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OS GI > Malabsorption > Flashcards

Malabsorption Flashcards

1
Q

What are some S/S that make you suspicious of steatorrhea?

A 
Weight loss
Osteomalacia: deficient vitamin D absorption
Easy bruising
Iron deficiency anemia w/o blood loss
Adult lactase deficiency
Gastric surgery
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2
Q

What is Billroth 1?

A

pylorus is removed and the proximal stomach is anastomosed directly to the duodenum

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3
Q

What is Billroth II?

A

greater curvature of the stomach is connected to the first part of the jejunum in a side-to-side manner

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4
Q

What mechanisms are responsible for oily stool?

A

Increased osmotic particles
Hydroxylation of 10-hydroxy-oleate
Fatty acids impair electrolyte & fluid absorption

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5
Q

What is a chemical fat balance test?

A

Compare the fat eaten vs. how much in stool (>5% found in stool is bad)

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6
Q

What is the secretin test?

A

Most sensitive test

Give secretin directly and measure bicarb and pancreatic secretions

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7
Q

What should you look for on XR if suspecting malabsorption?

A

Calcification of pancreas

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8
Q

What is the hydrogen breath test?

A

Give carbs. If not digesting the carbs, then bacteria eat it (overgrowth occurs) and produce hydrogen gas. 4 hours indicates proximal intestines

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9
Q

What is the MCC of steatorrhea?

A

pancreatic insufficiency

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10
Q

What are some causes of intraluminal stage malabsorption?

A

Chronic pancreatitis (lipase deficiency)
Z-E S (gastrin - high acid - inactive lipase)
Post-gastrectomy (bypassing duodenum means no CCK)
CF
Ileal resection: can’t reabsorb bile acids

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11
Q

What are some causes of intestinal stage malabsorption?

A 
Disaccharidase insufficiency
Stasis (of fluid) syndrome
Gluten-sensitive enteropathy
Radiation
Tropical sprue
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12
Q

What is Whipple disease?

A

Systemic PAS+ disease where small intestine is laden with macrophages containing rod shaped bacilli Tropheryma whippelii

M>F

Intestinal stage malabsorption
Hyperpigmentation
Joint pain
Dementia

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13
Q

Explain malabsorption in gluten sensitive enteropathy

A

Immature surface cells
absorptive functions are reduced

CCK producing cells reduced
Surface area reduced

Disease is most severe in proximal intestine

B12 is ok

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14
Q

How do you diagnose GSE?

A

ELISA IgA

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15
Q

What are some ‘unexplained’ causes of steatorrhea?

A 
Giardiasis
Adrenal insufficiency
Amyloid
Diabetes
Hyperthyroidism
CVID
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16
Q

What are some causes of malabsorption in the lymphatic transport stage?

A 
Lymphatic duct obstruction
Lymphoma
Whipple disease
TB
Carcinoid
17
Q

What is the characteristic pathological finding in celiac sprue / GSE?

A

VIllous blunting and CD8 T cells

18
Q

How can viral enteritis cause malabsorption?

A

Temporary disccharidase deficiency

19
Q

What should be in your differential for malabsorption?

A

GSE
Chronic pancreatitis
Zebras

OS GI (9 decks)

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