NVD Flashcards
How is diarrhea defined?
- 3+ loose or watery stools per 24 hours
What is the difference between acute vs chronic?
- acute = 14 days or less
- chronic = >30 days
What is the most commonly diagnosed gastrointestinal condition?
- Irritable Bowel Syndrome (IBS)
How is IBS characterized?
- chronic abdominal pain with altered bowel habits
What are the 3 causes of constipation?
- Antacids
- Opioids
- Iron
What are the 4 causes of diarrhea?
- Alcohol
- Augmentin
- Antibiotics
- Lactulose
What dietary modifications is recommended in IBS?
- low FODMAPs diet
What agent is used as first line therapy for diarrhea?
- Loperamide
What is the second line therapy for diarrhea?
- Cholestyramine
What is the first line therapy for constipation?
- psyllium (metamucil)
What is the second line therapy for constipation?
- osmotic laxatives
* PEG, lactulose, milk of magnesia
What are the 4 alarming symptoms that warrant referral for colonoscopy?
- weight loss
- nocturnal symptoms
- unexplained iron deficiency anemia
- family history of selected organic diseases
What serum antibody assays are related to Celiac Disease? (2)
- IgA EMA
- IgA/IgG tTG
What 2 genes are related to Celiac Disease?
- HLA-DQ2
- HLA-DQ8
What is the difference in the diagnostic approach of celiac disease if the patient is gluten free or not?
- consuming gluten = look for IgA tTG + total IgA
- gluten free= perform gluten challenge then look for the assays
Prevalence of lactose malabsorption and intolerance is lowest n what population?
- Europeans + White Americans
What 4 symptoms are common after ingestion of lactose in a lactose intolerant patient?
- abdominal pain
- bloating
- flatulence
- borborygmi
What is the most common test for lactose intolerance?
- Lactose breat hhydrogen test
What are the big “pit falls” that needs to be ruled out in a patient that is vomiting?
- SBO
- Pregnancy
What anti-emetic increases the risk of tardive dyskinesia?
a. serotonin receptor antagonists (Ondansetron)
b. phenothiazines (prochlorperazine)
c. dopamine antagonist (metoclopramide)
c. dopamine antagonist (metoclopramide)
What are the 2 major ions that is lost with vomiting?
- Sodum
- Chloride
What are the 2 major ions that is lost with diarrhea?
- Sodium
- Potassium
What is the pathophysiology of cannabinoid hyperemesis?
prolonged exposure to cannabinoids inactivates the TRPV1 receptor which results in nausea and emesis
What drug therapy is used for cannabinoid hypermesis?
- butyrophenones (haloperidol)
* benzos are second choice
