Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MP322 > MP322 - MANAGEMENT OF DIARRHOEA AND CONSTIPATION > Flashcards

MP322 - MANAGEMENT OF DIARRHOEA AND CONSTIPATION Flashcards

1
Q

diarrhoea

A

increased liquidity of the stool and/or increased loose or liquid stool frequency (>3 times/day)

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

classification of diarrhoea

A

acute <14 days
persistent >14 days
chronic >30 days

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

physiological classification of diarrhoea

A

inflammatory and non-inflammatory

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

inflammatory diarrhoea

A
  • presence of an inflammatory process
  • mucoid and bloody stool, tenesmus, fever cramp-like abdominal pain
  • small frequent bowel movements
  • histology of GI tract is abnormal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

non-inflammatory diarrhoea

A

osmotic and secretory
- watery, large-volume, frequent stool (>10-20/day)
- volume depletion is possible due to frequency
- histology of GI tract is preserved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

osmotic non-inflammatory diarrhoea

A
  • presence of unabsorbed or poorly absorbed solute (e.g. Mg2+, mannitol)
  • stool volume is small
  • stops or improves with fasting
  • due to maldigestion or malabsorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

secretory non-inflammatory diarrhoea

A
  • altered transport of ions across the mucosa
  • increased secretion and decreased absorption of fluids
  • doesn’t improve with fasting
  • stool volume larger than osmotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

bacteria that cause diarrhoea

A

E. Coli
Campylobacter
Salmonella
C. difficile
Listeria
V. Cholerae

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

viruses that cause diarrhoea

A

rotavirus
norovirus
adenovirus
astrovirus

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

parasites/protozoa that cause diarrhoea

A

Entamoeba Histoltica
Giardia Lamblia
Cryptosporidium

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

mechanisms causing diarrhoea

A

increased secretion or decreased absorption of fluids and electrolytes

absorption of water is passive and secondary to the absorption of solutes

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

Cl- transport in the intestine

A
  • secreted Cl- is provided by the Na+/K+/2Cl- cotransporter
  • activity is driven by low intracellular Na+
  • Cl- is secreted through Cl- channels
  • Na+ and water enter lumen by paracellular transport
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

infection - Vibrio Cholerae

A
  • cholera toxin enters cells
  • activates G protein, which activates adenylyl cyclase
  • increases cellular cAMP and activation of protein kinase A (PKA)
  • phosphorylation of Cl- channel
  • increased efflux of Cl- (and water)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

use of antibacterial

A
  • disruption of normal intestinal microflora
  • proliferation of opportunistic pathogens (C. Difficile)
  • impaired fermentation of poorly absorbed carbohydrates and/or reduced production of short chain fatty acids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

increased motility

A
  • reduction in intestinal transit time results in inadequate absorption
  • drugs with cholinergic activity (e.g. pilocarpine for dry mouth)
  • drugs with anticholinesterase activity (e.g. donepezil for Alzheimer’s disease)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

drug treatment of diarrhoea

A

antimotility drugs (stop excess water being secreted)
prolong the duration of intestinal transit

17
Q

diphenoxylate drug

A
  • opioid receptors on neuronal varicosities
  • activation of opioid receptors decreases ACh release
  • peristaltic activity decreased
  • segmental contraction increase
  • usually provided as a mixture with atropine (co-phenotrope)
18
Q

codeine phosphate

A

POM
- symptomatic relief of chronic diarrhoea
- mechanism of action similar to diphenoxylate

19
Q

adverse effects of opiates

A

rebound constipation
higher doses can have CNS effects
prolonged use can lead to opioid dependence

20
Q

Racecadotril

A

PRO-DRUG
- activation of S opioid receptors decreases the cellular cAMP levels
- decreased secretion of Cl-
- decreased water secretion
- metabolised to thiorphan

thiorphan - enkephalinase inhibitor (prevents the breakdown of enkephalins)

Enkephalins are the endogenous activator of S opioid receptors

21
Q

Constipation

A

heterogeneous disorder
symptoms:
- <3 bowel movements per week
- straining
- lumpy or hard stools
- sensation of anorectal obstruction
- sensation of incomplete defaecation
- manual manoeuvring required to defaecate

22
Q

causes of primary constipation

A
  • normal-transit constipation
  • slow-transit constipation
  • pelvic floor dysfunction
  • IBS with constipation
23
Q

causes of secondary constipation

A
  • medications
  • metabolic disorders
  • endocrine disorders
  • psychiatric (anxiety, depression)
24
Q

drug induced constipation

A

drugs with anticholinergic activity
- antidepressants, antihistamines, antimuscarinics, antipsychotics, antiparkinsonian agents
- opioids
- drugs affecting electrolytes
- laxative misuse (atonic colon)

25
Q

treatment of constipation

A

laxatives
- osmotic
- stimulant
- bulk-forming
- faecal softeners

26
Q

Linaclotide

A

guanylate cyclase-C agonist
- 14 amino acid synthetic peptide
- increases cellular cAMP and activation of protein kinase G (PKG)
- phosphorylation of Cl- channels
- increased efflux of Cl- (and water)
- restricted use (SMC)

used to treat IBD with constipation

27
Q

Lubiprostone

A

Prostone
- derived from functional fatty acids that occur naturally
- directly activates Cl- channel (CIC-2)
- increased efflux of Cl- (and water)
- may restore mucosal barrier function

28
Q

adverse effects of linaclotide and lubiprostone

A

generally well tolerated
diarrhoea
nausea
vomiting
abdominal pain

MP322 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions