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2010-07-14 #1.2

Types of diarrhea

diarrhea with blood & leukocytes; low-volume: causes? invasive: Shigella spp; Campylobacter jejuni; Entamoeba histiolytica
X inflammation in bowel mucosa: high-volume diarrhea; Dx? secretory; osmotic
loss of isotonic fluid; caused by laxative, enterotoxins, carcinoid syndrome: Dx? secretory
causes of secretory diarrhea laxatives: melanosis coli with use of phenanthracene laxatives; Vibrio cholerae & ETEC; ↑serotonin
loss of hypotonic salt solution: causes? osmotic: disaccharidase deficiency; "Stunned gut" in giardiasis; ingestion of poorly absorbable solutes (magnesium sulfate laxatives)
fecal smear for leukocytes[-]; stool osmotic gap <50 mOsm/kg: Dx? secretory
difference between secretory & osmotic screening test results secretory: increased 5-HIAA due to carcinoid syndrome; gap < 50; osmotic: gap > 100
Created by: mataos