Malabsorption

Question 1

Gastric emptying is controlled by _____

Answer 1

acidity 
osmolarity
fat content
calorie content
peptide YY

Question 2

Peptide YY

Answer 2

mechanism for slowing gastric emptying when fat reaches ileum

Question 3

What requirements do you have to meet to absorb fat?

Answer 3

bile salts
pancreatic lipase
colipase
nearly neutral pH 
healthy enteroctyes

Question 4

maldigestion

Answer 4

abnormal HYDROLYSIS of nutrients

typically problems in the pancreas

Question 5

Zollinger Ellison Syndrome

Answer 5

inactivation of pancreatic enzymes leading to deficiency

Question 6

How might a vitamin B12 deficiency present?

Answer 6

anemia 
glossitis 
chelilitis 
angular stomatitis
diarrhea
paresthesias 
ataxia

Question 7

How might a vitamin D deficiency present?

Answer 7

osteoporesis
osteomalacia
paresthesias
tetany

Question 8

How might a vitamin zinc deficiency present?

Answer 8

anorexia
diarrhea
rash
alopecia

Question 9

How might a vitamin A deficiency present?

Answer 9

night blindness
dry eyes
hyperkeratosis
diarrhea

Question 10

How might a vitamin K deficiency present?

Answer 10

ecchymoses

bleeding

Question 11

How might a vitamin E deficiency present?

Answer 11

paresthesias
ataxia
retinopathy

Question 12

What do you need to absorb B12?

Answer 12

HCl and intrinsic factor from parietal cells

trypsin from pancreas

Question 13

When is it appropriate to give cholestyramine for secretory diarrhea?

Answer 13

For small ileal resection

Question 14

How do you treat small bowel bacterial overgrowth?

Answer 14

Rifaxamin
Augmentin
Cipro
Metronidazole

Question 15

Where does iron and folate get absorbed?

Answer 15

Duodenum

Question 16

Why is it important to know where in the GI tract things are absorbed?

Answer 16

Because depending on the deficiency of the pt you can tell where they’re having a problem

Question 17

Where are many drugs absorbed?

Answer 17

Jejunum

Question 18

> 90% of nutrient absorption occurs _____

Answer 18

Within the first 100-150 cm of jejunum

Question 19

Where is B12 and bile salts absorbed?

Answer 19

Ileum

Question 20

What mediates ileal brake?

Answer 20

Peptide YY

Mechanism for slowing gastric emptying when fat reaches ileum

Question 21

We produce ____ of saliva a day. Our small bowel absorbs ____ of fluid a day

Answer 21

1.5 L

7 L

Question 22

What do parietal cells produced?

Answer 22

HCl and intrinsic factors
Allow for absorption of B12

You also need trypsin to absorb B12 —comes from pancreas

Question 23

Crohns decrease affects of the _____

Answer 23

Ileum

Question 24

What happens when you have to resect 100cm of the small bowel?

Answer 24

Fat Malabsorption —secretory diarrhea

Tx: cholestyramine

Question 25

Cholestryamine

Answer 25

Binds bile acids and improves diarrhea Used in small ileal resection May worsen secretory diarrhea resulting from larger ileal resection (>100 cm)

Question 26

How do you treat small bowel bacterial overgrowth?

Answer 26

Augmentin, cipro, metronidazole, rifaxamin

Question 27

What is the normal fat fecal excretion based on a 100 g fat/day diet?

Answer 27

100 grams of fat excreted/day

Question 28

What diseases are associated with malabsorption?

Answer 28

``` Celiac disease Short bowel syndrome Pancreatic insufficiency Small bowel bacterial overgrowth Crohn’s disease Infections Obstructive biliary disease Neuroendocrine tumors ```