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Malabsorption and Malnutrition Flashcards

1
Q

what are common causes of malabsorption

A

coeliac
lactose intolerant
crohn’s
post infcetion

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2
Q

what would the symptom of easy bruising suggest

A

vit K + C deficiency

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3
Q

what is Acrodermatitis enteropathica (minging dry/flakey red rash) associated with

A

zinc deficiency

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4
Q

what is Dermatitis Herpetiformis (tiny itchy blisters) associated with

A

coeliac

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5
Q

what is spooning of the nails associated with

A

iron deficiency

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6
Q

what is Glossitis + angular stomatitis (red rash on/in mouth) associated with

A

Vit B + iron deficiency

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7
Q

what is lactose intolerance

A

inability to adequately digest lactose resulting in a deficiency of lactose

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8
Q

what are the 3 types of lactase deficiency

A

primary (most common worldwide)
secondary (most common in uk)
congenital

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9
Q

what is primary lactase deficiency caused by

A

lack of the lactase persistence (LP) allele

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10
Q

what is secondary lactase deficiency caused by

A

damage to/ infection of the proximal small intestine

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11
Q

what is congenital lactase deficiency caused by

A

rare autosomal recessive disease

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12
Q

what is the diagnostic test(s) for lactose intolerance

A

lactose breath hydrogen test

oral lactose intolerance test

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13
Q

treatment of lactose intolerance

A

lactose free diet

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14
Q

treatment of coeliac disease

A

gluten free diet

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15
Q

investigations for coeliac disease

A

IgA anti-tissue transglutaminase test (tTGA) = 1st line
elevated giladin antibodies
confirmative biopsy

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16
Q

what immune cells mediate coeliac disease

A

T cell

IEL

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17
Q

what causes coeliac disease

A

expression of HLA-DG2 or HLA-DQ8

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18
Q

what is the cause of malnutrition

A

nutrient/energy imbalance

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19
Q

when is enteral feeding indicated

A

inadequate or unsafe oral intake AND a functional, accessible GI tract

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20
Q

what is enteral feeding

A

supply of food directly to the stomach, duodenum, or jejunum

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21
Q

what are the contra-indications of enteral feeding

A

severe D or V
intestinal ischaemia
lower GI obstruction

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22
Q

when is parenteral feeding indicated

A

severe malnutrition
multi-organ failure
unsafe oral and enteral nutritional intake
non-functional/inaccessible/perforated GI tract

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23
Q

give examples of conditions which would cause a non-functional/inaccessible/perforated GI tract

A

IBD with severe malabsorption
short bowel syndrome
motility disorders

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24
Q

what is refeeding syndrome

A

potentially fatal shifts in fluid and electrolytes in organ function and metabolic regulation that may result from referring after a period of under nutrition

25
what are the metabolic features of refeeding syndrome
hypokalaemia altered glucose metabolism fluid overload
26
what are the physiological features of refeeding syndrome
``` arrhythmias altered levels of consciousness seizure Rest failure cardiovascular collapse death ```
27
what patients are at a moderate risk of refeeding syndrome
had little to no nutritional intake for > 5 days
28
what patients are at a high risk of refeeding syndrome
1 of: BMI<16 little/no nutritional intake for >10days low K,Mg,Po before feeding 2 of; BMI<18.5 little/no nutritional intake >5 days history of drug/alcohol abuse
29
what patients are at a extremely high risk of refeeding syndrome
BMI <14 | no intake for > 15 days
30
what BMI is considered underweight
<18.5
31
what BMI is considered normal
18.5-24.9
32
what BMI is considered overweight
25-29.9
33
what BMI is considered obese
30-39.9
34
what BMI is considered morbidly obese
>40
35
what are the ways to measure BMI
Kg/m squared | mid upper arm circumference
36
how can height be measured
ulnar length | measure standing height
37
what is the MUST score?
BMI score + weight loss score +acute disease score
38
what score is a low risk of malnutrition according to MUST
0
39
what score is a medium risk of malnutrition according to MUST
1
40
what score is a high risk of malnutrition according to MUST
2 or more
41
a BMI of >20 gives you what on the MUST score
0
42
a BMI of 18.5-20 gives you what on the MUST score
1
43
a BMI of <18.5 gives you what on the MUST score
2
44
an unplanned weight loss of <5% gives you what on the MUST score
0
45
an unplanned weight loss of >10% gives you what on the MUST score
2
46
an unplanned weight loss of 5-10% gives you what on the MUST score
1
47
what MUST score does a patient who is acutely ill and has no nutritional intake for >5 days get
2
48
what are the symptoms of coeliac disease
``` weight loss diarrhoea nutritional deficiencies excess flatus abdominal discomfort ```
49
what causes Whipple's disease
Tropheryma whipplei
50
what are the symptoms of Whipple's disease
``` weight loss diarrhoea steatorrhoea abdominal distension arthritis fever nutritional deficiency ```
51
what is the cause of giardiasis
giardia lamblia (parasite)
52
what are the risk factor for giardiasis
foreign travel | contaminated water supply
53
what is the diagnosis for giardiasis
stool examination
54
what is the treatment for giardiasis
metronidazole for 1 week
55
what are the symptoms for giardiasis
``` asymptomatic diarrhoea, flatulence abdominal cramps/epigastric pain nausea/vomiting significant malabsorption with steatorrhea + weight loss. ```
56
what is the cause of small bowel bacteria overgrowth
E.coli
57
what are the symptoms of small bowel bacteria overgrowth
diverticula fistulas strictures
58
what is the diagnosis of small bowel bacteria overgrowth
Lab = low cobalamin + high folate | schillings test
59
what is the treatment of small bowel bacteria overgrowth
tetracycline for 2-3 weeks

GI - mine (17 decks)

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