Sandbox:Umar

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Umar Ahmad, M.D.[2]

Examples

Boxes and Charts

Differential Diagnosis of DISEASE on the basis of BLANK:

The differential diagnosis of Dumping syndrome based on BLANK is as follows:

Differential Diagnosis for Constipation predominant symptoms	Clinical features	Diagnosis
A	Obstipation, constipation	Barium enema, flexible sigmoidoscopy, colonoscopy, CT scan
B	Fatigue, increased sensitivity to cold, dry skin, constipation, weight gain, puffy face, muscle weakness, hoarseness	Serum Thyroid Stimulating Hormone levels
C	Opiates, cholestyramine, Calcium-channel blockers, Anticholinergic medications	Medication history.
D	Concurrent multiple sclerosis, Parkinson disease, autonomic dysfunction(Shy-Drager)	History and neurologic examination
E	Straining, self digitation	Rectal examination, defecography, anorectal manometry, balloon expulsion study
F	Infrequent bowel movements	Radiopaque markers, scintigraphy, wireless pH and motility capsule

Before

AB	CD
EF	HI

JK	LM
NO	PQ

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To this: |- This will connect the two

After

ABC	DEF
GHI	JKL
MNO	PQR
STU	VWX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hyperosmolar meal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rapid glucose absorption into the blood

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hyperglycemia

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rapid emptying of stomach

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fluid shift from blood to gut

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Release of hormones :
• VIP
• GIP
• PYY
• GLP-1
• NeurotensinExcessive
insulin release

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reactive hypoglycemia

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Symptoms

 

 

 

Hyperosmolar meal

Rapid gastric emptying

Reduced gastric volume

Hyperosmolar chyme jejunum

Release of GI hormones

Rapid glucose absorption into blood

Distention of intestine

Increased contractility

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•Nausea •Abdominal pain (cramps)

•Diarrhea •Bloating

Systemic and GI symptoms

Increased release of GLP-1

Peripheral vasodilation

Hypovolemia

Exaggerated insulin release

Hemoconcentration (Dehydrated blood)

Hypotension

Late reactive hypoglycemia

Increased heart rate

•Decreased ANP •Increased Aldosterone

•Hunger •Tremor •Perspiration

•Flushing •Dizziness •Palpitations