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Unit 6: Path - Gastrointestinal Tract > Malabsorption > Flashcards

Malabsorption Flashcards

1
Q

Two substances preferentially absorbed by the distal small intestine?

A

Bile salts and B12

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2
Q

Two phases of intestinal absorption?

A
  • Luminal - Alteration of physicochemical state of nutrients, so that they can be taken up by absorptive cells
  • Intestinal - Processes occurring in cells and transport chennels of the intestinal wall
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3
Q

What processes occur in the luminal phase of digestion?

A

Pancreatic enzyme degradation and bile acid complexation

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4
Q

What determines bile quantity and quality?

A
  1. Adequate liver function
  2. Unobstructed bile flow
  3. Intact enterohepatic bile salt circulation
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5
Q

What is a frequent cause of luminal phase malabsorption?

A

Insufficient bile acids

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6
Q

Causes of luminal malabsorption?

A
  • Iterruption of the normal continuity of the ddistal stomach and duodenum
  • Pancreatic dysfn
  • Deficient/ineffective bile salts due to: Impaired excretion of the bile, bacterial overgrowth, deficient bile salts
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7
Q

What does intestinal-phase malabsorption frequently reflect?

A

Specific enzyme defects

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8
Q

What do defects in microvilli often result in?

A

Malabsorption of sugars (ie primary disaccharidase deficiencies)

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9
Q

What is short bowel syndrome?

A

Malabsorption due to resection of the small bowel

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10
Q

A disorder in which absorptive cells cannot synthesize the apoprotein required for the assembly of lipproteins and chylomicrons?

A

Abetalipoproteinemia

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11
Q

Lactose tolerance test?

A

Measuring blood sugar after ingestion of a standard amount of disaccharide

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12
Q

Isotopically labeled vit B12 given orally and its blood level then determined?

A

Schilling test

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13
Q

Typical deficiency seen in generalized malabsorption?

A

Typically always impaired absorption of dietary fat

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14
Q

Describe the D-xylose absorption test

A

D-xylose does not require any component of the intestinal phase to be absorbed, so this test is used to evaluate the luminal phase of absorption

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15
Q

Utility of the 14CO2-cholyl-glycine breath test?

A

Measured in exhaled air after oral admin is a test of bile salt abs in the ileum

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16
Q

What causes intolerance to milk products?

A

Lactase deficiency

17
Q

Characteristics of Celiac Disease?

A
  1. Generalized malabsorption
  2. Small intestinal mucosal lesions
  3. Prompt clinical and histopathological response to withdrawal of gluten-containing foods from diet
18
Q

Crucial risk factors for celiacs?

A
  • Genetic predisposition
  • Gliandin
19
Q

What are the compoents of grains that exacerbate celiac disease?

A

Gluten and gliandin

20
Q

Relationship of adenovirus to celiac disease manifestation?

A

Adenovirus codes an AA that has homology to alpha-gliadin.

21
Q

Histocompatibility complexes associated with celiac disease?

A

HLAB8, DR8, DQ2

22
Q

What skin disease is associated with celiac disease?

A

Celiac herpetiformis

23
Q

What are the characterisitcs of fully developed celiac disease?

A
  • Blunting/total disappearance of villi
  • Damaged mucosal surface epithelial cells with numerous intraepithelial lymphocytes
  • Increased plasma cells in the lamina propria but not in the deep layers
24
Q

Number one characteristic of celiac disease?

A

Generalized malabsorption

25
Q

Tests used to ID celiac disease?

A
  • IgA antiendomysial Ab
  • antitissue transglutaminase Ab
26
Q

Number one Tx to lead to complete and prolonged clinical/histopathologic remission?

A
  • Strict gluten free diet
27
Q

Probable cause of refractory sprue?

A

Monoclonal T-cell proliferation

28
Q

Syndrome that autoimmune enteropathy is found?

A

IPEX syndrome

  • X-linked
  • Immunodysregulation
  • Polyendocrinopathy
  • enteropathy

Due to FoxP3 mutation

29
Q

What is Whipple disease?

A

Small bowel filled with macrophages packed with small rod-shaped bacteria

30
Q

Bug that causes Whipple Disease?

A

Tropheryma whippelii

31
Q

Probable pathogenesis of Whipple Disease?

A

Impaired ability to degrade intracellular microorganisms; Circulating cells expressing CD11b are reduced. CD11b is used to activate macrophages.

32
Q

What does abetalipoproteinemia involve?

A

Failure to make apoprotein B

33
Q

What is apoprotein B typically used for?

A

Chylomicrons do not assemble and lipids cannot be transported out of cells

34
Q

What does abetalipoproteinemia lead to?

A

Acanthocytosis in erythrocytes and selective demyelinization

35
Q

Absorption of what vitamins are impaired in abetalipoproteinemia?

A

ADEK

36
Q

Lymphangiectasia and peripheral lymphedema?

A

Milroy disease

37
Q

What is lymphangiectasia?

A

Pathologic dilation of lymph vessels

38
Q

Cause of tropical sprue?

A

Etiology unknown, some studies suggest long-term contamination of the bowel with bacteria

39
Q

What does tropical sprue cause?

A

Folate deficiency

Unit 6: Path - Gastrointestinal Tract (36 decks)

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