Malabsorption and Small Intestinal Disease

Question 1

What would pain after a fatty meal suggest?

Answer 1

Gallbladder problems

Question 2

What effects gut length?

Answer 2

Size

Gender

Question 3

Why does the gut breakdown food slowly?

Answer 3

Prevents vast osmotic shift

Question 4

What are the symptoms of malabsorption?

Answer 4

Weight loss
Increased appetite
Steatorrhoea

Question 5

What are the clinical signs of malabsorption?

Answer 5

Deficiencies: 
Iron 
B12, folate 
Ca2+, Mg2+ 
Vitamin D,A

Question 6

What is dermatitis herpetiformis?

Answer 6

Cutaneous manifestation od coeliac disease. Causes blistering, itching

Question 7

What causes dermatitis herpetiformis?

Answer 7

IgA deposits in the skin

Question 8

What tests are used to investigate the small bowel?

Answer 8

Small bowel biopsy 
Small bowel study (barium meal) 
CT 
MRI/ capsule enterography 
White cell scan 
Bacterial overgrowth

Question 9

In coeliac disease what is the particular sensitivity to gluten?

Answer 9

The gliadin fraction of gluten

Question 10

Where is gluten found?

Answer 10

Wheat
Rye
Barley

Question 11

What is the pathology of coeliac disease?

Answer 11

Inflammatory response
Villous atrophy
Increased intra-epithelial lymphocytes

Question 12

How do you diagnose coeliac disease?

Answer 12

Distal duodenal biopsy

Serology (anti endomusial IgA, anti tissue transglutaminase)

Question 13

What is the treatment for coeliac disease?

Answer 13

Withdraw gluten

Question 14

What are the complications of coeliac disease?

Answer 14

Refractory coeliac disease 
Small bowel lymphoma 
Oesophageal carcinoma 
Colon cancer 
Small bowel adenocarcinoma

Question 15

What are the causes of malabsorption?

Answer 15

Inflammation 
Infection (HIV, tropical sprue, giardia lambda)
Whipple's disease 
Cystic fibrosis 
Iatrogenic 
Impaired motility