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GI - mine > Malabsorption and Malnutrition > Flashcards

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
Q

what are the metabolic features of refeeding syndrome

A

hypokalaemia
altered glucose metabolism
fluid overload

26
Q

what are the physiological features of refeeding syndrome

A 
arrhythmias
altered levels of consciousness
seizure
Rest failure
cardiovascular collapse
death
27
Q

what patients are at a moderate risk of refeeding syndrome

A

had little to no nutritional intake for > 5 days

28
Q

what patients are at a high risk of refeeding syndrome

A

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
Q

what patients are at a extremely high risk of refeeding syndrome

A

BMI <14

no intake for > 15 days

30
Q

what BMI is considered underweight

A

<18.5

31
Q

what BMI is considered normal

A

18.5-24.9

32
Q

what BMI is considered overweight

A

25-29.9

33
Q

what BMI is considered obese

A

30-39.9

34
Q

what BMI is considered morbidly obese

A

> 40

35
Q

what are the ways to measure BMI

A

Kg/m squared

mid upper arm circumference

36
Q

how can height be measured

A

ulnar length

measure standing height

37
Q

what is the MUST score?

A

BMI score + weight loss score +acute disease score

38
Q

what score is a low risk of malnutrition according to MUST

A

0

39
Q

what score is a medium risk of malnutrition according to MUST

A

1

40
Q

what score is a high risk of malnutrition according to MUST

A

2 or more

41
Q

a BMI of >20 gives you what on the MUST score

A

0

42
Q

a BMI of 18.5-20 gives you what on the MUST score

A

1

43
Q

a BMI of <18.5 gives you what on the MUST score

A

2

44
Q

an unplanned weight loss of <5% gives you what on the MUST score

A

0

45
Q

an unplanned weight loss of >10% gives you what on the MUST score

A

2

46
Q

an unplanned weight loss of 5-10% gives you what on the MUST score

A

1

47
Q

what MUST score does a patient who is acutely ill and has no nutritional intake for >5 days get

A

2

48
Q

what are the symptoms of coeliac disease

A 
weight loss
diarrhoea
nutritional deficiencies
excess flatus
abdominal discomfort
49
Q

what causes Whipple’s disease

A

Tropheryma whipplei

50
Q

what are the symptoms of Whipple’s disease

A 
weight loss
diarrhoea
steatorrhoea
abdominal distension
arthritis 
fever
nutritional deficiency
51
Q

what is the cause of giardiasis

A

giardia lamblia (parasite)

52
Q

what are the risk factor for giardiasis

A

foreign travel

contaminated water supply

53
Q

what is the diagnosis for giardiasis

A

stool examination

54
Q

what is the treatment for giardiasis

A

metronidazole for 1 week

55
Q

what are the symptoms for giardiasis

A 
asymptomatic
diarrhoea,
flatulence
abdominal cramps/epigastric pain
nausea/vomiting 
significant malabsorption with steatorrhea + weight loss.
56
Q

what is the cause of small bowel bacteria overgrowth

A

E.coli

57
Q

what are the symptoms of small bowel bacteria overgrowth

A

diverticula
fistulas
strictures

58
Q

what is the diagnosis of small bowel bacteria overgrowth

A

Lab = low cobalamin + high folate

schillings test

59
Q

what is the treatment of small bowel bacteria overgrowth

A

tetracycline for 2-3 weeks

GI - mine (17 decks)

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