SBD

Question 1

What is the difference between malabsorption and maldigestion?

Answer 1

Maldigestion= Impaired breakdown of nutrients to absorbable products
Malabsorption= Defective mucosal uptake and transport of adequately digested nutrients including vitamins and trace elements

Question 2

What are the 4 major causes for maldigestion?

Answer 2

Gastric dysmotility
Pancreatic insufficiency
Bile salt deficiency
Poor mucosal defense (pathogens)

Question 3

What are the 5 causes for malabsorption?

Answer 3

Decreased intestinal surface area
Decreased circulation/lymphatic drainage
Mucosal infiltration w/ abnormal cells (lymphoma)
Transport protein mutations
Impaired motility

Question 4

What 2 tests are helpful in diagnosin malabsorption?

Answer 4

Fecal fat/Qualitiative fecal fat

Urinary d-xylose test

Question 5

What is SBBOG?

Answer 5

Small Bowel Bacterial Over-growth

Question 6

How is SBBOG diagnosed and medically treated?

Answer 6

C14Xylose Breath test

Aspiration of Fluids

Question 7

What are the diagnostic tests for confirming celiac sprue?

Answer 7

TTG

Anti-endomesial Ab

Question 8

What are the diagnostic tests for confirming pancreatic insufficiency? (chronic pancreatitis)

Answer 8

Secretin stimulation test (gold standard)
Measurement of pancreatic enzymes
in the blood (trypsinogen/trypsin) or in the stool (elastase/chymotrypsin)- easiest

Question 9

What are the diagnostic tests for confirming pancreatic ductal obstructive problems?

Answer 9

ERCP (can be therapeutically or to remove a stone)

Question 10

How is celiac sprue managed?

Answer 10

Gluten free diet

Question 11

How is pancreatic insufficiency managed?

Answer 11

pancreatic enzymes

Question 12

What is the Schilling Test and what does it rule out?

Answer 12

Used to determine causes for Vitamin B12 malabsorption- w/ rule outs of pernicious anemia, SBBOG, BB mucosal dz, Pancreatic insufficiency