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Block 15 Ellen > L5: Malabsorption and malabsorption > Flashcards

L5: Malabsorption and malabsorption Flashcards

1
Q

malnutrition=

A

insufficient dietary intake to meet metabolic requirements

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2
Q

malabsorption=

A

inability to utilise an appropriate dietary intake

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3
Q

nutrients are absorbed via____

A

thoracic duct or portal vein

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4
Q

2 types of malnutrition

A
  • protein-energy malnutrition (PEM)

- specific nutrient malnutrition

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5
Q

what is it called when you predominatly lack protein

A

kwashiorkor

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6
Q

where are kwashiorkor and marasmus mainly seen

A

undeveloped countries

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7
Q

what is it called with total dietary lack (caloric)

A

marasmus

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8
Q

resulting symptoms with marasmus

A 
growth failure 
apathy 
diarrhoea 
hepatomegaly 
muscle wasting
oedema 
anaemia 
stomatitis
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9
Q

4 main reasons for PEM in the UK

A
  • anorexia
  • neglect
  • dysphagia
  • increased metabolic demands
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10
Q

anorexia=

A

suppression of appetite

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11
Q

3 reasons for anorexia

A

malignancy
infection/inflammation
anorexia nervosa

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12
Q

3 reasons for neglect

A

elderly
hospitalised
neurological disease

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13
Q

dysphagia=

A

inability to swallow

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14
Q

lack of iron anaemia

A

microcytic hypo-chromic

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15
Q

2 reasons for iron deficiency

A

menses

vegetarian

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16
Q

3 effects of Vitamin B deficiency

A
  • neuropathy
  • cardiomyopathy and encephalopathy
  • stomatitis
  • pellagra
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17
Q

B6 deficiency–>

A

neuropathy

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18
Q

B1 deficiency–>

A

cardiomyopathy/ encephalopathy

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19
Q

B2–>

A

stomatitis

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20
Q

folic acid deficiency–>

A

megaloblastic anaemia

neural tube defect in pregnancy

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21
Q

vit D deficiency–>

A

osteomalacia

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22
Q

who is more prone to Vit D deficiency

A

darker skin

indian sub-continent diet

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23
Q

B12 deficiency –>

A 
megaloblastic anaemia 
neuropathy 
SACD 
ataxia 
dementia
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24
Q

vit C deficiency –>

A

scurvy

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25
vit K deficiency -->
coagulopathy
26
what breaks down polysaccharides
amylase
27
where is amylase release from
mouth pancreas (brush border of small bowel)
28
what is needed for Vit D absorption
Ca
29
fat soluble vitamins
ADEK
30
for people with fat poor diets which vitamin are they most deficient in
K
31
water soluble vitamin=
B12
32
enzymes in the mouth=
amylases | lipase
33
where does most food processing happen
stomach
34
how long is food in the stomach for
4-6 hours
35
what nerve stimulates digestion
vagus nerve
36
what digestion only starts in the stomach
protein
37
what does the vagus nerve cause
Ach production
38
what does Ach do in the stomach
releases histamine
39
3 roles of histamine
lowers pH enzyme activity increases intrinsic factor produced
40
what do parietal cells produce
acid
41
what do chief cells release
pepsinogen
42
what do fundic cells increase
gastric lipase
43
which part of the pancreas are digestive juices secreted from
exocrine part
44
what stimulates pancreas secretion
food presence in duodenum
45
where do enzymes enter the duodenum
ampulla in second part of duodenum
46
what enzyme detects fat
cholecystokinin (CCK)
47
what does CCK trigger
gallbladder to empty bile acids
48
what do bile acids do
emulsify fat
49
3 main enzymes of exocrine pancreas
amylase lipase proteolytic
50
2 jobs of bile
emulsifies fats | micelle formation
51
3 parts of small intestine
duodenum jejunum ileum
52
where in the small intestine does most absorption happen
jejunum
53
what is absorbed in the ileum
vit B12 and intrinsic factor | bile acids
54
what passes into the colon
indigestible starch/ fibre
55
what is the vascular system like in a villus
countercurrent arcade
56
3 roles of the villus
increase SA enzyme production leaky mucous membrane
57
3 types of small intestine diseases
luminal mucosal post mucosal
58
luminal diseases=
infections, bacterial overgrowth
59
mucosal diseases=
loss of absorptive SA
60
e.g of 3 mucosal diseases
Crohn's lymphoma coeliac disease
61
post mucosal disease=
lymphangiectasia
62
3 luminal infections
Giardiasis TB tropheryma whippelii
63
ancylostoma=
fe deficiency
64
giardiasis causes
bloating and steatorrhoea
65
steatorrhoea=
excretion of abnormal quantities of fat
66
how does bacterial overgrowth effect B12/ folate
causes high folate and low B12
67
4 causes of bacterial overgrowth
jejunal diverticulosis blind loop syndrome obstruction motility disorders
68
what is autonomic neuropathy (seen in diabetes)
nervous system to bowel disordered so less peristalsis
69
3 features of coeliac disease
- subtotal villous atrophy - crypt hyperplasia - intraepithelial lymphocytes
70
autoantibody test in coeliac disease
anti-tissue transglutaminase
71
3 substrate deficiency in coeliac disease
Fe deficiency folate osteomalacia
72
features of small bowel Crohn's (5)
- deeply ulcerated - fissured - bowel wall inflammation - thickened wall - no villi
73
lymphangiectasia=
lymph system underlying mucosa is greatly dilated and distended
74
ADEK malabsorption -->
``` coagulopathy osteomalacia ataxia night blindness xerophthalmia ```
75
bile duct system=
cystic duct (from gallbladder) joins common hepatic (from R and L hepatic) --> common bile duct
76
what 2 ducts enter the duodenal ampulla
pancreatic | common bile duct
77
most common cause of pancreatitis =
alcoholic
78
tumour presenting with jaundice mean
blocking pancreatic duct = quite advanced= poor life expectancy

Block 15 Ellen (11 decks)

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