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GI - 2 > 17-5 -- Malabsorption > Flashcards

17-5 -- Malabsorption Flashcards

1
Q

What is a stool sign of malabsorption?

A

Steatorrhea

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2
Q

Steatorrhea

A

Fatty, greasy, stools

- sign of malabsorption

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3
Q

Diarrhea can occur due to what 4 mechanisms being impaired?

A
  • Intraluminal digestion
  • Terminal digestion
  • Transepithelial Transport
  • Lymphatic Transport
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4
Q

Diarrhea can occur due to what 4 mechanisms being impaired?

A
  • Intraluminal digestion
  • Terminal digestion
  • Transepithelial Transport
  • Lymphatic Transport
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5
Q

What is absorbed with Intraluminal digestion and what 3 conditions is it impaired with?

A

Breakdown of carbs, fats and proteins

= IBD, Pancreatitis and Cystic Fibrosis

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6
Q

What is absorbed with Lymphatic Transport and what condition is it impaired with?

A

Lipid absorption

= Whipple disease

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7
Q

Increased stool mass/frequency/fluidity > 200 mg per day

A

Diarrhea

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8
Q

4 types of Diarrhea?

A
  1. Secretory
  2. Osmotic
  3. Malabsorptive
  4. Exudative
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9
Q

4 types of Diarrhea?

A
  1. Secretory
  2. Osmotic
  3. Malabsorptive
  4. Exudative
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10
Q

Isotonic diarrhea; persists during fasting

A

Secretory Diarrhea

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11
Q

Diarrhea fluid is more concentrated than plasma; stops with fasting

A

Osmotic Diarrhea

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12
Q

Steatorrhea diarrhea; relieved by fasting

A

Malabsorptive Diarrhea

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13
Q

Purulent, bloody diarrhea due to inflammatory disease; persists during fasting

A

Exudative Diarrhea

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14
Q

How does Cystic Fibrosis cause diarrhea?

A
  • pancreatic abnormalities that cause an accumulation of mucous
  • Impaired secretions = impaired digestion
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15
Q

What may be seen in a child with Cystic Fibrosis that causes a bowel obstruction?

A

Meconium Ileus

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16
Q

What is an immune disease triggered by the ingestion of gluten?

A

Celiac disease

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17
Q

Describe the pathogenesis of Celiac Disease

A
  • Gluten broken down to Gliadin
  • Gliadin induces cells to express IL-15
  • IL-15 triggers CD8+ T cell activation
  • T cells express NKG2D
  • NKG2D recognizes MIC-A on enterocytes and T cells attack
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18
Q

What HLA molecules does Gliadin interact with to cause more tissue damage with Celiac Disease?

A

HLA-DQ2 and HLA-DQ8

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19
Q

What physical changes to the intestines are seen with Celiac Disease?

A

Villous atrophy
Crypt hyperplasia
Loss of mucosal surface area

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20
Q

What cell type is increased intraepithelially with Celiac Disease?

A

Lymphocytes

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21
Q

Celiac disease involves IgA antibodies. What specific antibodies can diagnose Celiac disease?

22
Q

EMA and tTG antibodies can diagnose?

A

Celiac Disease

23
Q

What are some classic symptoms of Celiac Disease?

A

Diarrhea and bloating
Malabsorption which causes Anemia
Dermatitis Herpetiformis (blisters from IgA deposits)

24
Q

What are some classic symptoms of Celiac Disease?

A

Diarrhea and bloating
Malabsorption which causes Anemia
Dermatitis Herpetiformis (blisters from IgA deposits)

25
Those with Celiac disease have an increased risk for what malignancy?
T cell lymphoma
26
What causes Environmental Enteropathy?
Poor sanitation/hygiene or | Defective mucosal immune function
27
3 symptoms of Environmental Enteropathy?
Malabsorption Malnutrition Stunted growth
28
Malabsorption and stunted growth are seen with which Enteropathy?
Environmental Enteropathy
29
How is Autoimmune Enteropathy inherited?
X-linked Recessive
30
Autoimmune Enteropathy involves loss of?
FOXP3 | ==> defective development of CD4 T REG cells
31
Autoimmune Enteropathy involves loss of?
FOXP3 | ==> defective development of CD4 T REG cells
32
Autoimmune Enteropathy involves antibodies to what cells?
Enterocytes Goblet cells Parietal cells Islet cells
33
What cell type infiltrates the intestinal mucosa with Autoimmune Enteropathy?
Neutrophils
34
What are the symptoms of Autoimmune Enteropathy?
Persistent diarrhea Autoimmune disease ** in CHILDREN **
35
What age group does Autoimmune Enteropathy primarily affect and what are the symptoms?
CHILDREN | - Persistent diarrhea and autoimmune disease
36
With Abetalipoproteinemia, what can the body NOT make?
Unable to assemble triglyceride-rich lipoproteins
37
With Abetalipoproteinemia, what can the body NOT make?
Unable to assemble triglyceride-rich lipoproteins
38
Abetalipoproteinemia involves a mutation in?
MTP
39
With Abetalipoproteinemia, where do lipids accumulate?
Intracellularly
40
Symptoms of Abetalipoproteinemia and when it presents?
Presents in INFANCY | = failure to thrive, diarrhea, steatorrhea
41
Symptoms of Abetalipoproteinemia and when it presents?
Presents in INFANCY | = failure to thrive, diarrhea, steatorrhea
42
What 4 molecular things are seen with Abetalipoproteinemia?
NO apolipoprotein B Decreased Vitamins Acanthocytes Spiky RBCs
43
What 4 molecular things are seen with Abetalipoproteinemia?
NO apolipoprotein B Decreased Vitamins Acanthocytes Spiky RBCs
44
Describe how diarrhea arises with Lactase Deficiency
Lactose cannot be converted to glucose + galactose = Lactose remains in lumen and attracts fluid == Diarrhea
45
2 types of Lactase Deficiency?
Congenital | Acquired
46
Congenital Lactase Deficiency
Mutation in gene encoding lactase
47
Symptoms of Congenital Lactase Deficiency?
When milk ingested in infancy: | = explosive diarrhea and abdominal distention
48
Acquired Lactase Deficiency?
Downregulation of lactase gene expression due to not ingesting milk after weaning or infections
49
Symptoms of Acquired Lactase Deficiency?
Diarrhea and flatulence
50
Milk ingested in infancy which causes explosive diarrhea and abdominal distention is likely?
Congenital Lactase Deficiency

GI - 2 (61 decks)

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