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GI AM > Malbsorotion and small intestinal disease > Flashcards

Malbsorotion and small intestinal disease Flashcards

1
Q

What are the functions of the small intestine?

A

Digestion
Absorption
Endocrine and neuronal control
Barrier against pathogens

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2
Q

What are the barrier functions of the small intestine?

A

Immune sampling
Monitoring of the presence of pathogens
Translocation of bacteria
Gut assocatied lymphoid tissue

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3
Q

What is the structure of the small intestine?

A

250-450cm

Villous architecture

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4
Q

Why is there a low bacterial population of the small intestine?

A

Digestive enzymes
Bile salts
Presence of IgA etc

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5
Q

Where does digestion commence?

A

Stomach

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6
Q

What are proteins broken down to?

A

Oligopeptides and amino acids

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7
Q

What happens to digested proteins at the brush border?

A

Final hydrolysis and absorption

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8
Q

What breaks down fats?

A

Pancreatic lipase

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9
Q

What are fats broken down to?

A

Glycerol and free fatty acids

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10
Q

How are glycerol and fatty acids absorbed?

A

Via lacteals into the lymphatic system

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11
Q

What are the causes of malabsorption?

A 
Inflammation
Infection
Infiltration
Impaired motility
Iatrogenic
Pancreatic
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12
Q

What are the inflammatory causes of malabsorption?

A

Coeliac

Crohn’s

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13
Q

What are the infective causes of malabsorption?

A 
Tropica sprue
HIV
Giardia lambila
Whipples diseae
Tropheryma whippelii
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14
Q

What are the impaired motility causes of malabsorption?

A

Systemic sclerosis
Disabetes
Pseudo obstruction

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15
Q

What are the iatrogenic causes of malabsorption?

A

Gastric surgery
Short bowel syndrome
Radiation

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16
Q

What are the pancreatic causes of malabsorption?

A

Chronic pancreatitis

Cystic fibrosis

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17
Q

What are the symptoms of malabsorption?

A

Weight loss
Increased appetite
Steatorrhoea

18
Q

What are the characteristics of steatorrhoea?

A

Stool floats, pale, foul smelling, may leave oily mark

19
Q

What are the signs of malabsorption?

A 
Specific deficiencies
Clubbing
Scleroderma
Aphthous ulceration
Dermatitis herpetiformis
20
Q

What specific deficiencies can arise from malabsorption?

A

Iron
B12, folate
Ca, Mg, vit A, C, D, K
Vit B complex

21
Q

What does Ca, Mg and vit D deficiency cause?

A

Tetany

Osteomalacia

22
Q

What does a vit A deficiency cause?

A

Night blindness

23
Q

What does a vit B complex deficiency cause?

A

Thiamine deficiency- memory, dementia

Niacin deficiency- dermatitis, unexplained heart failure

24
Q

What i clubbing a sign of?

A

Crohn’s

coeliac

25
Q

What is aphthous ulceration a sign of?

A

Crohn’s

Coeliac

26
Q

What is the cutaneous manifestation of coeliac?

A

Dermatitis herpetiformis

IgA deposits in skin

27
Q

What are the forms of small bowel investigation?

A

Tests of structure
Tests of function
Other

28
Q

What are the structural tests of the small bowel?

A 
Biopsy via endoscopy
Barium swallow
White cell scan
CT
MRI enterography
Capsule enterography
29
Q

What tests can be used to determine bacterial overgrowth?

A

H2 breath test

Culture of duodenal/jujenal aspirate

30
Q

What is coeliac?

A

Sensitivity to the gladden fraction of gluten

31
Q

What is gluten found in?

A

Wheat, rye, barley

32
Q

What is gluten absent from?

A

Maize, rice, oats

33
Q

What are the symptoms of coeliac?

A 
Weight loss
Diarrhoea and/or constipation
Abdo pain
Anaemia
Fatigue
Bloating
Dermatitis herpeformis
34
Q

What is the pathology of coeliac?

A

Produces inflammatory response, causing partial or total villous atrophy and increased epithelial lymphocytes

35
Q

How is coeliac diagnosed?

A

Serology then if + distal duodenal biopsy

36
Q

Whatvare the 3 levels of villous atrophy?

A

Partial- villi shortened
Subtotal- lining flat but glands extended
Total- lining flat

37
Q

What is the treatment of coeliac?

A

Withdrawal of gluten

Referral o state registered dietician

38
Q

What conditions are associated with coeliac?

A 
Demartitis herpetiformis
Type 1 diabetes
Autoimmune thyroid disease
Autoimmune hepatitis
Primay biliary cirrhosis
Autoimmune gastritis
Sjogren syndrome
IgA deficiency
Downs Syndrome
39
Q

What are the possible complications of coeliac?

A 
Refractory coeliac disease
Small bowel lymphoma
Oesophageal carcinoma
Colon cancer
Small bowel adenocarcinoma
40
Q

What is refractory coeliac disease?

A

Coeliac disease with doesn’t respond to diet

Treat with steroids

GI AM (34 decks)

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