131b malabsorption Flashcards
what is the end result of malabsorbtion? what does that mean?
steatorrhea
loss of fecal fat (normally absorb 95%+)
what do bacteria do to bile salts? why does this matter?
deconjugate
wont form micelles
lactose deficiency?
most common disaccharidase deficiency
lactase isn’t present
bacteria ferment lactose to form gas
short chain fatty acids are the preferred fuel of colon???
protein digestion - is acid required? what marks low protein absorption?
acid not required (hypochlorhydria)
low protein –> hypoalbuminemia –> edema
vit D deficiency symptoms?
osteoporesis; osteopenia
vit k deficiency symptoms?
bleeding
steatorrhea amount of fat/24hrs?
5 grams
where are bile salts absorbed?
terminal ileum
where is Fe absorbed?
duodenum
what is aborbed proximally?
iron
water soluble vitamins/minerals
fats, fat soluble vitamin (ADEK)
carbs, amino acids, small peptides
sudan stain
good specificity for steatorrhea, low sensitivty
stains fat - doesn’t tell maldigestion vs malabsorption
schiling test - how is it done? what does various results mean?
B12 shot to saturate all sites + radioactive PO B12
R-protein + IF + B12 –> splitting off R-protein in order to absorb requires pancreas enzymes –> if bad pancreas then can’t split off and absorb B12
measure how much comes out in urine
- if low then give IF to test; if corrects then pernicious anemia
- if corrects with pancreatic enzymes –> pancreatic insufficiency
- if corrects with antibiotics –> bacterial overgrowth
- never corrects –> ilieum resection/disease
CCK-Secretin duodenal drainage test
measure output following CCK and secretin admin
d-xylose - how is test done? what is normal? If abnormal, what does it indicate?
25 grams sugar PO that is passively absorbed in intestine
renal clearance (urine + blood test) should be > 5 grams
if < 5 grams –> malabsorption or bacterial overgrowth
early peak of hydrogen breath test?
bacterial overgrowth
