GI Flashcards
vit a
night blindness, xerophthalmia (dry conjunctiva, cornea)
vit D
rickets/osteomalacia, dental caries, hypocalcemia, hypophosphatemia
Vit E
anemia/ hemolysis, neuro deficit, altered prostaglandin syn
vit K
abn bone matrix sun
B1
thiamine, beriberi (cardiac failure, peripheral neuropathy, hoarseness, or aphonia, wrenches’ encephalopathy)
B6
pyridoxine. dermatitis, cheilosis, glossitis, microcytic anemia, peripheral neuritis
Vit C
scurvy (hematologic abn, edema, impair collagen syn= wound healing, swelling of gums)
B12
cobalamin
megaloblastic anemia, demyelination, methylmalonic acidemia
foli cacid
megaloblastic anemia, neutropenia, impaired growth, diarrhea
niacin
pellagra (diarrhea, dermatitis, dementia) glossitis, stomatitis
zinc
skin lesion, poor wound healing, immune dysfunc, diarrhea, growth failure
malnutrition
1) marasmus- most common energy depletion state- near starvation from protein and nonprotein def. thin from loss of M and fat
2) kwashiokor- protein def, edema, abd distension, pigmentaiton change, thin sparse hair
if both= protein -energy malnutrition
malabsorption
diarrhea, abd distension, impaired growth
Carb malabsorption
undigested carb are osmotically active –> incr stool V, draw water, incr peristaltic activity, decr transit time –> fermented by bacteria = watery, acidic stool w/ unabsorbed sugar detected as reducing substances by positive Flintiest run. pH
protein malabsorption
etio: congenital enterokinase def (hypoproteinemia + edema and growth impairment),protein losing enteropathies, inflammatory D
look at fecal alpha antitrypsin lvl. see low serum albumin
lipid malabsorption
decr lipase = steatorrhea. exocrine pacreatic insuf (CF, pancreatitis), intestinal mucosal atrophy, BA def
macrocytic blood smear
folic acid or B12 def
acanthocytosis of erythrocyte
abetalipoproteinemia
neutropenia
schwachman -diamond syndrome. FTT, short stature, AR
celiac disease
P: D, V, bloating, anorexia, FTT
SB bx- deep crypt, flat villi, vacuolated epi. serum IgA endomysial and serum tissue transglutaminase ab testing abetalipoproteinemia.
tx: corticosteroid for D. noncompliance growth failure and delayed sexual maturity
protein intolerance
Cow's milk protein cause this. P: enteropathy- progressive onset of D, V, irritability, colicky abd pain, chronic blood loss in stool lead to anemia stool protein loss cause edema, FTT enterocolitis: acute onset of same sx dx: stop ag= stop sx tx: avoid ag. resolve by 1-2yo
short bowel syndrome
malabsorption - malnutrition, compromised bowel function
2/2 bowel resection (nec, crohn, ca) carb and fat mal with steatorrhea
dehydratoim, hyponatremia, hypokalemia. distal SB= B12, bile absorption
tx: TPN. SB transplant in pt with liver disease.
complication: TPN cholestasis - gallstone and cholestatic liver disease, intestinal bacterial overgrowth, nutritional def, poor bone mineralization, renal stone, secretory diarrhea
GERD
etio: predom is inappropriate transient lower esophageal sphincter relaxation (TLESR). result in inflm.
happy spitters
emesis is begin but dramatic and resolve by 6-12mo
1) infant: emesis -most common. FTT. sandier syndrome - torticollis arching of the back caused by painful esophagitis. feeding refusal. constant hunger.
older kids- midepigastric pain. N upon awakening, hoarseness, halitosis, wheezing
sequelae: upper and lower airway disease exacerbated. acid reflex induce bronchopulmonary constriction - chronic laryngitis, hoarseness, wheezing,
gastrointestinal sequelae- FTT, barrett’s esophagus