142b - Clinical Features of Malabsorption

Question 1

Where in the GI tract is iron absorbed?

Answer 1

Duodenum

Question 2

Where in the GI tract are monosaccharides and amino acids absorbed?

Answer 2

Jejunum

Question 3

How is protein malabsorption diagosed?

Answer 3

Clinical presentation + alpha-1-antitrypsin clearance

Question 4

Which part of the GI tract is most affected by Celiac disease?

Answer 4

Small intestine

Proximal (duodenum) more affected than distal

=> problems with iron absorption

Question 5

Which enzyme is useful in diagnosis in pancreatic exocrine insufficiency?

Answer 5

Elastase

• Low fecal elastase is consistent with pancreatic insufficiency
  
  • Not included in PERT, therefore can still be measured in pts receiving exogenous pancreatic enzymes

Question 6

Describe the presentation of fat malabsorption

Answer 6

• Steatorrhea​​
  
  • Greasy, foul-smelling stools that float
  • Stick to toilet bowl, difficult to flush
• Weight loss
• Nutrient deficiencies
  
  • Fat soluble vitamins: ADEK

Question 7

Where in the GI tract are lipids abosrbed?

Answer 7

Ileum

Question 8

Which mineral deficiency is associated with celiac?

Why?

Answer 8

Iron deficiency

• Iron is absorbed in the duodenum
• Celiac disease often affects the duodenum more than other parts of the GI tract

Question 9

What nutrients are abosrbed in the ileum?

Answer 9

• Lipids
• Fat soluble vitamins (ADEK)
• Folate
• Terminal ileum
  
  • Vitamin B12
  • Bile salts

Question 10

In a patient with pancreatic exocrine insufficiency, what do you expect from their:

• Fecal fat levels:
• Fecal elastase levels:

(In general)

Answer 10

• Fecal fat levels: high
• Fecal elastase levels: low

Fecal elastase isn’t really an important enzyme, but useful diagnostically b/c not part of pancreatic enzyme replacement therapy

Question 11

Where in the GI tract is vitamin B12 absorbed?

Answer 11

Terminal ileum