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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
Q

vit K deficiency –>

A

coagulopathy

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26
Q

what breaks down polysaccharides

A

amylase

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27
Q

where is amylase release from

A

mouth
pancreas
(brush border of small bowel)

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28
Q

what is needed for Vit D absorption

A

Ca

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29
Q

fat soluble vitamins

A

ADEK

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30
Q

for people with fat poor diets which vitamin are they most deficient in

A

K

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31
Q

water soluble vitamin=

A

B12

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32
Q

enzymes in the mouth=

A

amylases

lipase

33
Q

where does most food processing happen

A

stomach

34
Q

how long is food in the stomach for

A

4-6 hours

35
Q

what nerve stimulates digestion

A

vagus nerve

36
Q

what digestion only starts in the stomach

A

protein

37
Q

what does the vagus nerve cause

A

Ach production

38
Q

what does Ach do in the stomach

A

releases histamine

39
Q

3 roles of histamine

A

lowers pH
enzyme activity increases
intrinsic factor produced

40
Q

what do parietal cells produce

A

acid

41
Q

what do chief cells release

A

pepsinogen

42
Q

what do fundic cells increase

A

gastric lipase

43
Q

which part of the pancreas are digestive juices secreted from

A

exocrine part

44
Q

what stimulates pancreas secretion

A

food presence in duodenum

45
Q

where do enzymes enter the duodenum

A

ampulla in second part of duodenum

46
Q

what enzyme detects fat

A

cholecystokinin (CCK)

47
Q

what does CCK trigger

A

gallbladder to empty bile acids

48
Q

what do bile acids do

A

emulsify fat

49
Q

3 main enzymes of exocrine pancreas

A

amylase
lipase
proteolytic

50
Q

2 jobs of bile

A

emulsifies fats

micelle formation

51
Q

3 parts of small intestine

A

duodenum
jejunum
ileum

52
Q

where in the small intestine does most absorption happen

A

jejunum

53
Q

what is absorbed in the ileum

A

vit B12 and intrinsic factor

bile acids

54
Q

what passes into the colon

A

indigestible starch/ fibre

55
Q

what is the vascular system like in a villus

A

countercurrent arcade

56
Q

3 roles of the villus

A

increase SA
enzyme production
leaky mucous membrane

57
Q

3 types of small intestine diseases

A

luminal
mucosal
post mucosal

58
Q

luminal diseases=

A

infections, bacterial overgrowth

59
Q

mucosal diseases=

A

loss of absorptive SA

60
Q

e.g of 3 mucosal diseases

A

Crohn’s
lymphoma
coeliac disease

61
Q

post mucosal disease=

A

lymphangiectasia

62
Q

3 luminal infections

A

Giardiasis
TB
tropheryma whippelii

63
Q

ancylostoma=

A

fe deficiency

64
Q

giardiasis causes

A

bloating and steatorrhoea

65
Q

steatorrhoea=

A

excretion of abnormal quantities of fat

66
Q

how does bacterial overgrowth effect B12/ folate

A

causes high folate and low B12

67
Q

4 causes of bacterial overgrowth

A

jejunal diverticulosis
blind loop syndrome
obstruction
motility disorders

68
Q

what is autonomic neuropathy (seen in diabetes)

A

nervous system to bowel disordered so less peristalsis

69
Q

3 features of coeliac disease

A
  • subtotal villous atrophy
  • crypt hyperplasia
  • intraepithelial lymphocytes
70
Q

autoantibody test in coeliac disease

A

anti-tissue transglutaminase

71
Q

3 substrate deficiency in coeliac disease

A

Fe deficiency
folate
osteomalacia

72
Q

features of small bowel Crohn’s (5)

A
  • deeply ulcerated
  • fissured
  • bowel wall inflammation
  • thickened wall
  • no villi
73
Q

lymphangiectasia=

A

lymph system underlying mucosa is greatly dilated and distended

74
Q

ADEK malabsorption –>

A 
coagulopathy 
osteomalacia 
ataxia 
night blindness
xerophthalmia
75
Q

bile duct system=

A

cystic duct (from gallbladder) joins common hepatic (from R and L hepatic) –> common bile duct

76
Q

what 2 ducts enter the duodenal ampulla

A

pancreatic

common bile duct

77
Q

most common cause of pancreatitis =

A

alcoholic

78
Q

tumour presenting with jaundice mean

A

blocking pancreatic duct = quite advanced= poor life expectancy

Block 15 Ellen (11 decks)

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