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Year 3 > Malabsorption (GI) > Flashcards

Malabsorption (GI) Flashcards

1
Q

Define malabsorption.

A

Malfunction of the intestinal wall resulting in insufficient absorption of breakdown products

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2
Q

What diseases can cause malabsorption? (3)

A
  • IBD (Crohn’s, UC)
  • Coeliac disease
  • lactose intolerance
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3
Q

Define global malabsorption.

A

In diseases causing diffuse mucosal damage or reduction in absorptive surface e.g. Coeliac

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4
Q

Define partial malabsorption.

A

Localised absorption impairment resulting in deficiencies of specific nutrients e.g. vitamin B12 deficiency in patients with disease of terminal ileum

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5
Q

Define maldigestion.

A

Insufficient secretion of pancreatic enzyme or bile preventing adequate breakdown of food in intestinal lumen

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6
Q

What can cause maldigestion? (2)

A

Exocrine pancreatic insufficiency OR cholestasis

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7
Q

What are the clinical features of malabsorption? (5)

A
  • diarrhoea
  • steatorrhoea - floating and foul-smelling stool
  • abdominal distension
  • weight loss and fatigue
  • partial malabsorption - Sx specific to individual nutrient deficiencies
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8
Q

What do we see on bloods in malabsorption?

A

Anaemia and vitamin deficiencies

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9
Q

How do we assess absorptive function of upper small intestine (malabsorption)?

A

D-xylose absorption test

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10
Q

How do we manage malabsorption (non-severe)?

A
  • oral supplementation of fluid, nutrients and vitamins
  • calorie and protein-enriched diet
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11
Q

How do we manage severe malabsorption?

A

IV nutrition

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12
Q

What is a gastric cause of malabsorption?

A

Post-gastrectomy (Dumping syndrome)

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13
Q

What are some small bowel causes of malabsorption? (3)

A
  • Coeliac disease
  • Crohn’s disease
  • small bowel resection (fatty stool, diarrhoea)
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14
Q

What are some pancreatic causes of malabsorption - loss of digestive enzymes –> maldigestion? (3)

A
  • chronic pancreatitis (ADEK deficiency)
  • pancreatic cancer
  • cystic fibrosis
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15
Q

What are some hepatobiliary pathway causes of malabsorption? (2)

A
  • primary biliary cirrhosis (PBC)
  • ileal resection (failure of bile acid absorption at terminal ileum) –> fatty stool, diarrhoea
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16
Q

What are the features of vitamin A deficiency (malabsorption)?

A

Loss of vision –> blindness

17
Q

What are the features of vitamin B1 deficiency (malabsorption)?

A

Thiamine

  • muscle weakness
  • severe weight loss (Beri-Beri)
  • chronic alcohol use
  • replace via IV Pabrinex
18
Q

What are the features of vitamin B2 deficiency (malabsorption)?

A

Riboflavin - poor diet and mouth sores (ariboflavinosis)

19
Q

What are the features of vitamin B3 deficiency (malabsorption)?

A

Niacin - diarrhoea and dermatitis (pellagra)

20
Q

What are the features of vitamin B5 deficiency (malabsorption)?

A

Pantothenic acid - ischaemic attacks, MS affect brain, paraesthesia

21
Q

What are the features of vitamin B6 deficiency (malabsorption)?

A

Pyridoxine - low RBCs

22
Q

What are the features of vitamin B7 deficiency (malabsorption)?

A

Biotin - red and itchy skin (dermatitis)

23
Q

What are the features of vitamin B9 deficiency (malabsorption)?

A

Folic acid - immature RBCs in bone marrow –> megaloblastic anaemia

24
Q

What are the features of vitamin B12 deficiency (malabsorption)?

A

Cyanocobalamin - abnormal absorption in small intestine, pernicious anaemia

25
Q

What are the features of vitamin C deficiency (malabsorption)?

A

Ascorbic acid - bleeding gums and swollen joints, scurvy

26
Q

What are the features of vitamin D deficiency (malabsorption)?

A

Calciferol - weakening of bones near joints, rickets

27
Q

What are the features of vitamin E deficiency (malabsorption)?

A

Tocopherols - faster depletion of RBCs from body, haemolytic anaemia

28
Q

What are the features of vitamin K deficiency (malabsorption)?

A

Phylloquinone - irregular and slow bleeding and clotting, bleeding diathesis

Required for synthesis of clotting factors II, VII, IX, X therefore deficiency due to malabsorption may result in bleeding diathesis

29
Q

What are the fat-soluble vitamins and when is their absorption impaired?

A

Vitamins A, D, E, K

Absorption impaired in fat malabsorption syndromes e.g. biliary obstruction, Coeliac disease, CF and short-gut syndrome

Year 3 (203 decks)

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