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IP 2 Exam IBS

alchemist04's version from 2018-11-05 00:24


Question Answer
Secretory Diarrhearesults when a substance causes elevated rates of fluid transport into the intestinal lumen through increased secretion or decreased absorption of water and electrolytes. Stimulative substances include hormones, unabsorbed dietary fat, laxatives, bacterial toxins, and excessive bile salts. Secretory diarrhea produces large stool volumes (>1 liter per day) with normal ionic contents and osmolality equal to plasma. Stool volume does not change with fasting.
Osmotic Diarrhearesult from ingestion of poorly absorbed food/nutrient like nonabsorbable carbohydrate (lactulose, sorbitol), magnesium salts in laxatives and antacids, Celiac spruce. It cease w/ fasting
Exudative DiarrheaDirect damage to the intestinal mucosal lining or brush border. Inflammatory bowel disease or infection can lead to discharge of mucus; Autoimmune disease, Crohn disease, ulcerative colitis, and other severe infections such as E. coli or other forms of food poisoning. It does not stop w/ fastin
Dysmotility Diarrhearesults in decreased transit time in the small intestine, premature emptying of the colon, and bacterial overgrowth. This can cause inadequate absorption of fluids, electrolytes, and nutrients. It is often caused by surgical resection of the intestine or prokinetic drugs such as metoclopramide (ReglanĀ®), which increases the frequency of contractions in the small intestine. It ceases with fasting.


Question Answer
Rome III is forIBS diagnosis and includes IBS-C, IBS-D, IBS-M and IBS-U
Complimentary/alternative therapy for IBS arePeppermint oil, Fennel seed oil, Artichoke leaf extra, Fennel tea, clown mustard plant and probiotics
LomotilAtropine + diphenoxylate
Linaclotide is also known as what and how long must it be taken before or after meal?Linzess, 30 mins b4 breakfast


Question Answer
How does Opioid cause GERD?by exerting anticholinergic effect in the GI and causing delayed emptying which results in GERD
How does Opioid cause constipation?opioid agonist slows down or reduced the number of the propulsive peristaltic waves in the large intestine. This results in a delay in passage of bowel contents and increased water absorption in both the small and large intestine.
Which receptor does Loperamide/imodium and Lomotil bind to?mu receptor
Inhibition of 5HT will result inConstipation
Activating 5HT will result inrelieve of constipation


Question Answer
Dicyclomine (antispasmodic)IBS only
Hyoscyamine (antispasmodic)IBS only
Eluxadoline (Viberzi)IBC-D


Question Answer
Loperamide (inodium)Diarrhea primarily
MIralax (PEG 3550 or Polyethylene glycol)Constipation primarily
LomotilDiarrhea primarily
Amitriptyline (TCA)IBS only


Question Answer
Linaclotide (Linzess)IBS-C
Rifaximin (Xifaxan)IBS-D
Desipramine (TCA)IBS only
Lubriprostone (Amitiza)IBS-C


Question Answer
Paroxetine (SSRI)IBS only
Alostetron (Lotronex)IBS-D
Tegaserod (Zelnorm)IBS-C
Citalopram (SSRI)IBS only