Digestion

Question 1

Describe the digestion and absorption of dietary carbohydrates.

Answer 1

Question 2

Describe the digestion and absorption of dietary protein.

Answer 2

Question 3

Describe the digestion and absorption of dietary fats.

Answer 3

Question 4

Why do patients with diabetes experience eye problems?

Answer 4

high blood sugar damages blood vessels in the retina

Question 5

What are the treatments for T2DM?

Answer 5

Glucose-lowering medication (e.g. metformin, gliclazide), lifestyle modification, wt loss.

Question 6

What are three potential consequences of T2DM if left untreated?

Answer 6

Nephropathy
Retinopathy
Diabetic Foot

Question 7

What is the underlying problem in T2DM?

Answer 7

Insulin on glucose or Food intake

Question 8

Mr P, a 45-year old male, has been suffering from episodic central chest pain. The chest pain does not radiate down the left arm and is not associated with breathlessness. He adds that the pain does not disappear with rest. Anecdotally, he mentions that he has been experiencing a throaty cough, despite not having any other cold-like symptoms. The cardiology SpR refers the patient for an exercise tolerance test, which comes back negative (therefore normal).

What is your diagnosis?

Answer 8

Gastro-oesophageal reflux disease.

Question 9

What does an exercise tolerance test involve?

Answer 9

An incremental exercise bike/treadmill test to precipitate symptoms as a diagnostic tool.

Question 10

What condition does episodic central chest pain indicate?

Answer 10

Gastro-oesophageal reflux disease

Question 11

Where is the underlying problem for gastro-oesophageal reflux disease?

Answer 11

Parietal cells-> H+

Question 12

What are the treatment options for Gastro-oesophageal reflux disease?

Answer 12

Proton Pump Inhibitors (Lansoprazole, omeprazole) or H2 receptor blockers like Ranitidine

Question 13

Explain the symptoms of lactose intolerance in the context of the disease

Answer 13

Pain and flatulence caused by commensal bacteria feeding off undigested sugars.

Watery stools due to increased motility and osmotic potential.

Symptoms in morning - due to drinking milk with cereals but not gluten (as sandwiches don’t precipitate symptoms).

Question 14

What is the underlying issue of lactose intolerance?

Answer 14

lactase on lactose

Question 15

What is the treatment for lactose intolerance?

Answer 15

lifestyle modifications

Question 16

What is obstructive sleep apnoea?

Answer 16

Episodic closure of pharyngeal airway overnight due to cervical obesity, fluid migration & decreased airway tone.

Causes frequent desaturations resulting in microarousal, preventing effective sleep & regular hypoxic dips in saturation.

Question 17

What are the side effects of obstructive sleep apnoea?

Answer 17

Steatorrhoea

Question 18

What is the underlying problem of obstructive (sleep apnea) and obesity that can be addressed?

Answer 18

pancreatic lipase

Question 19

Is it appropriate to treat obesity with surgery and/or medication?

Answer 19

Patients should be treated without discrimination.