Malabsorption Flashcards
1
Q
common cause of bile salt deficiency
A
- slceroderma
2
Q
conditions associated with bacterial overgrowth
A
- hypo or achlorhydria
- small intestine stagnation
- diverticuli
- scleroderma
3
Q
celiac sprue
A
- malabsorption of nutrients by part of the intestine that is damaged
- lesion of the small intestinal mucosa is common
- gluten sensitive enteropathy
- characterized by villous atrophy of the small intestine resulting in malabsorption and diarrhea
- diffuse infiltration of the lamina propria with plasma cells and lymphocytes
- women more than men
4
Q
symptoms of celiac
A
- diarrhea
- gas
- weight loss
- fatigue
- dermatitis herpetiformis: diffuse papulovesicular eruption, goes away with proper diet
5
Q
diagnosis of celiac
A
- small intestinal biopsy showing villous atrophy and therapeutic response to gluten withdrawal with normal findings 3-6 months later
- tissue transglutamase (tTG-IgA/IgG) most sensitive
- IgA deficiency so cannot use tTG-IgA, have to use IgG
6
Q
treatment for celiac
A
- avoid all foods containing wheat, rye, and barley grain
- avoid oats
- limit milk and milk products initially
- lifelong gluten free diet
7
Q
complications of celiacs
A
- always rule out malignancy first
- lymphomas T-cell type
8
Q
tropical sprue
A
- acquired in endemic tropical areas characterized by abnormalities of small intestinal structure and function that become progressively more severe
- can be cured with folic acid and/or tetracycline
9
Q
symptoms of tropical sprue
A
- acute episode of watery non-bloody diarrhea
- development of chronic diarrhea
- development of malabsorption
10
Q
tropical sprue lab abnormalities
A
- megaloblastic anemia (deficiency of folate/B12)
- low carotene
- low vitamin A
- hypocholesterolemia
- hypocalcemia
- hypoalbuminemia
11
Q
diagnosis of tropical sprue
A
- D-xylose test abnormal
- steatorrhea present
- Schillings test abnormal
- broadening and shortening of the villi
12
Q
treatment of tropical sprue
A
- folic acid
- tetracycline for 3-6 months
- replacement of vitamins and minerals
13
Q
symptoms of Whipple’s disease
A
- weight loss
- diarrhea
- abdominal pain
- arthralgia
- common in farmers and people who had occupational exposure to soil and animals
14
Q
diagnosis of Whipple’s diase
A
- D-xylose abnormal
- Steatorrhea present
- irregular thickening of the mucosal folds particularly in the duodenum and proximal jejunum
- small intestinal biopsy definitive
- infiltration of the lamina propria of the small intestine by PAS-positive macrophage containing Gr (+), acid fast (-) bacilli accompanied by lymphatic dilation is specific and diagnostic
15
Q
treatment for Whipple’s
A
- ceftriaxone for 14 days followed by
- trimethoprine-sulfamethoxazole twice daily for 1 year
