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Malabsorpton Flashcards

1
Q

Define malabsorption

A

Defective mucosal absorption

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2
Q

What are common causes of malabsorption

A 
Coeliac
Chron's
Post Infectious
Biliary obstruction 
Cirrhosis
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3
Q

What are uncommon causes of malabsorption

A 
Pancreatic cancer
Parasites
Bacterial Overgrowth
Drugs
Short Bowel
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4
Q

Digestive causes of protein malabsorption

A

Partial or total gastrectomy
Exocrine pancreatic insufficiency
Trypsinogen deficiency
Congenital deficiency of enterokinase

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5
Q

Absorptive causes of protein malabsorption

A 
Coeliac disease
Methionine malabsorption 
Short bowel
Jejunoilial bypas
Hartsnup disease (defects in neutral AA transporter)
Cystinuria I-III
Occulucerebral syndrome of Lowe
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6
Q

Digestive causes of fat malabsorption

A

Less time to mix- resection, neuropathy, amyloidosis

Decreased micelle formation- biliary obstruction, SIBO, CCK deficiency

Decreased lipolysis- chronic pancreatitis, cystic fibrosis, lipase deficiency

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7
Q

Absorptive causes of fat malabsorption

A

Decreased chylomicron formation and or mucosal absorption

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8
Q

Post absorptive causes of fat malabsorption

A

Defective lymphatic transprt- lymphoma, whipples

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9
Q

Digestive causes of carb malabsorption

A

Severe pancreatic insufficiency

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10
Q

Absorptive causes of carb malabsorption

A

Primary or acquired lactase deficiency

  • post infective
  • celiac
  • chrons
  • trehalase deficiency
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11
Q

Cause of VB12 deficiency

A

Atrophic gastritis

Intrinsic factor deficiency- pernicious anaemia

Pancreatic insufficiency- zolinger ellis- reduced release of B12 from R binding protein

Helminth infections/SIBO

Ileal/crhon’s disease/resection

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12
Q

Cause of folic acid deficiency

A

Disease affecting proximal/small bowel

Celiac disease

Whipple

tropical sprue

Alcoholism

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13
Q

Calcium deficiency

A

Renal disease, genetic, Celiac, bile acid deficiency

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14
Q

Magnesium deficiency

A

Loss of mucosal surface

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15
Q

Iron deficiency

A

Reduced mucosal surface area, GI bleed

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16
Q

Zinc deficiency

A

Acrodermatitis enterohepathica

17
Q

Copper deficiency

A

Menkes disease (kinky hair disease

18
Q

Describe the cause of Celiac

A

Intestinal antigen presenting cells in people expressing HLA-DQ2 or HLA-DQ8 bind with dietary gluten peptides in their antigen-binding grooves activate specific mucosal T lymphocytes cytokines which cause mucosal damage

19
Q

Symptoms of Celiac

A

Spectrum: asymptomatic to nutritional deficiencies weight loss, diarrhoea, excess flatus, and abdominal discomfort

20
Q

Diagnosis of Celiac

A

IgA anti-tissue transgulatminase test (tTGA)

Biopsy is confirmative

21
Q

Cause of lactose malabsorption

A

Deficiency of lactase

22
Q

lactose malabsorption presenting complaint

A

Induction of diarrhoea, abdominal discomfort and flatulence following ingestion of dairy products

23
Q

Diagnosis of lactose malabsorption

A

Clinical, confirmed by hydrogen breath test

24
Q

Cause of tropical sprue

A

Colonisation of investing by an infectious agent or alterations to intestinal bacterial flora induces by exposure to another environmental agent

25
Q

Clinical findings in tropical sprue

A

Diarrhoea, steatorrhoea, weight loss, nausea, anorexia, anaemia

26
Q

Diagnosis and treatment of tropical sprue

A

Biopsy

Tetracycline and folic acid

27
Q

Causes of whipple’s disease

A

Torpheryma whipplei. Multi system involvement, increase in the frequency of HLA-B27

28
Q

Clinical findings in whipples disease

A

Weight loss, steatorrhoea, abdominal distension, arthritis, fever, nutritional deficiency symptoms

29
Q

Diagnosis of whipple’s disease

A

Demostration of T.whipplei in involved tissues by microscopc=y

30
Q

Treatment of T.whipplei

A

Antimicrobial

31
Q

Causes of parasitic infections

A

Giardia lamblia

32
Q

Risk factors of giardiasis

A

Travel to areas where the water supply ma be contaminated, swimming in ponds

33
Q

Clinical findings of giardiasis

A

Diarrhoea, flatulence, abdo cramps, epigastric pain, nausea,
1/3rd vomit
steatorrhea, weight loss

34
Q

Testing for parasitic infections

A

Stool examination for ova and parasites, three separate stools is ideal

35
Q

Treatment of parasitic infections

A

Metronidazole- 1 week

36
Q

Symptoms of SIBO

A

Diarrhoea, steattorhea, microcytic anaemia

37
Q

Causes of SIBO

A

E.coli, bacteroides

Diverticula, fistulas, strictures relating to chron’s disease
Bypass surgeries functional stasis

38
Q

Lab testing of SIBO

A

Low cobalamin and high folate

Aerobic/ anaerbic colonic type bacteria in jejunal aspirate obtained by intubation. Established by schillings test

39
Q

treatment of SIBO

A

Surgical correction of anatomical blind loop

tetracyclines 2-3 week

Quick Revision (20 decks)

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