Clinical Approach Flashcards
You should suspect malabsorption in known disease states such as those involving: 3
Liver
Pancreas
Small bowel
what could be important in the PMH? 4
- Gastric or small bowel resection
- Gastrointestinal diversion (bariatric surgery
- Radiation exposure
- Travel
you want to know about ____ - where to how long , ____ consumption and ____ (new, illicit)
travel, alcohol, drugs
what do you want to know about the stool? 5
- Duration
- Malabsorptive stool
- Fat globules
- Floating - hard to flush away
- Smelly
what are some signs of malabsorption?
easy bruising
what does easy bruising suggest?
vitamin K and C deficiency (vitamin C - scurvy)
what things can be noted on examination of the skin? 4
- acrodermatitis enteropathica
- dematitis herpetiformis
- glottis and angular stomatitis
- spooning of nails
acrodermatitis enteropathica is a ____ ____ condition
autosomal recessive
- acrodermatitis enteropathica
causes impaired ___ uptake
zinc
what are the symptoms and signs of - acrodermatitis enteropathica ? 4
- Rash
- Perioral
- Acral
- Alopecia
what is the treatment for acrodermatitis enteropathica
life long zinc supplements
Dermatitis Herpetiformis may indicate ____ disease?
coeliac
what happens in Dermatitis Herpetiformis? 3
get itchy blisters, extensor surfaces and sub epithelial IgA deposition
____ and ____ _____ results from deficiency in B vitamins and iron
glottitis and angular stomatitis
what can cause spooning of the nails?
iron, thyroid problems
what are the baseline investigations in someone with a deficiency ? 6
- FBC
- Coagultaion - looking for increase
- LFT’s
- Albumin
- Calcium/magnesium
- Stool culture
what are you looking for in stool cultures? 3
- alpha 1 antitrypsin
- fat globules
- elastase
what stain is used for fat globules
sudan stain
what anatomical investigations are done?
endoscopy and ERCP
imaging
- barium contrast
- CT
- MRI
what can be diagnosed through endoscopy? 2
biliary obstruction and chronic pancreatitis
what are the management aims?
- Treat the underlying cause
- Replace the deficiency
- Support nutritionally
