worsening
Nocturnal diarrhea
Fevers/vomiting
Unexplained weight loss
Melena, hematochezia, (+) occult blood
Personal or family history of colon cancer, IBD, Celiac
Iron deficiency anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Labs for IBS

A 
Not usually indicated
\+/-
CBC, CMP, TSH
ESR/CRP
Celiac serologies
stool studies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Further workup for IBS is indicated in cases of…

A

Atypical history
alarm features
refractory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Further workup for concerning IBS cases includes

A

Laboratory/stool studies
Cross sectional/small bowel imaging
Endoscopy/colonoscopy with biopsies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How much fiber should an IBS patient be taking?

A

20-35 g daily→ start low, increase slowly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diet for IBS

A

FODMAP diet:

Eliminate sugars and fibers that cause pain and bloating

Eliminate x 4-8 weeks→ gradually reintroduce 1-2 foods at a time→ assess tolerance

Trained dietician to avoid unnecessary over-restriction, may not be appropriate for everyone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Levsin

A

anticholinergic for abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bentyl

A

anticholinergic for abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Side effects of anticholinergic meds

A

Dry eyes
Dry mouth
Constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Rifaximin

A

Diarrhea meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Imodium

A

Diarrhea meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Alosetron

A

Diarrhea meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Viberzi

A

Diarrhea meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which diarrhea med can only be prescribed to women and needs a risk management program?

A

Alosetron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Psychosocial meds for IBS

A

TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Evaluate for _____ on DRE (for constipation)

A 
evaluate for fissures
hemorrhoids
tenderness,
masses
stool
anal stricture
anal sphincter tone
perineal descent
dysynergic defecation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Rx agents for constipation side effects

A

Diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Lubiprostone

A

Rx agent for constipation

can cause diarrhea

24
Q

Linaclotide

A

Rx agent for constipation

can cause diarrhea

25
Plecanatide
Rx agent for constipation | ***can cause diarrhea***
26
More at risk for fecal impaction
dementia neurologic disease immobile hypomotility meds
27
Diarrhea
Passage of >3 unformed stools/day
28
Diarrhea is most commonly
infectious viral self-limiting
29
Acute diarrhea
<14 days
30
Persistent diarrhea
14-30 days
31
Chronic diarrhea
>30 days
32
Red flag for diarrhea (but not IBS or constipation)
Signs of volume depletion
33
Exposures that could cause diarrhea
Recent hospitalization or abx Travel Ingestion of improperly stored/prepared food Sick contact exposure, community outbreaks Pets/animals New meds or dose changes
34
Public health risk
healthcare worker daycare worker food-handlers
35
Physical exam for diarrhea
***Volume status + complications*** Temp, HR, orthostatic BP Skin turgor, mucous membranes Abdominal distention, bowel sounds, tenderness, peritoneal signs, masses Rectal tenderness, stool guaiac, perianal disease Mental status
36
Noniflammatory diarrhea symptoms
``` Watery nonbloody diarrhea N/V Mild diffuse abdominal cramps bloating/flatulence +/- Low grade fever ```
37
Inflammatory diarrhea symptoms
Fever bloody diarrhea severe abdominal pain
38
Viral causes of NONinflammatory diarrhea
*Norovirus* | Rotavirus
39
Viral causes of inflammatory diarrhea
Cytomegalovirus
40
Bacterial causes of NONinflammatory diarrhea
Vibrio cholera Clostridium perfringens Staph aureus Bacillus cereus
41
Bacterial causes of inflammatory diarrhea
``` ***Salmonella Campylobacter Shigella, Enterohemorrhagic E coli 0157:H7 Clostridioides difficile*** Vibrio parahaemolyticus Yersinia ```
42
Protozoal causes of NONinflammatory diarrhea
***Giardia*** Cryptosporidium Cyclospora
43
Protozoal causes of inflammatory diarrhea
Entamoeba histolytica
44
Diarrhea diagnostics
``` *Not routinely warranted for most patients* +/- CBC, CMP, CRP Stool cultures→ Salmonella, Shigella, Campylobacter E coli 0157:H7 culture Ovum + Parasites ( Giardia, C diff Hemoccult Imaging ```
45
Diarrhea patients who need prompt evaluation
Signs of inflammatory diarrhea: Fever >101.3 F, leukocytosis, bloody diarrhea, severe abdominal pain ``` Intractable vomiting Profuse watery diarrhea + dehydration AKI/Lyte abnormalities Elderly or nursing home residents Immunocompromised Hospital-acquired diarrhea, exposure to abx ```
46
Supportive care for acute diarrhea
Oral rehydration therapy Trial of lactose free diet Probiotics +/- Antidiarrheal agents→ safe + effective for patients without dysentery
47
Loperamide
Antidiarrheal agent
48
Bismuth subsalicylate
Antidiarrheal agent
49
Bismuth subsalicylate side effect
black stool
50
Antibiotic treatment for acute diarrhea
generally not indicated as most cases are self-limited Some organisms require specific antibiotics→ Reference Sanford Guide Empiric abx→ Fluoroquinolone or Azithromycin x3-5 days
51
Vibrio cholerae
Non-inflammatory bacterial diarrhea | Causes "rice-water" diarrhea
52
Norovirus
Non-inflammatory viral diarrhea
53
Giardia lamblia
Non-inflammatory protozoal diarrhea found in camping, lakes, streams, ponds, daycares, and pools
54
Clostridiodides difficile
Inflammatory bacterial diarrhea Causes: recent abx use or community acquired Tx: discontinue inciting abx. Vancomycin Fidaxomicin Metronidazole
55
Yersinia enterocolitica
Inflammatory bacterial diarrhea that can mimic appendicitis

PCQ (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions