142b - Clinical Features of Malabsorption Flashcards
Where in the GI tract is iron absorbed?
Duodenum
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Where in the GI tract are monosaccharides and amino acids absorbed?
Jejunum
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How is protein malabsorption diagosed?
Clinical presentation + alpha-1-antitrypsin clearance
Which part of the GI tract is most affected by Celiac disease?
Small intestine
Proximal (duodenum) more affected than distal
=> problems with iron absorption
Which enzyme is useful in diagnosis in pancreatic exocrine insufficiency?
Elastase
- Low fecal elastase is consistent with pancreatic insufficiency
- Not included in PERT, therefore can still be measured in pts receiving exogenous pancreatic enzymes
Describe the presentation of fat malabsorption
-
Steatorrhea
- Greasy, foul-smelling stools that float
- Stick to toilet bowl, difficult to flush
- Weight loss
- Nutrient deficiencies
- Fat soluble vitamins: ADEK
Where in the GI tract are lipids abosrbed?
Ileum
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Which mineral deficiency is associated with celiac?
Why?
Iron deficiency
- Iron is absorbed in the duodenum
- Celiac disease often affects the duodenum more than other parts of the GI tract
What nutrients are abosrbed in the ileum?
- Lipids
- Fat soluble vitamins (ADEK)
- Folate
- Terminal ileum
- Vitamin B12
- Bile salts
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In a patient with pancreatic exocrine insufficiency, what do you expect from their:
- Fecal fat levels:
- Fecal elastase levels:
(In general)
- 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
Where in the GI tract is vitamin B12 absorbed?
Terminal ileum
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