Friday, May 23, 2008

It's All About the Bowels

One more week of classes, then a week off for studying, and then it's our big exam for the semester. I don't know what's worse, having to write 5 exams in potentially completely unrelated subject areas you've covered during the semester or having one exam on everything you've done in the semester. I guess with one exam you get it all done and over with, but what if you have a bad day?

This accumulation of knowledge is really starting to get to me. New information is getting processed but at the same time, older information is being wiped away to make room for the more recent stuff. I'm at that point where I feel like I'm getting this error saying, "Disk full. Please insert a new disk."

I'm all about the mnemonics to remember stuff. Here are few more that I've come across or made up myself during the last few weeks of GI:

SECS causes bloody diarrhea (invasive bacteria)

Salmonella typhi - fecal-oral transmission
Enteroinvasive Escherichia coli - uncooked hamburger and swimming water
Campylobacter (eg. C. jejuni) - uncooked meat, esp poultry
Shigella dysenteriae - fecal-oral transmission

In a severe attack of ulcerative colitis, you get...HEAPS oF feces

Hb < 10 g/dL
ESR > 30 mm/hr
Albumin < 30 g/L
Pulse > 90 bpm
Stools > 6/day with blood
Fever > 37.5ยบC

DOMES for diarrhea

  • eg. Thyrotoxicosis, IBS
  • Food ingestion --> increased solute drag --> greater than 500 mL stool/day
  • Disappears with fasting
  • eg. lactose intolerance, magnesium antacids, gastric surgery
  • Voluminous, bulky, fatty, pale, smelly, floating, difficult to flush stools --> steatorrhea (more than 7 g fat in a 24 hr stool collection)
  • eg. Coeliac disease, chronic pancreatitis, previous gastrectomy
  1. Lipolytic phase defects (eg. pancreatic enzyme deficiency)
  2. Micellar phase defects (eg. bile salt deficiency)
  3. Mucosal defects (eg. diseased epithelial lining)
  4. Delivery phase defects (eg. inability to transport fat from cells to lymphatics)
  • Inflammation of colon --> small volume, frequent, bloody and/or purulent stools
  • eg. IBD, colon cancer
  • High volume, no pus/blood, not excessively fatty, diarrhea that persists when fasting.
  • Net secretion > net absorption
  • Causes
    • Infection (eg. E. coli, S. aureus, Vibrio cholerae)
    • Hormonal conditions (eg. vasoactive intestinal polypeptide-secreting tumor, Zollinger-Ellison syndrome, carcinoid syndrome)
    • Villous adenoma



Blogger billy said...

This comment has been removed by the author.

12:51 AM  
Blogger billy said...

i linked to yours without asking already :P so its coooool hahaha. yes unashamed is awesome... and "filled with your glory"... i emailed the distributors so we'll see if i can get some sheet music without having to buy a whole book!! then we can bring it to YF heheh :)

[last time i bought a whole Kutless book for one song.. which some people had issues with so we couldnt use it :( i dont even understand why!! but anyway...]

12:55 AM  
Blogger billy said...

ps - why is this still in canada time!

12:55 AM  
Blogger n2hj said...

Great to read some of your blogs. Sorry about having to remember so many mnemonics. It brings back baddddd memories. Just remember to not get caught studying the about albino zebras or else you'll get run over by the common beasts. Most exams want you to test core topics/concepts and if you get an esoteric "Timbit" have a donut!
About getting pimped. Been there still rubbing the bullseye off my body. Usually the pimper just gave rounds on the topic so he/she could pass for Drs. House/Cecil/Harrison all rolled up into one.
Have fun after your exam. I'm sure you'll do fine! Have a fun time between semesters. If you're looking for an elective in NZ I have a friend that just moved to Napier and is doing GP work there.
It's great that you have friends that sent you to see the Foo Fighters (they've got to be good since even I've heard of them!)
Take care and keep us in the ether-loop
Avalanche SCC 2009!

10:48 PM  

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