Ch. 338 Flashcards
Specific findings on examination can guide toward a specific malabsorption disorder: Edema
Protein-losing enteropathy
Specific findings on examination can guide toward a specific malabsorption disorder: Digital clubbing
CF and celiac disease
Specific findings on examination can guide toward a specific malabsorption disorder: Perianal excoriation and gastric abdominal distension
Carb malabsorption
Specific findings on examination can guide toward a specific malabsorption disorder: Perianal and circumoral rash
Acrodermatitis enteropathica
Specific findings on examination can guide toward a specific malabsorption disorder: Abnormal hair
Menke syndrome
Clinitest reagent is used for screening carb malabsorption which identifies reducing substances such as carbs in stool. A positive test is
An acidic stool with >2+ reducing substance
___ is used to identify the specific carbohydrate that is malabsorbed
Breath hydrogen test
Procedure in Breath hydrogen test
After an overnight fast, the suspected sugar is administered as an oral solution. A rise in breath hydrogen of 20 ppm above the baseline is considered a positive test. The child should not be on antibiotics at the time of the test, because colonic flora is essential for fermenting the sugar.
a sensitive test to assess exocrine pan creatic function in chronic cystic fibrosis and pancreatitis
Fecal elastase-1
Main clinical expression of malabsorption
Diarrhea
Investigation for carb malabsorption: Can measure mucosal disaccharidase concentrations directly
Small bowel mucosal biopsies
MCC of hypoalbuminemia in children
Renal disorder
Measurement of ___ is a useful screening test for protein-losing enteropathy
alpha1-antitrypsin
MCC of exocrine pancreatic insufficiency
Cystic fibrosis
Gold standard for exocrine pancreatic function
Direct analysis of duodenal aspirate (volume, bicarb, trypsin, and lipase upon secretin and pancreozymin/cholecystokinin stimulation)
Gluten-sensitive enteropathy
Celiac disease
Immune-mediated disorder characterized by chronic inflammation of the small intestine
Celiac disease
Antibodies seen in Celiac disease
Antibodies to TG2
MC extraintestinal manifesration of celiac disease
IDA unresponsive to iron therapy
Ultimate diagnosis of celiac disease relies on
Demonstration of specific but not pathognomonic histopathologic abnormalities in the small bowel mucosa
ESPHAN Criteria for celiac disease
1) Villous atrophy with hyperplasia of the crypts and abnormal surface epithelium while patient is eating adequate amounts of gluten 2) Full clinical remission after withdrawal of gluten from diet
The only treatment for celiac disease
Lifelong strict adherence to a gluten-free diet
Short bowel syndrome is the loss of >___% of small bowel with or without a portion of the large intestine
50
Main site for carb, protein, iron, water-soluble vitamin absorption
Proximal 100-200cm of jejunum
Vitamin B12 and bile salts are only absorbed in
Distal ileum
Primary adult type hypolactasia is caused by
Physiologic decline in lactase activity that occurs following weaning in most mammals
Secondary lactose intolerance is caused by
Small bowel mucosal damage, usually transient improving with mucosal healing
