UW revision factitous laxatives

Question 1

Factitious. Behavioural characteristics? 2

Answer 1

Intentional falsification of illness: feigninng illness, self-induced illness, exacerbation of preexisting illness

Question 2

Factitious. CP? 4

Answer 2

Overt, dramatic symptoms

Frequent visits for medical care

Patient possibly refusing consent to release records or tampering with test samples

More common in healthcare workers (have access to drugs)

Question 3

Factitious. Dx? 4

Answer 3

Direct obervation or discovery or medical supplies

Confirmatory testing (sulfonylurea screen, sool laxative screen)

Medical record review

prie klausimo buvo stool osmolality measure (dar yra stool electorlytes or stool osmotic gap)

Question 4

Factitious. Stool osmotic gap formula?

Answer 4

290 - 2x(stool Na + stool K)

Question 5

Factitious. Stool osmotic gap < 50?

Answer 5

secretory diarrhea

Question 6

Factitious. Stool osmotic gap 50-125?

Answer 6

indeterminate

Question 7

Factitious. Stool osmotic gap >125?

Answer 7

Osmotic diarrhea

Question 8

SECRETORY DIARRHEA. Causes? 4

Answer 8

Toxins (eg Vibrio cholera), hormones (produced by VIPomas), congenital disorders of ion transport (eg CF), or bile acids (in postsurgical patients)

Question 9

SECRETORY DIARRHEA. CP?2

Answer 9

Low osmotic stool gap
Diarrhea persist during periods of fasting (eg diarrhea during night)

Question 10

OSMOTIC DIARRHEA. Causes?

Answer 10

Osmotic laxatives
Causative substances = milk in a patient with lactose intolerance

Question 11

OSMOTIC DIARRHEA. CP?

Answer 11

Diarrhea presents only then substance is consumed, but not present when fasting.

Question 12

Secretory diarrhea can occur after bowel resection or cholecystectomy - unabsorbed bile acids reach the colon and result in the direct stimulation of luminal ion chales.

Answer 12

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