Malabsorption and Malnutrition

Question 1

What is malabsorption and what causes it?

Answer 1

• defective mucosal absorption

- caused by digestive disorders or absorption defects

Question 2

What is a symptom of protein malabsorption and why?

Answer 2

• watery diarrhoea
• oedema
• attracts water into the lumen

Question 3

symptoms of fat malabsoprtion

Answer 3

• steatorrhea (fatty stools)

- decrease in fat soluble vitamins

Question 4

What may be the cause of exocrine pancreatic insufficiency?

Answer 4

• chronic pancreatitis
• alcohol abuse
• cystic fibrosis

Question 5

What might chronic pancreatitis look like on AXR?

Answer 5

• Calcium deposits

Question 6

What are the symptoms of exocrine pancreatic insufficiency?

Answer 6

• global malabsorption
• chronic diarrhea
• unintentional weightless
• bloating

Question 7

Describe the symptoms of cholestasis?

Answer 7

• impaired bile flow
• obstructive or hepatocellular
• clay coloured stools
• skin appears yellow

Question 8

What are the symptoms of lactose intolerance?

Answer 8

• gas and bloating
• ## diarrhoea and abdominal pain

Question 9

what tests can be done to test for lactose intolerance?

Answer 9

• hydrogen breath test

- stool test

Question 10

What causes IgA antibodies in coeliac disease?

Answer 10

• gliadin

Question 11

Dermatitis herpetrformis may be a sign of what?

Answer 11

• coeliac disease

Question 12

What is tropical sprue?

Answer 12

• bacterial overgrowth which results in absorption defects

- treat with triglycerides and folic acid

Question 13

What is Whipple’s disease?

Answer 13

• bacteria
• foamy macrophages
• can affect joints

Question 14

Easy bruising can be a sign of what?

Answer 14

• vitamin C or K deficiency

Question 15

spooning of the nails can be a sign of what?

Answer 15

• iron

- thyroid

Question 16

What investigations would you carry out for a malabsorption syndrome?

Answer 16

• FBC
• LFTs
• stool culture
• coagulation

Question 17

Define malnutrition

Answer 17

• state of nutrition in which a deficiency, excess or imbalance or energy, protein and other nutrients causes measurable adverse effects

Question 18

What are disease causing malnutrition disorders?

Answer 18

• decreased intake
• impaired digestion/absorption
• increased nutritional requirements
• increased nutrient losses

Question 19

What are the effects of malnutrition?

Answer 19

• impaired immune responses
• impaired wound healing
• reduced muscle strength and fatigue

Question 20

What biochemical measures should you be checking in terms of malnutrition in the elderly?

Answer 20

• vitamin A,C,D,E
• albumin
• zinc

Question 21

What is an enteral tube feeding (ETF)

Answer 21

• Delivery of nutritionally complete feed via a tube into the stomach, duodenum, jejnum

Question 22

What are the 3 main types of enteral feeding tubes?

Answer 22

• NG (nasogastric)
• NJ (Nasojejunal)
• PEG (Percutaneous endoscopi gastrostomy

Question 23

What are some features of refeeding syndrome?

Answer 23

• hypokalaemia
• hypophosphataemia
• hypomagnesaemia
• fluid overload
• arryhtmias
• sezures
• death

Question 24

How should you prevent refeeding syndrome?

Answer 24

• introduce nutrition support at a 50% maximum for the first 48 hours
• monitor clinical and biochemical parameters

Question 25

What screening tool should you use in malnutrition?

Answer 25

• MUST
• Malnutrition, Universal Screening tool
• BMI, Weight loss, acute disease