kiddy diarrhea

Question 1

def dia

Answer 1

increased stool fluid content above normal

- over 3 loose/lquid stools per day

Question 2

location of villi

Answer 2

small and large bowel

Question 3

how much fluid enters colon and how much is absrobed

Answer 3

1.5-2L/day - 90% absrobed

Question 4

most important ion for flow

Answer 4

Na

Question 5

main pump and 3 main mech that pull H2o into body

Answer 5

Na/K pump

1. SGLT-1 - glucose/Na cotransporter pulls Na and glucose in from lumen
2. Na comes in from electro selective Na channels
3. Anion co-exchanger (Cl/CO3)

Question 6

Main secretory channel

Answer 6

CFTR - pushes Cl into lumen and Cl and Na come into enterocyte - pushes NA out

Question 7

what is net water movement

Answer 7

follows the gradient that has been created

Question 8

4 mech that affect electrolytre movement

Answer 8

1. enteric nervous system
2. lamina propria cells
3. mucosal epi cells - somatostatin
4. blood

Question 9

what is important molecule that increases absorbtion

Answer 9

aldosterone - increases Na absorbtion via Na/K pump

Question 10

how do most substances affect gut levels

Answer 10

via secretion

Question 11

what are 3 main messangers involved in secretons

Answer 11

1. cAMP
2. cGMP
3. Ca/kinase

Question 12

how do they work (2)

Answer 12

1. inhib. Na/CL influx

2. increase Cl efflux

Question 13

what part of lumen is most absorbtion and secretion

Answer 13

absorb - villi
secrete -crypt
- since there are more villi than crypt, get fluid absorbtion1

Question 14

2 types of villous problems with absorbtion

Answer 14

1. too little time to absorb

2. not enough ville (destructions)

Question 15

def osmotic diarrhea

Answer 15

too much solute pulls water into gut

• proportional to intake of solute
• stool ion gap high
• not usually too bad

Question 16

3 things that might cause osmotic

Answer 16

1. carbs
   2, fat
2. protein

Question 17

2 possible cause of them being there and one possible outcome

Answer 17

1. lack of disgestion
2. lack of absorbtion
   - can ferment and cause gas

Question 18

what are only carbs that can be absorbed without digestion

Answer 18

glucose and fructose

Question 19

what happens to fats

Answer 19

1. emulsified by bile to micelles
2. hydrolized to fatty acids
3. absorbed via passive diffusion

Question 20

what happens to chol.

Answer 20

special transport protein

Question 21

what happens to protein

Answer 21

hydrolyzed by various proteases then taken up as di/tri peptides or AAs

Question 22

def secretory diarrhea

Answer 22

increase in enterocyte secretion

Question 23

features of secretory

Answer 23

large volume

• no response to fasting
• colon responses vary

Question 24

2 mech of sectetory

Answer 24

1. increased secondary messangers

2. loosening of the tight junctions

Question 25

3 cause of diarrhea

Answer 25

motility

Question 26

main cause of acute diarrhea

Answer 26

infection

- enteric or extraintestinal

Question 27

def. chronic diarrhea

Answer 27

> 14 days

Question 28

what is main question to ask

Answer 28

are they still growing?

- if so, probably not bad

Question 29

7 “zebra” causes

Answer 29

1. protein indegestiokn
2. fat assimilation
3. bile acid disorders
4. general malabsorb
5. pancreatic insuff.
6. immune based
7. defects in electrolyte transport

Question 30

9 common causes (other than infection)

Answer 30

1. diet - sorbitol
2. meds
3. pancreatic insuff. -CF, inflammation
4. bile acid disorders - too little or too much
5. carbo malabsorbtion
6. immune based - celiac, IBD,
7. motility disorders - hirschprung, thyrotoxicosis
8. neoplastic
9. surgical

Question 31

important questions on Hx

Answer 31

1. age of onset
2. duration freq
3. birth Hx
4. diet
5. stool
6. med and fam Hx

Question 32

5 exam points

Answer 32

1. growth and demeanor
2. clubbing
3. nasal polyps
4. skin integrity
5. perianal appearance

Question 33

3 most common cause in finfants

Answer 33

1. formula intolerance
2. CF
3. immunodef. states

Question 34

3. most common causes in toddlers

Answer 34

1. post-infetious enteritis
2. diet related
3. celiac

Question 35

3 most common in older

Answer 35

1. celiac
2. lactose
3. IBD