02b: Malabsorptive Disorders Flashcards
Worldwide, (X) is the most common cause of malabsorption.
X = Infestation (Giardia and other organisms)
In industrialized societies, the common causes of malabsorption are: (star the two most common)
- Lactose intolerance*
- Celiac disease*
- Pancreatic insufficiency
- Bacterial overgrowth
Chronic pancreatitis causes malabsorption via which mechanism? Which other diseases have this similar effect?
Lack of pancreatic enzymes/HCO3 (failure of digestion)
CF, pancreatic cancer
Bacterial overgrowth causes malabsorption via which mechanism? Which other diseases have this similar effect?
Lack of bile salts (defective micelle formation)
Obstructive jaundice, cholestatic liver disease, bile salt loss (ex: resection of terminal ileum)
List some disease states that cause malabsorption due to loss of villi surface in small bowel.
- Celiac
- Post-infectious
- Whipple’s disease
- Crohn’s
Patient describes stool as light-colored and sticky to the toilet bowl. This is suggestive of (X) from (Y) malabsorption.
X = steatorrhea Y = fat
CHO malabsorption: you would expect diarrhea to be (secretory/osmotic).
Osmotic (unabsorbed osmoles promote water movement into lumen)
Fat malabsorption: you would expect diarrhea to be (secretory/osmotic).
Secretory (lipids metabolized by bac in colon to produce FA that promote secretion)
Patient with diarrhea and night blindness is likely deficient in (X).
X = Vit A
Patient with diarrhea and easy bruising is likely deficient in (X).
X = Vit K
Patient with diarrhea and peripheral neuropathy is likely deficient in (X).
X = Vit B12
Edema is a common physical finding in malabsorption of:
Protein
Clubbing of fingers is a finding suggestive of which GI issue?
IBD
What is angular stomatitis? It’s suggestive of (X) deficiency.
Inflammation on sides of mouth;
X = Iron
Glossitis is suggestive of (X) deficiency.
X = Iron and vitamin B
Aphthous ulcers are commonly found in which malabsorptive disease(s)?
Celiac’s and Crohn’s
ZES causing (low/high) duodenal pH will cause (CHO/fat) malabsorption via which mechanisms?
Low; fat
- Inhibits fat digestion by pancreatic lipase
- Decrease bile salt solubility
Bacterial overgrowth occurs in (small/large) bowel and is clinically diagnosed by (X).
Small;
X = breath test (orally administered CHO metabolized by intraluminal bac and CO2/H measured)
What would constitute an “abnormal” breath test, indicating bacterial overgrowth?
H2 exhaled in breath detected earlier than normal (since overgrowth occurs in small bowel and normal bacteria is colonic)
T/F: Pts with bacterial overgrowth are treated with antibiotics.
True - rifaximin, tetracycline, and ciprofloxacin for a week or so
Protein losses/malabsorption is more common in (pancreatic/intestinal) diseases.
Intestinal (absorption);
Both protein and CHO digestion can be maintained until over 90% of pancreatic function (protease/amylase secretion) is lost
CHO maldigestion is often the result of defective (X).
X = brush border hydrolases (convert oligos into monosacc)
Why would hyperthyroidism cause CHO malabsorption?
Rapid transit states don’t allow brush border enzymes enough time for adequate digestion
T/F: Lactase is a brush-border enzyme.
True
