Gastroenterology Flashcards
What are essential nutrients?
Cannot be synthesized by the body and must be derived from the diet
What are the macronutrients?
Supply energy and essential nutrients needed for growth, development, disease prevention, and activity
- Carbohydrates
- Proteins
- Fats
- Minerals
Carbohydrates make up approximately __% of the typical diet
50%
How many essential amino acids are there?
9
What are micronutrients?
- Water-soluble vitamins
- Fat soluble vitamins (ADEK)
- Essential trace minerals (iron, iodine, fluoride, zinc, selenium, and copper)
What is the most common ernergy depletion state?
Marasmus - characterized by near starvation from protein and nonprotein deficiencies
What is Kwashiorkor?
Protein deficient state characterized by generalized edema, abdominal distension, changes in skin pigmentation, and thin, sparse hair
What is malabsorption?
Inadequate absorption of nutrients - most often characterized by diarrhea, abdominal distension and impaired growth
How does malabsorption of carbohydrates lead to diminished absorption of nutrients?
Undigested sugars are osmotically active and draw water into the intestinal lumen, causing increased stool volume, increased peristaltic activity, and decreased transit time
In carbohydrate malabsorption the resulting stool is watery and ______
acidic
What is a clinitest?
Detects unabsorbed sugars as reducing substances; test for carbohydrate malabsorption
What are some causes of carbohydrate malabsorption?
- Congenital enzyme deficiency (Lactase deficiency)
- Mucosal atrophy
What breaks down dietary proteins into amino acids or oligopeptides?
Pepsinogen and pancreatic proteases in the proximal small intestine
What are some causes of protein malabsorption?
- Congenital enterokinase deficiency
- Protein-losing enteropathies (transudation of protein from inflamed intestinal mucosa)
- Inflammatory disorders (Chron’s, colitis)
Levels of _______can be used to document enteric protein losses
Fecal α1-antitrypsin levels
Fats are ________ in water and must be incorporated into ______ ______ _______ to be absorbed
insoluble; bile salt micelles
What results from decreased lipase activity?
Steatorrhea
Decreased absorption of fat soluble vitamins
What are some causes of fat malabsorption?
- Exocrine pancreatic insufficiency
- Intestinal mucosal atrophy
- Bile acid deficiency
- Abetalipoproteinemia
What stool studies should be done to determine fat malabsorption?
Stool studies for fat, carbohydrates, pH, reducing substances, and α1-antitrypsin
Infection with _____ ______ can cause chronic fat malabsorption and can be diagnosed by stool studies
Giardia Lamblia
What are the symptoms of protein intolerance?
Diarrhea, vomitting, and colicky abdominal pain after exposure to dietary protein
Protein intolerance occurs in up to __% of children
8%
Describe Enteropathy vs. Enterocolitis in protein intolerance
Enteropathy: Progressive onset of diarrhea, vomiting, irritability, and abdominal pain; chronic blood loss in stool may lead to anemia, and protein loss may cause edema and FTT
Enterocolitis: Acute diarrhea, rectal bleeding, mucus in stool, abdominal distension , and irritability (may also cause edema and FTT)
What is the management of protein intolerance?
Withdrawal and avoidance of suspected dietary protein; most protein intolerance is transitory