Malabsorption

Question 1

Uncommon causes of malabsorption?

Answer 1

Pancreatic cancer, parasites, bacterial overgrowth

Question 2

Trypsinogen deficiency can lead to what?

Answer 2

Protein malabsorption

Question 3

Hartsnup Disease

Answer 3

Deficiency in amino acid transport

Question 4

Atrophic gastritis may cause malabsorption of what?

Answer 4

Vitamin B12 due to decreased levels of acid secretion

Question 5

What may lead to folic acid malabsorption

Answer 5

Diseases affecting the proximal small bowel (celiac disease, whipple, sprue, alcoholism)

Question 6

Fat soluble vitamins

Answer 6

ADEK

Question 7

Acrodermatitis enteropathica can cause decreased absorption of what?

Answer 7

Zinc (this condition is a defect in the zinc transport protein)
Symptoms: rash (peri-oral and acral), alopecia

Question 8

Defects in HLA-DQ2 and HLA-DQ8 associated with what?

Answer 8

Coeliac disease

Question 9

Diagnosis of coeliac disease

Answer 9

IgA anti-tissue transglutaminase test and biopsy

Question 10

Deficency in lactase causes what?

Answer 10

Lactose malabsorption

Question 11

Confirmation of lactose intolerance?

Answer 11

Lactose breath hydrogen test

Question 12

Treatment of Tropical Sprue?

Answer 12

Tetracycline and folic acid.

tetracycline 250mg 6-hourly for 28 days

Question 13

Diagnosis of Whipple’s disease?

Answer 13

Demonstration of Tropherymia whipplei in involved tissues by microscopy

Question 14

Treatment for Whipple’s disease?

Answer 14

IV ceftriaxone, oral co-triamoxazole (anti-microbials)

Question 15

Risk factors for Giardia lamblia?

Answer 15

Travelling to places where water supply may be contaminated, swimming in ponds

Question 16

Treatment for Gardia lamblia?

Answer 16

Metronidazole 1 week

Question 17

Treatment of other parasites

Answer 17

Coccidial, strongyloides

Question 18

What bacteria may cause bacterial overgrowth?

Answer 18

E.coli or bacteroides

Question 19

What may E.coli or bacteroides cause?

Answer 19

Bacterial overgrowth

Question 20

Low cobalamin and high folate sign of what?

Answer 20

Bacterial overgrowth

Question 21

What does bacterial overgrowth cause?

Answer 21

Diarrhoea, steatorrhoea, macrolytic anemia

Question 22

Schilling test best for diagnosing what?

Answer 22

Bacterial overgrowth.

Look for bacteria in jejunal aspirate obtained by intubation

Question 23

When to suspect malabsorption?

Answer 23

In these disease states -> liver, pancreas and small bowel

Question 24

Past medical history which may lead to malabsorption

Answer 24

Gastric/small bowel resection, gastrointestinal diversion (bariatric), radiation, travel

Question 25

Vitamin C and K deficiencies may cause what?

Answer 25

Easy bruising

Question 26

Dermatitis herpetiformis may indicate what?

Answer 26

Coeliac disease. Sub-epithelial IgA deposition

Question 27

Glossitis and angular stomatitis caused by what?

Answer 27

B vitamin and iron deficiency

Question 28

What causes spooning of nails?

Answer 28

Iron deficiency