Gastro Flashcards
what gets absorbed
in distal ileum
B12, Bile
Folic acid gets absorbed
in
First part of intestine
What gets aAbsorbed from proximal as well as distal si
GIucore
AA
Lipids
Mined anemia may occur
due to malabsorption in
Proximal ?
order of sequence absorption of fat
TG → Fat globules → ED → FA → micalle → enterocyte → FA → TG → chylomicrons → lymph → blood →
Bacterial overgrowth synchome
conj bile→ un conj bile
Causes of fat malabsorption
Decreased bile Decreased lipase Mucosal disease of intestine Decreased chylomicrons lymphangiectasia
Ix Fat malabsorption
72 hour sfool fat
Steatorrea > 7 g/ dy
spot test
Breath test
Triglyceride used for breath test
tripalmitin
triolain
tri octaneon
Monosacharides in
intestine alesorbed
by
SGLT -1(glucose and galactose )
Fructose transporter
GLUT_ 5
D- Xylose is a test of
mucosa of proximal SI
25g show wine
<4.5 g positive test
False positive d- xylose test
Pyloric
stenosis
Renal failure
Third space shifting
R- Binder
Transcobalamine
haptocorin
Vit B 12 alesorption
secreted by salivary glands
Cubulin receptors
found in
Distal SI
IF receptors
Role of pancreatic enzymes
in Vit B12 absorbtion
Breaks down
transcobalamin + vit B12
C auses of malabsorption Vit B12
Pernicious Anemia
Pancreatic diseases
Diseases of distal
SI
SCHILLING TEST
Vit B12 gold Std ing of vit B12 IM 24 hour urine < 10% add IF add Pancreatic enzymes CT contrast?
coeliac spru e a/ w
Trype I DM Ig A def Dermatitis herpeteformis Downs Turners
Coeliac spruce affects which part of SI
Proximal more
. Anti tTg
most sensitive specific
antibody for coeliac sprue
anti bodies coeliac sprue
Endomysial Ab
guinea pig tTG
human ttG
IGA IGG anti glia din
Ix coeliac sprue
ab
biopsy
Reversal of changes *****
Flat villi with crypt
hyperplasia
hallmark of coeliac sprue
Indication for glucocorticoids in coeliac
Refractory
crisis
Tropical sprue caused by
klebsiella pneumoniae
Enter obacter cloacae
E. coli
Mononuclear cell infiltrate throughout the lamina
propria
Biopsy- tropical sprue
Rx for tropical sprue
Doxycyclihe or tetra cycline (250 Qid)
x 6 months
Folic acid
Vit B 12
Whipple s disease associations
migratory poly arthritis pan card itis dementia supranuclear ophthalmoplegia seizures cerebellar ataxia polyserositis hepatos planomegaly
PAs positive macrophages
whipple’s disease
Rx coeliac sprue
Inj ceftriaxone or
Inj meropenam
X2mweeks
or? Trimethoprim + sulphamethOxazole
which IL helps in inhibition of
Immune system against food
1L- 10
Co mmon feature UC CD
Age se x - Turners Diarrhea Anorexia Nausea, vomiting fever, weight loss Euleaintes tinal manifestation
gross blood in stool and mucous common in
UC
smoking appendicectomy IBD
doubt?
ocP and infection risk factor for which IBD
C D
most commonly affected
site in uc
Rectum> sigmoid
Rectal sparing IBD
CD
Uc cannot affect
SI
Trans mural 11BD
CD
Collar button ulcer
uc
Non caseating granuloma . IBD
CD
strictures and skip lesion
which IBD
CD
Pyoderma gangsinosun IBD
UC> CD
Ocular manifestations of IBD
conjunctivitis
Anterior uveitis
episcleritis
Ix IBD
ESR CRP Leucocytesis anemia
hypoalbuminea
PANCA* ,ASCA, OMP C ,I2 ,anti c - ….
Fecal cal protectin, lactoferrin
Classification criteria
for uc
MAYO
TRUELOVE and WITTS
