Small Intestinal Disorders and Investigation Flashcards
What are the common symptoms of small intestinal disorders?
Weight loss
Increased appetite (due to malabsorption)
Steatorrhoea
Why is steatorrhoea a common symptom in small intestinal disorders?
Fat is the first thing to stop being absorbed from small intestine due to malabsorption -> higher fat content being passed out in stool
Give 6 signs of specific deficiencies arising from small intestinal disorders
Anaemia
Deficiency in: Vitamin B12 Ca Mg Vitamin D Vitamin A Vitamin K Vitamin B Thiamine Niacin Vitamin C
What are the non-specific signs of specific small intestinal illnesses?
Clubbing
Scleroderma
Apthous ulceration
Dermatitis herpetiformis is a cutaneous manifestation of
coeliac disease
What is the typical presentation of dermatitis herpetiformis?
Blistering, intensely itchy skin, appears commonly on the scalp, shoulders, elbows and knees
Why are blisters occurring as a result of dermatitis herpetiformis rarely seen?
As patients scratch them while asleep
Give 5 investigations that can be done to determine small intestinal structure
Small bowel biopsy via endoscopy Barium meal White cell scan CT MRI enterography Capsule enterography
What is coeliac disease?
A common disease
Sensitivity to Gliadin fraction of gluten, produces an inflammatory response causing partial or subtotal villous atrophy
What would be seen in the serology of a patient with coeliac disease?
Anti-endomysial IgA
Anti-tissue transglutaminase
Give 5 conditions associated with coeliac disease
Dermatitis herpetiformis Insulin dependent diabetes mellitus Autoimmune thyroid disease Autoimmune hepatitis Primary biliary cirrhosis Autoimmune gastritis Sjogren syndrome IgA deficiency Downs syndrome
What are the possible complications of coeliac disease?
Refractory coeliac disease Small bowel lymphoma Oesophageal carcinoma Colon cancer Small bowel adenocarcinoma
Give 6 causes of malabsorption
Inflammation Infection Infiltration Impaired motility Iatrogenic Pancreatic
Give an example of an inflammatory cause of malabsorption
Crohn’s disease
Coeliac disease
Give an example of an infection causing malabsorption
Tropical sprue
HIV
Giardia lamblia
Whipple’s disease - tropheryma whippelii
