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Alimentary System > Malabsorption and Small Intestine Disease > Flashcards

Malabsorption and Small Intestine Disease Flashcards

1
Q

What are the functions of the small intestine?

A

Digestion
Absorption
Endocrine and neuronal control functions

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2
Q

What is the digestive function of the small intestine?

A

The breaking down of food into its components

Components that can then be absorbed

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3
Q

What is the absorption function of the small intestine?

A

The passage of nutrients into the blood stream

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4
Q

Describe the structure of the small intestine

A 
3 pars 
Duodenum 
Jejunum
Ileum 
Large surgace area 
Covered in villi 
Villi covered in microvill
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5
Q

Does the large intestine frequently turn over its cells?

A

Yes very

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6
Q

Why is the rarity of malignancy of the small intestine so surprising?

A

Because of the high cell turnover rate

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7
Q

Describe the bacterial population in the small intestine

A

Low bacterial population

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8
Q

Why do most bacterial not survive in the small intestine?

A

Because bile is incredibly toxic

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9
Q

Where does digestion commence?

A

In the stomach

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10
Q

How is fat digested?

A

By pancreatic lipase
Absorption of glycerol and free FA
Via lacteal and lymphatic system

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11
Q

Hows are carbohydrates absorbed?

A

Pancreatic amylase
Breakdown to disaccharides
Final digestion by brush border

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12
Q

What are the symptoms of general malnutrition?

A

Weight loss
Increased appetite
Diarrhoea
Fatigue

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13
Q

What causes steatorrhea?

A

Fat malabsorption

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14
Q

What is steatorrhea?

A

High fat content in stools

Stools are lens dense and float

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15
Q

How does steatorrhea present?

A

Floating stools
Foul smelling
May leave an oily mark

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16
Q

What are signs of general malnutrition?

A

Signs of weight loss

Low of falling BMI

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17
Q

What are signs of iron deficiency?

A

Anaemia
Painful tongue
Angular stomatitis

18
Q

What are some non-specific signs in malnutrition?

A

Clubbing
Scleorderma
Apththous ulceration

19
Q

What is aphthous ulceration?

A

Mouth ulcers

20
Q

What investigations are done for the small bowel?

A 
Small bowel biopsy 
Small bowel study
White cell scan 
CT scan 
MRI enterography
Capsule enteropraphy
21
Q

What can clubbing be a sign of in small bowel disease?

A

Crohn’s

Coeliac disease

22
Q

What is a White cell scan?

A
  • WBC are removed and tagged with radioactive material

- Injected back into locate the site and extent of inflammation

23
Q

Is coeliac disease common or uncommon?

A

Common

24
Q

Why is coeliac disease considered to be an iceberg?

A

Because so many people go undiagnosed

25
Q

What are coeliacs sensitive to?

A

The Gliadin fraction of gluten

26
Q

Where is gliadin (of gluten) found food wise?

A

Wheat
Rye
Barley

27
Q

Where is the gold standard of coeliac diagnosis?

A

Distal duodenum biopsy

28
Q

What does gliadin do in coeliac?

A

Produces an inflammatory response

29
Q

How is the inflammatory response in coeliac thought to be mediated?

A

Via tissue transglutaminase

30
Q

What is the pathological appearance of coeliac?

A

Partial or subtotal villous atrophy

Increased intra-epithelial lymphocytes

31
Q

What are the potential complications of coeliac?

A 
o	Refractor coeliac disease 
o	Small bowel lymphoma 
-	rare
o	Oesophageal carcinoma 
o	Colon cancer 
o	Small bowel adenocarcinoma
32
Q

How is coeliac diagnosed?

A

Distal duodenal biopsy
Serology
IgA
Total plasma IgA

33
Q

What is the difference between partial, subtotal and total villous atrophy?

A

Partial - shortened villi
Subtotal - the lining is flat with extended glands
Total - the lining is down to a thin line

34
Q

What is the treatment for coeliac?

A

Withdraw gluten

Refer to a state registered dietician

35
Q

What are causes of malabsorption?

A 
Inflammation
Infection 
Whipples Disease 
Impaired gut motility 
Iatrogenic 
Pancreatic problems 
Infiltration  
Tropheryma Whippelii
36
Q

What inflammatory diseases can cause malabsorption?

A

Coeliac

Crohn’s

37
Q

What pancreatic conditions can cause malabsorption?

A

Chronic pancreatitis

CF

38
Q

What skin condition is associated with coeliac

A

Dermatitis Herperiformis

39
Q

Diagnostic procedure for coeliac

A

Distal duodenal biopsy

40
Q

Histological finding of coeliac disease

A

Partial or total villous atrophy

41
Q

Commonest treatment for coeliac disease

A

Removal of gluten from diet

42
Q

Cause of coeliac disease

A

Autoimmune inflammatory response to harmless gliadin fraction of gluten

Alimentary System (29 decks)

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