Malabsoprtion pathology Flashcards
What is the characterisitc pathologic finding for gluten-sensitivity enteropathy?
villous blunting. Also intra-epithelial lymphocytes (CD8)
Viral gastro-enteritis can cause temporary ______.
dissacharidase (lactase) deficiency
What is Whipple disease?
Rare intestinal, lymph nodal, cerebral, cardiac and joint infection with Tropheryma whippelii, a PAS stain-positive actinomycete, in late middle-aged white males #Foamy Whipped cream in a CAN--> foamy macrophages, cardiac symptoms, arthralgias, and neurologic symptoms. M
Intestinal infestation with round worms such as Ascaris can be severe enough to cause ____.
malabsorption
What is the DDx for malabsorption syndrome?
- Gluten-sensitive enteropathy
- Chronic pancreatitis
- zebras
Fat absorption is normally __% efficient.
98
What is the definition of steatorrhea?
> 5% of dietary fat in stool
What may present as a result of steatorrhea?
weight loss, osteomalacia, easy bruising, iron deficiency anemia w/out blood loss, lactose insufficiency, gastric surgery
Why does steatorrhea lead to osteomalacia?
VD deficiency
Why does steatorrhea lead to iron deficiency anemia?
achloridria and diffuse proximal intestine mucosal dysfunction
What does steatorrhea look like?
floats, greasy, stinks, hard to flush, oil droplets
Why is there diarrhea with steatorrhea?
Increase osmotically active particles from mal-absorbed dietary constituents. Hydroxylation of 10-hydroxy-oleate which acts as cathartic. Fatty acids impair fluid and electrolyte absorption.
What causes most steatorrhea?
pancreatic insufficiency
What are 4 causes of intraluminal stage steatorrhea?
chronic pancreatitis, zollinger-ellisone syndrome, post-gastrectomy, cystic fibrosis
What causes malabsorption in gluten-sensitive enteropathy?
Immature surface cells. Intestine is in a secretory state. Absorptive functions of mature enterocytes with disaccharidases are reduced. Complex lipid synthesis is reduced. Endocrine cells that produce CCK are reduced as is the absorptive area.
