(F) L5: GITP: Large Intestine Flashcards
The large intestine starts from the distal ileum to the anus which measures how long?
5 feet
Which among the ileum and large intestine is longer?
Ileum (6 feet long)
Note: The large intestine is only 5 feet long
TOF: Secretion of substances and storage of feces are the important functions of the large intestine
False (reabsorption, not secretion)
If 1L of water is absorbed, how much of it becomes stool and is reabsorbed by the intestines? (2 answers)
200mL becomes stool while 800mL is reabsorbed
TOF: Sodium, chloride, and some fat-soluble vitamins are reabsorbed
False (WATER-soluble)
Mechanism of Undigested Food
Unidgested food is acted upon by what microorganisms?
Bacteria
Mechanism of Undigested Food
Carbohydrates become what?
Gasses
Mechanism of Undigested Food
Proteins will become what?
Amino acids
Mechanism of Undigested Food
Amino acids will become what? (3)
- Indole
- Skatole
- H2S
Mechanism of Undigested Food
This end product of amino acid breakdown is responsible for the odor of stool
Skatole
Mechanism of Undigested Food
Bilirubin becomes this substance which is responsible for the color of stool
Stercobilin
Intestinal Diseases
- A deficiency of lactase leading to the accumulation of lactose
- Manifests with bloating and diarrhea
Lactose Intolerance
Intestinal Diseases
- Aka Tropical Sprue
- Associated with cereals which triggers auto antibodies thereby producing disease in the SI
- Has a tropical and non-tropical type
Celiac Disease
Intestinal Diseases
Caused by Treponema whipplei
Whipple’s Disease
Intestinal Diseases
Inflammation of the SI
Crohn’s Disease
Intestinal Diseases
Intestinal cancer
Primary Intestinal Lymphoma
Intestinal Diseases
Loss of oxygen in the intestine
Ischemia
Intestinal Diseases
Is caused by microorganisms
Amyloidosis
Intestinal Diseases
Caused by parasites (especially Giardia), viruses, and the like
Infection
Intestinal Diseases
Caused by microoganisms:
A. Whipple’s Disease
B. Amyloidosis
C. Infection
D. All of the above
E. None of the above
D. All of the above
- Whipple - Treponema whipplei
- Amyloidosis - microorganisms
- Infection - parasites and viruses
Intestinal Diseases
Caused by ingestion of certain foods:
A. Celiac Disease
B. Lactose Intolerance
C. Both
D. Neither
C. Both
- Celiac for cereal
- Lactose intolerance for dairy
Aka Tropical Sprue
A. Non-tropical celiac disease
B. Crohn’s disease
C. Both
D. Neither
A. Non-tropical celiac disease (just celiac disease in general)
Intestinal Function Tests
An invasive procedure used to diagnose lactose intolerance as well as malabsorption
Oral Lactose Tolerance Test (OLTT)
Intestinal Function Tests (OLTT)
How many grams of lactose is given to the patient alongside 200mL of water?
50 grams
Intestinal Function Tests (OLTT)
How many samples are drawn and at what time intervals?
- FBS at 30 mins.
- 1 hour
- 2 hours
Intestinal Function Tests (OLTT)
Interpret results:
> 30 mg/dL in FBS
Normal
Intestinal Function Tests (OLTT)
Interpret results:
20-30 mg/dL in FBS
Borderline
Intestinal Function Tests (OLTT)
Interpret results:
< 20 mg/dL in FBS
Lactose Intolerant
Intestinal Function Tests
- A non-invasive test used instead of the OLTT
- When lactose is acted upon by bacteria, this will yield lactic acid which is the analyte being measured
Hydrogen Gas Breath Test
Intestinal Function Tests
In a lactose intolerant person (someone who lacks lactase), if the enzyme will not act upon the lactose ingested, what will?
Bacteria
Intestinal Function Tests (Breath Test)
TOF: Hydrogen gas is measured in a non-fasting sample
False (overnight fast)
Intestinal Function Tests (Breath Test)
How much lactose is given alongside 180mL of water?
50 grams
Intestinal Function Tests (Breath Test)
Hydrogen gas is measured by intervals of what?
15, 30, 60, 90, and 120 minutes
Intestinal Function Tests (Breath Test)
Interpret results:
< 5ppm
Normal
Intestinal Function Tests (Breath Test)
Interpret results:
Greater than 200 ppm
Significant for Lactose Intolerance
Intestinal Function Tests (Breath Test)
Interpret results:
Greater than 20 ppm
Lactose intolerance
Note: Manual-based
50 grams of glucose is given
A. Oral Glucose Tolerance Test
B. Hydrogen Breath Test
C. Both
D. Neither
C. Both
- OLTT is given with 200mL of water
- H2 Breath Test is given with 180mL of water
Is measured at intervals of 30, 60, and 120 only
A. Oral Glucose Tolerance Test
B. Hydrogen Breath Test
C. Both
D. Neither
A. Oral Glucose Tolerance Test
- H2 Breath Test has an interval of: 15, 30, 60, 90, and 120
Intestinal Function Tests
A non-invasive method measuring the absorptive capacity of the intestine
D-Xylose Test
Intestinal Function Tests
TOF: Xylose is a disaccharide sugar, therefore, it is not ready to be absorbed
False (it is a monosaccharide therefore it CAN be absorbed)
Intestinal Function Tests
TOF: Xylose is normally present in the blood because only around 80% of it is excreted in the stool
False (should NOT be in the blood as 100% of it is excreted in the URINE
Note: Ante anuna minali ko na lahat
Intestinal Function Tests (D-Xylose)
This interference can decrease xylose results
Aspirin
Intestinal Function Tests (D-Xylose)
This interference (medication) is given to rheumatoid arthritis patients as it can inhibit D-Xylose values therefore decreasing results
Indomethacin
Intestinal Function Tests (D-Xylose)
Intereferences that can increase results:
A. Aspirin
B. Indomethacin
C. Both
D. Neither
D. Neither (should be decrease for both)
Intestinal Function Tests (D-Xylose)
How much D-xylose is given alongside 250mL of water for ADULTS?
25 grams
Intestinal Function Tests (D-Xylose)
How much D-xylose is given alongside 250mL of water for CHILDREN?
0.5 grams per kg of body weight
Intestinal Function Tests (D-Xylose)
After 1 hour upon ingestion of D-xylose, how much water should the patient drink?
250mL
Intestinal Function Tests (D-Xylose)
After 5 hours upon ingestion of D-xylose, what specimen should be collected?
Urine
Intestinal Function Tests (D-Xylose)
250mL of water
A. After 30 minutes
B. After 1 hour
C. Both
D. Neither
B. After 1 hour (the other is upon starting the test)
Intestinal Function Tests (D-Xylose)
Interpret results:
4 grams of xylose in urine after 5 hours
Normal
Intestinal Function Tests (D-Xylose)
Interpret results:
< 4 grams of xylose in urine after 5 hours
Intestinal absorption defect
Intestinal Function Tests
What are the 3 major carotenoids in human serum?
- Lycopene
- Xanthophyll
- Beta carotene
Intestinal Function Tests
- This produces a yellow to orange or purple pigment
- Are fat soluble which makes them absorbable in the intestine in association with lipids
- A decrease of these is associated with malabsorption
Serum Carotenoids
Intestinal Function Tests (Serum Carotenoids)
What is the normal value?
50 to 250 mg/dL