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Clinical > Malabsorption > Flashcards

Malabsorption Flashcards

1
Q

Definition of malabsorption?

A

Defective mucosal absorption caused by:
Defective luminal digestion
Mucosal disease
Structural disorders

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2
Q

5 common causes of malabsorption?

A 
Coeliac disease
Crohn's disease
Post-infectious malabsorption
Biliary obstruction
Cirrhosis
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3
Q

5 uncommon causes of malabsorption?

A 
Pancreatic cancer
Parasites
Bacterial overgrowth
Drugs
Short bowel syndrome (inc. due to resections)
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4
Q

What is hartsnup disease?

A

Dysfunction of neutral amino acid uptake; defect in system B0AT1

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5
Q

What is cystinuria?

A

Dysfunction of cationic amino acid uptake; defect in system b0+AT

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6
Q

Symptoms of coeliac disease?

A

Weight loss (nutritional deficiencies)
Diarrhoea
Excess flatus
Abdominal discomfort

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7
Q

Cause and symptoms of lactose malabsorption?

A 
Deficiency of lactase:
History of diarrhoea induction
Abdominal discomfort
Flatulence
....all following ingestion of dairy products
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8
Q

Diagnosis of lactose malabsorption?

A

Lactose breath hydrogen test

Alternative: oral lactose intolerance test

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9
Q

What is tropical sprue?

A

Colonisation of the intestine by an infectious agent OR alterations in the intestinal bacterial flora, induced by exposure to an environmental agent

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10
Q

Symptoms of tropical sprue?

A 
Diarrhoea
Steatorrhea
Weight loss
Nausea and anorexia
Anaemia
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11
Q

Diagnosis of tropical sprue?

A

Biopsy

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12
Q

Treatment of tropical sprue?

A

Tetracycline + folic acid

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13
Q

What is Whipple’s disease?

A

Rare disease assoc. with GI malabsorption that is caused by Tropheryma whipplei; it is a multi-system disorder that is assoc. with HLA-B27

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14
Q

Symptoms of Whipple’s disease?

A 
Weight loss
Diarrhoea and steatorrhea
Abdominal distension 
Fever
Arthritis
Nutritional deficiency symptoms
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15
Q

Diagnosis of Whipple’s disease?

A

Demonstration of T. whipplei in the involved tissues, using microscopy

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16
Q

Treatment of Whipple’s disease?

A

Antibiotics

17
Q

How can Crohn’s disease cause malabsorption?

A

Patients can have extensive ileal involvement, extensive intestinal resections, enterocolic fistulas and strictures; this can lead to small intestinal bacteria overgrowth. They may also develop significant malabsorption

18
Q

Symptoms of Crohn’s disease?

A 
Abdominal pain and diarrhoea
Fever and weight loss
Abdominal tenderness (often in RLQ)
19
Q

Diagnosis of Crohn’s disease?

A

Endoscopy
Barium imaging of small bowel mucosal disease, inc. strictures, ulcerations, fistulas

CT/MRI scan

20
Q

Treatment of Crohn’s disease?

A

Steroids and immunosuppressants
Azathioprine 6-MP
Anti-TNF therapy

21
Q

Risk factors for infection with Giardia Lamblia?

A

Travel to areas where the water supply may be contaminated, swimming in ponds, etc

22
Q

Symptoms of Giardia infection?

A

Diarrhoea and flatulence

Abdominal cramps and epigastric pain

Malabsorption syndrome with steatorrhea; weight loss

23
Q

Diagnosis of Giardia lamblia?

A

Stool examination for ova and parasites (three separate stool samples)

24
Q

Treatment of Giardia lamblia infection?

A

Metronidazole (oral)

25
Q

Symptoms of small bowel bacterial overgrowth?

A

Diarrhoea, steatorrhea and macrocytic anaemia (B12), E. coli or Bacteroides

26
Q

Diagnosis of small bowel bacterial overgrowth?

A

Low cobalamin and high folate levels

Best established by a Schilling test (for pernicious anaemia)

27
Q

Treatment of small bowel bacterial overgrowth?

A

Surgical correction of an anatomical blind loop

Tetracycline

28
Q

GI symptoms of malabsorption?

A

Diarrhoea (duration, steattorhea - floaters - offensive)

Easy bruising

Vitamin C scurvy
Vitamin K deficiency

29
Q

What is acrodermatitis enteropathica and symptoms?

A

Autosomal recessive disorder affecting zinc uptake

Symptoms:
Peri-oral rash
Alopecia
Acral (skin cancer)

30
Q

What is dermatitis herperiformis and symptoms?

A

Assoc. with HLA-B8 and may indicate coeliac disease

Symptoms:
Itchy blisters on extensor surfaces (e.g: elbows)

Signs - sub-epithelial IgA deposition

31
Q

Causes of glossitis and angular stomatitis?

A

Vitamin B/Iron deficiency

32
Q

Causes of koilonychia?

A

Iron deficiency

Clinical (54 decks)

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