PHCP - WEEK 3 Flashcards
Digestion and
assimilation of nutrients
from food
Intestine
acts as a reservoir,
emptying intermittently by
bolus movements.
– allows time for salvage of
fluids, electrolytes,
nutrients
Distal ileum
-Segmented
– compartmentalizes the
colon
– facilitates mixing, retention
of residue, and formation
of solid stools.
Haustra
-Segmented
– compartmentalizes the
colon
– facilitates mixing, retention
of residue, and formation
of solid stools.
Haustra
- Tonic contraction of the puborectalis muscle, which forms a sling around
the rectoanal junction, is important to maintain continence; - during ______, sacral parasympathetic nerves relax this muscle,
facilitating the straightening of the rectoanal angle
Defecation
Increase in fluidity,
frequency, or volume of
stool output
* Often a symptom of an
underlying disease
Mechanisms
– Dec sodium abs/inc
Chloride secretion
– Inc intestinal motility
– Inc tissue hydrostatic
pressure
Diarrhea
Diarrhea <2weeks
Acute
Diarrhea 2-4weeks
Persistent
Diarrhea >4weeks
Chronic
Ingested, poorly
absorbable, osmotically
active solutes draw
enough fluid into the
lumen to exceed the
reabsorptive capacity of
the colon
* Fecal output increases in
proportion to such a
solute load
* Ceases with fasting or
discontinuation of
causative agent
Osmotic Diarrhea
Fat malabsorption
* Greasy, foul smelling,
difficult-to-flush
* Associated with weight
loss and nutritional
deficiencies
– Concominant
malabsorption of amino
acids and vitamins
Steatorrheal Diarrhea
Discharge of mucus,
proteins or blood into
the gut
Exudative Diarrhea
delay the transit of
intraluminal content or increase gut capacity, prolonging
contact and absorption. The limitations of the opiates
are addiction potential (a real concern with long-term
use) and worsening of diarrhea in selected infectious
diarrheas.
Opiates and opioid derivatives
often recommended for managing acute
and chronic diarrhea. Diarrhea lasting 48 hours beyond
initiating ___ warrants medical attention
*Loperamide
are used for
symptomatic relief (see Table 23–4). _______are
nonspecific in their action; they adsorb nutrients, toxins,
drugs, and digestive juices. Coadministration with other
drugs reduces their bioavailability
Adsorbents
is often used for
treatment or prevention of diarrhea (traveler’s
diarrhea) and has antisecretory, antiinflammatory, and antibacterial effects. Bismuth
subsalicylate contains multiple components that
might be toxic if given in excess to prevent or
treat diarrhea.
Bismuth subsalicylate
is intended to replace
colonic microflora. This supposedlyrestores
intestinal functions and suppresses the growth of
pathogenic microorganisms. However, a dairy
product diet containing 200 to 400 g of lactose or
dextrin is equally effective in recolonization of
normal flora.
Lactobacillus preparation
Empirical Treatment
– Severely ill patients with febrile dysentery
Quinolones, Ciprofloxacin (500mg bid for 3-5d)
Empirical Treatment
- Suspected giardiases
Metronidazole (250mg qid for 7d)
