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41 Cards in this Set
- Front
- Back
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define diarrhea
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stool wt >300 g/day
(normal= 100-300 g/day) |
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characterize small-bowel diarrhea
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stools are voluminous, watery, and fatty
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characterize large-bowel diarrhea
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stools are smaller in volume but more frequent
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what should you suspect when prominent vomiting occurs with diarrhea?
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1. viral enteritis
2. staph aureas food poisoning |
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what are you concerned with in malabsorption diarrhea?
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1. characterized by high-fat content of stools
2. can cause iron deficiency, megaloblastic anemia (B12 loss), and hypocalcemia |
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what is the tx for diarrhea?
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1. oral rehydration
2. iv fluids 3. electrolytes |
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what is the #1 cause of acute diarrhea?
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1. infectious diarrhea!!
2. causes include non-inflam (enterovirus spp. and norwalk virus) 3. inflam (campylobacter, E. coli, salmonella, shigella, clostr. diff) 4. parasites (giardia, entamoeba, cryptosporidium) |
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what are the main causes of noninflammatory diarrhea?
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1. enterovirus spp.
2. Norwalk virus (cause of cruise-ship diarrhea) |
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what are the main causes of inflammatory diarrhea?
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1. campylobacter
2. E.coli for traveler's diarrhea 3. Salmonella 4. Shigella 5. Clostridium difficile with antibiotic exposure |
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what si/sx suggest invasive diarrhea?
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1. blood/mucus in stools
2. fevers/chills 3. vomiting 4. pain |
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what are dx tools for diarrhea?
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1. stool leukocytes
2. gram stain and culture 3. Ova and parasites (O&P) for parasitic 4. C. difficile toxin test |
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what is tx for infectious diarrhea?
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1. ciprofloxacin
2. metronidazole for C. difficile |
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What are parasitic causes of diarrhea?
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1. Giardia
2. Entamoeba 3. cryptosporidium |
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What are causes of osmotic diarrhea?
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1. lactose intolerance
2. oral Mg 3. sorbitol/mannitol |
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What are the dx and tx for osmotic diarrhea?
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1. check for an increase in the osmotic gap
2. check for fecal fat 3. for tx: withdrwa the inciting agent |
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what are causes of secretory diarrhea?
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1. toxins (cholera)
2. enteric viruses 3. increased dietary fat |
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what are the sx of secretory diarrhea?
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1. will see normal osmotic gap
2. with fasting, will not see a change in diarrhea 3. supportive tx |
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what are the causes of exudative diarrhea?
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1. mucosal inflammation from plasma and serum leakage
2. enteritis 3. TB 4. colon CA 5. inflammatory bowel dz |
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what are sx of exudative diarrhea?
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1. increased ESR and CRP
2. radiologic imaging or colconscopy to visualize intestine |
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what is encopresis?
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oozing around fecal impaction in children or sick elderly
"fecal soiling" *seen with hx of constipation *seen in kids who have been potty-trained *leaking stool into underwear |
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how do you tx encopresis?
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1. laxatives
2. fiber-rich diet 3. scheduling a time for going to the bathroom |
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what are si/sx of celiac sprue?
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1. bluten allergy (wheat, barley, rye, oats containing gluten)
2. weakness 3. failure to thrive 4. growth retardation 5. dermatitis herpetiformis=pruritic, red papulovesicular lesions on shoulders, elbows and knees |
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what is the classic rash a/c celiac sprue?
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dermatitis herpetiformis=pruritic, red papulovesicular lesions on shoulders, elbows and knees
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what do 10-15% of celiac sprue pts develop?
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intestinal lymphoma
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what is the dx for celiac sprue?
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1. positive for anti-endomysial, anti-tissue transglutaminase and antigliadin antibodies
2. dx confirmed by small bowel bx showing pathognomonic blunting of villi 4. tx is to avoid dietary gluten |
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what are si/sx of tropical sprue?
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1. likely caused by a tropical infection
2. glossitis, 3. diarrhea 4. wt loss 5. steatorrhea |
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how do you tx tropical sprue?
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1. tetracycline plus folate!!
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what is Whipple's disease?
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GI infection caused by Tropheryma whippelii
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what are si/sx of Whipple's disease?
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1. diarrhea
2. arthritis 3. rash 4. anemia |
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what is dx for whipple's disease?
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intestinal bx PAS-positive macrophages in intestine
(p-aminosalicylic acid (PAS)) |
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what is whipple's diease?
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1. multisystmic disease
2. fever, lymphadenopathy, arthralgias 3. malabosrption 4. duodenal biopsy c/ periodic acid-schiff (PAS)-positive macrophages c/ characterisitic bacillus |
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describe lactase deficiency
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1. most of world is lactase deficient as adults, losing the deficiency as they emerge from adolescence
2. abd pain 3. diarrhea 4. flatulence after ingestion of any lactose-containing product |
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what is intestinal lymphangiectasia?
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1. seen in children, congenital or acquired dilation of intestinal lymphatics which leads to marked GI protein loss
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what are si/sx of intestinal lymphangiectasia?
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1. diarrhea
2. hypoproteninemia 3. edema 4. dx with jeunal bx 5. tx is supportive |
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what are si/sx of diarrhea seen in pancreatic dz?
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1. typically seen in pancreatitis and cystic fibrosis d/t deficiency of pancreatic digestive nzs
2. foul-smelling steatorrhea 3. megaloblastic anemia (folate deficiency) 4. wt loss |
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what are bacterial infectious causes of diarrhea?
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1. e. coli
2. shigella 3. salmonella 4. campylobacter jejuni 5. vibrio parahaemolyticus 6. vibrio cholera 7. yersinia enterocolitica |
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how do you tx barterial infectious causes of diarrhea?
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1. ciprofloxacin (fluoroquinolone--inhibits DNA gyrase)
2. bactrim (sulfonamide--inhibits folic acid) |
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what are viral infectious causes of diarrhea?
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1. rotavirus
2. norwalk virus |
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how do you tx viral infectious causes of diarrhea?
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supportive
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what are parasitic infectious causes of diarrhea?
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1. giardia lamblia
2. cryptosporidium 3. entamoeba histolytica |
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how do you tx parasitic infectious causes of diarrhea?
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metronidazole!!!!
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