GI14 Flashcards
What are the Malabsorption syndromes? What do they cause?
Diarrhea, Steatorrhea, weight loss, weakness, and vitamin and mineral deficiencies
“These Will Cause Devastating Absorption Problems”
Tropical sprue Whipple's disease Celiac sprue Disaccharidase deficiency Abetalipoproteinemia Pancreatic insufficiency
Tropical sprue.
- Unknown cause
- Responds to Antibiotics
- Affects ENTIRE small bowel (otherwise similar to celiac sprue)
Whipple’s disease.
- Infection with Tropheryma whipplei (gram POSITIVE)
- PAS-positive foamy macrophages in intestinal lamia propria, mesenteric nodes
- Older men
What are associated symptoms with Whipple’s disease?
Cardiac symptoms
Arthralgias
Neurologic symptoms
Celiac sprue.
- AutoAb to gluten (gliadin) in wheat
- Distal duodenum or Proximal Jejunum
- Loss of VILLI
Disaccharidase deficiency.
- Most common is Lactase deficiency
- Normal appearing villi
- Osmotic diarrhea
Abetalipoproteinemia.
- Decreased synthesis of apolipoprotein B
- Inability to make CHYLOMICRONS
- Cant secrete Cholesterol, or VLDL into bloodstream
- Fat accumulates in enterocytes
When and how does Abetalipoproteinemia present?
Early Childhood
Malabsorption & Neurologic conditions
What pathologies can cause Pancreatic insufficiency?
- Cystic fibrosis
- Obstructing cancer
- Chronic pancreatitis
What does Pancreatic insufficiency cause?
Malabsorption of fat and fat-soluble vitamins (ADEK)
*Increased neutral fat in stool
What HLA genes are associated with Celiac sprue?
HLA-DQ2
HLA-DQ8
*northern European descent
What autoimmune Abs are seen in Celiac sprue?
Anti-gliadin
Anti-endomysial
Anti-tissue transglutaminase
What are the histological findings in Celiac sprue?
- Blunting of villi
- Lymphocytes in lamina propria
What other condition is Celiac sprue associated with?
Dermatitis herpetiformis
