Nutritional disorders/Malabsorption Flashcards
Scurvy
vit C deficiency
Scurvy sx
Fatigue
Poor dental hygiene (gingivitis, loos teeth, bad smell)
Bleeding (gum, joint, nose, etc)
Muscle pain/weakness
Oedema
Rx of scurvy
ascorbic acid
Dietary education
Beriberi def
Vit B1 deficiency (thiamine)
Beriberi sx
Heart failure + oedema (wet)
Neuropathy (dry)
Beriberi rx
Thiamine (pabrinex)
Pellagra def
lack of nicotinic acid
Pellagra sx
triad of
diarrhoea
dermatitis
dementia
Pellagra rx
Education,
electrolyte replacement,
nicotinamide PO
Xerophthalmia def
Vit A deficiency
Xeropthalmia sx
Dry conjuctivae -> oval spots (Bitot’s spots)
Soft, cloudy cornea
Blindness
Xeropthalmia rx
give vit A
Rickets/osteomalacia deficiency
Vit D
Angular stomatitis/cheilitis deficiency
vit B2 (riboflavin)
Causes of malabsorption
Coeliac
Chronic pancreatitis
Crohns
Coeliac pathophysiology
autoimmune disease in small bowel agaisnt prolamin
What contains prolamin
Wheat
Barley
Rye
+/- oat
Coeliac sx
Stinking stool
Diarrhoea
Abdo pain
Nause/vom
etc
Bloods of coeliac
Low:
Hb
ferritin
B12
Antibodies for coeliac
alpha gliadin
transglutaminase
anti-endomysial
Biopsy findings of coeliac
subtotal villous atrophy
increased intra-epithelial WBCS
crypt hyperplasia
Coeliac rx
life long gluten free diet
Chronic pancreatitis sx
epigatric pain
relieved by sitting forward or hot water bottles on epigastrium/back
steatorrhoea
Causes of chronic pancreatitis
Alcohol
CF
Haemochromatosis
Pancreatic duct obstruction (stones/tumour)
Increased PTH
Ix of chronic pancreatitis
US +/- CT (calcification)
MRCP, ERCP (risk acute attack)
increased glucose
breath tests, eg 13C-hiolien
Drug rx of chronic pancreatitis
Give analgesia
Lipase, eg Creon®
Fat-soluble vitamins (eg Multivite®)
Diet: No alcohol; low fat, medium-chain triglycerides (MCT oil®)
