F3: Fecalysis (Part 2: Malabsorption-Intestinal Hypermobility) Flashcards

1
Q
  • Impaired absorption of fats, carbohydrates and proteins
  • Results in: Creatorrhea and Steatorrhea
A

Malabsorption

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2
Q

MALABSORPTION

Increased meat fibers

A

Creatorrhea

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3
Q

MALABSORPTION

  • Increased fats in stool (>6 g/day)
  • Pancreatic disorders
  • Malabsorption
  • Absence of bile salts
A

Steatorrhea

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4
Q

Identify if Maldigestion or Malabsorption

  • Deficiency of pancreatic enzymes (Pancreatitis, Cystic Fibrosis, Pancreatic Cancer)
  • Decreased bile acid formation
A

Maldigestion

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5
Q

Identify if Maldigestion or Malabsorption

  • Damaged intestinal mucosa (Celiac disease, Tropical Sprue)
  • Lymphatic obstruction (Lymphoma, Whipple disease)
A

Malabsorption

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6
Q

T or F

Villi of patient with celiac disease absorb fewer nutrients due to inflammation (presents shorter villi)

A

T

Villi helps in the reabsorption of the nutrients; present in the small intestine

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7
Q
  • Fecal fat
  • Useful in diagnosing pancreatic insufficiency and small-bowel disorders that cause malabsorption
  • Absence of bile salts that assist pancreatic lipase in the breakdown and subsequent reabsorption of dietary fat ( produces an increase in stool fat (steatorrhea) that exceeds 6 g per day)
  • Present in those with either maldigestion or malabsorption conditions and can be distinguished by the D-xylose test
A

Steatorrhea

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8
Q

STEATORRHEA

Steatorrhea helps indicates

a. Pancreatic overload
b. Small-bowel disorders
c. both
d. NOTA

A

b. Small-bowel disorders

For a to be correct, it should be:

a. Pancreatic insufficiency

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9
Q

STEATORRHEA

These assist pancreatic lipase in the breakdown and subsequent reabsorption of dietary fat (primarily triglycerides)

A

Bile salts

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10
Q

STEATORRHEA

T or F

In STEATORRHEA, there is absence of bile salts which decreases digestion and reabosprotion

A

T

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11
Q

STEATORRHEA

T or F

Absence of bile salts = increase in stool fat exceeding 4g per day

A

F (Absence of bile salts = increase in stool fat exceeding 6g per day)

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12
Q

STEATORRHEA

Maldigestion or malabsoprtion conditions leading to steatorrhea can be distinguised by using what test?

A

D XYLOSE TEST

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13
Q

STEATORRHEA

  • To distinguish pancreatic insufficiency (maldigestion) from intestinal malabsorption
  • Absorbed without the aid of pancreatic enzymes
  • Give 25g of D xylose orally
  • Specimens: Blood, Urine
A

D xylose test

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14
Q

D XYLOSE TEST

Amount of D xylose taken orally by patient?

A

25g of D xylose

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15
Q

D XYLOSE TEST

What (2) specimens can be used for D xylose test

A
  • Blood
  • Urine
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16
Q

D XYLOSE TEST

T or F

For maldigestion or pancreatic insufficiency, d xylose value is normal

A

T

17
Q

D XYLOSE TEST

Normal D xylose test indicates

a. Xylose is still absorbed by body even if there is pancreatic insufficiency or maldigestion
b. Xylose is unabsorbed by body because there is pancreatic insufficiency or maldigestion
c. Xylose is unabsorbed by body because there is malabsorpotion
d. Xylose is still absorbed by body because there is malabsorpotion

A

a. Xylose is still absorbed by body even if there is pancreatic insufficiency or maldigestion

18
Q

D XYLOSE TEST

Decrease D xylose test indicates

a. Xylose is still absorbed by body even if there is pancreatic insufficiency or maldigestion
b. Xylose is unabsorbed by body because there is pancreatic insufficiency or maldigestion
c. Xylose is unabsorbed by body because there is malabsorption
d. Xylose is still absorbed by body because there is malabsorption

A

c. Xylose is unabsorbed by body because there is malabsorpotion

19
Q

D XYLOSE TEST

Condition where there is decreased d xylose (less than 3 g)

A

Malabsorption syndrome

20
Q

D XYLOSE TEST

Identify if Blood or Urine specimen is used

after 2 hrs should present xylose

A

Blood

21
Q

D XYLOSE TEST

Identify if Blood or Urine specimen is used

5 hr-urine should present xylose

A

Urine specimen

22
Q

D XYLOSE TEST

  • Condition where there is decreased d-xylose
  • Causes of this condition: Bacterial overgrowth, Intestinal resection, Celiac disease, Tropical sprue, Lymphoma
A

Malabsorption syndrome

23
Q

D XYLOSE TEST

Why is xylose still absorbed in maldigestionn or pancreatic insufficiency?

a. Xylose is a disaccharide hence absorbed,
b. Xylose is a monosaccharide hence absorbed
c. Xylose is a monosaccharide, neither digested or absorbed
c. Xylose is a disaccharide, neither digested or absorbed

A

b. Xylose is a monosaccharide hence absorbed, indicating normal intestinal absorption

Monosaccharide: may be absorbed as is, should not need any aid

24
Q

D XYLOSE TEST

Sugars that are absorbed as is, does not need any aid
ex. Xylose

A

Monosaccharides

25
Q
  • Excessive movement of intestinal contents through the GI tract that can cause diarrhea because normal absorption of intestinal contents and nutrients cannot occur
  • Transmit time for intestinal contents – too short
  • Less intestinal absorption
  • Causes of this condition: Secretory and osmotic diarrhea, Parasympathetic nerve activity, Laxatives, Enteritis, Complications with malabsorption
A

Intestinal Hypermobility

26
Q

INTESTINAL HYPERMOBILITY

  • Describes hypermotility of the stomach and the shortened gastric emptying half-time, which causes the small intestine to fill too quickly with undigested food from the stomach.
  • Hallmark of early dumping syndrome (EDS)
  • Gastric emptying time of less than 35 minutes
  • Causes of this condition: Disturbances in gastric reservoir or transporting function
  • Has (2) types: early, late
A

RAPID GASTRIC EMPTYING (RGE) DUMPING SYNDROME

27
Q

INTESTINAL HYPERMOBILITY

Healthy people have a gastric emptying half-time range of?

A

35-100 minutes

varies with age and gender

28
Q

INTESTINAL HYPERMOBILITY

Gastric emptiyng time with people who have RAPID GASTRIC EMPTYING (RGE) DUMPING SYNDROME?

A

Less than 35 minutes

29
Q

INTESTINAL HYPERMOBILITY

(2) types of RAPID GASTRIC EMPTYING (RGE) DUMPING SYNDROME

A
  • Early dumping symptom
  • Late dumping symptom
30
Q

INTESTINAL HYPERMOBILITY

Early or Late dumping syndrome?

  • Begins 10-30 mins after meal
  • Symptoms: Nausea, Vomiting, Bloating, Cramping, Diarrhea, Dizziness, Fatigue
A

Early dumping symptom

31
Q

INTESTINAL HYPERMOBILITY

Typical complication of dumping syndrome related to sugar

A

Hypoglycemia

32
Q

INTESTINAL HYPERMOBILITY

Familiarize main causes of dumping syndrome

A
  • Gastrectomy
  • Gastric bypass surgery
  • Post-vagotomy status
  • Zollinger-Ellison syndrome - duodenal ulcer disease
  • Diabetes mellitus