diarrhoea

Question 1

blood and pus in diarrhoea is a sign of?

Answer 1

inflammatory diarrhoea - crohn’s

Question 2

Increased gas, offensive smell, floating stools is a sign of?

Answer 2

steatorrhoea (stools also pale)

Question 3

What are the common causes of diarrhoea?

Answer 3

• gastroenteritis
• Parasites
• IBS
• Colorectal cancer
• crohns, UC, Coeliac

Question 4

What are the causes of bloody diarrhoea?

Answer 4

• Campylobacter, Shigella, Salmonella, Ecoli, ameobiassis
• UC / crohns
• colorectal cancer
• colonic polyps
• pseudomembranous colitis
• ischaemic colitis

***Fresh PR bleed (blood on paper and stool)

Question 5

When does mucus occur in diarrhoea?

Answer 5

• IBS
• colorectal cancer
• polyps

Question 6

When does frank pus appear in the diarrhoea?

Answer 6

• IBD
• diverticulitis
• fistula / abscess

Question 7

What can cause “explosive” diarrhoea?

Answer 7

• cholera
• giardia
• yersina
• rotavirus

Question 8

Water stool +/- blood, mucus
pelvic pain relieved by defeacation
tenesmus
urgency 
are all signs of?

Answer 8

Large bowel diarrhoea 
caused by
shigella
salmonella
C.diff
Entamoeba

Question 9

Periumbical pain not relieved by defaecation is?

Answer 9

small bowel symtpoms

Question 10

On examination of a patient with diarrhoea - what do you look for?

Answer 10

1) Dehydration (dry mucous membranes, decreased skin turgor, capillary refill time over 2s)
2) fever, weight loss, clubbing, anaemia, oral ulcers
3) rashes, or abdo scars
4) goitre / hyperthyroid signs
5) Rectal exam for masses / impacted faeces

Question 11

What invx should you do for a pt with diarrhoea?

Answer 11

BLOOD
- FBC , U&E, CRP/ESR, thyroid function

STOOL (if systemic signs)

SIGMOIDOSCOPY

COLONOSCOPY + barium enema

Question 12

A patient presents with diarrhoea. The FBC shows low MCV / iron deficiency what could be the cause of this?

Answer 12

• coeliac
• colon cancer
• crohns

Question 13

A patient presents with diarrhoe. The FBC shows high MCV what could be the cause?

Answer 13

• high alcohol intake

- low B12 absorption (pernicious anaemia, coeliac, crohn’s

Question 14

A patient presents with diarrhoea. The FBC shows raised eosinophil count - what does this indicate?

Answer 14

parasitic infection

Question 15

A patient presents with diarrhoea. A raised CRP / ESR indicates /……

Answer 15

crohns
UC
cancer

Question 16

A patient presents with diarrhoea. A low K+ on the U&E test indicates

Answer 16

severe D & V —> electrolyte loss

Question 17

What drugs can cause diarrhoea?

Answer 17

• Abx
• PPI
• Propanolol
• Cytotoxics
• Laxatives
• NSAIDs
• digoxin
• Alcohol

Question 18

What are the endocrine causes of diarrhoea?

Answer 18

• thyrotoxicosis (hypetthyroid)

- addison’s disease

Question 19

What are the vascular causes of diarrhoea?

Answer 19

ischaemic colitis