Malabsorption syndromes

Question 1

Malabsorption syndromes

Answer 1

Cause diarrhea, steatorrhea, weight loss, weakness, vitamin and mineral deficiencies

Question 2

Malabsorption syndrome

Types

Answer 2

“These will cause devastating absorption problem”

Tropical spruce
Whipple's disease
Celiac spruce
Disaccharidase deficiency
Abetaliproproteinemia
Pancreatic insufficiency

Question 3

Tropical spruce

Answer 3

Unknown cause,
but respond to antibiotics,
similar to celiac spurce, can affect entire small bowel

Question 4

Whipple’s disease

Answer 4

Infection with Tropheryma whipplei (gram +)
PAS positive foamy macrophages in intestinal lamina propria, mesenteric node.

Cardiac symptoms, arthralgias, and neurologic symptoms.

Most often in older men.

Question 5

Celiac spruce

Answer 5

Autoantibodies to gluten (gliadin) in wheat and other.
Primarily affects distal duodenum or proximal jejunum.
Histology: loss of villi.

Question 6

Disaccharidase deficiency

Answer 6

Most common is lactase deficiency
Milk intolerance
Normal appearing villi
Osmotic diarrhea
Since lactase located at the tip, self limited lactase deficiency can occur following injury.

Question 7

Lactose intolerance test

Answer 7

Admin of lactose produces symptoms

Glucose rises <20 mg/dL

Question 8

Abetalipoproteinemia

Answer 8

Decreased synthesis of apolipoprotein B
Inability to generate chylomicrons
Decrease secretion of cholesterol, VLDL into blood
Fat accumulation in enterocytes

Presents in early childhood with malabsorption and neurologic manifestation.

Question 9

Pancreatic insufficiency

Answer 9

Due to CF, obstructing cancer, and chronic pancreatitis.
Causes malabsorption of fat and fat soluble vit
Increased neutral fat in stool