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GI System > Small Intestine Disorders > Flashcards

Small Intestine Disorders Flashcards

1
Q

Name four basic function of the small intestines

A
  • Absorption
  • Digestion
  • Endocrine and neuronal control
  • Barrier functions
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2
Q

Describe the digestive role of the small intestine

A

Breaks food into its components via secretion of digestive enzymes to digest peptides, carbohydrates and fats into smaller molecules

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3
Q

Describe the endocrine and neural control role of the small intestine

A

Controlling the flow of materials from the stomach to the colon

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4
Q

Describe the barrier role of the small intestine

A

Regulates what stays in and out, i.e. maintaining a barrier against pathogens

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5
Q

How is the small intestine involved in maintaining a barrier against pathogens?

A
  • Immune sampling
  • Monitoring the presence of pathogens
  • Translocation of bacteria
  • Gut Associated Lymphoid Tissue (GALT)
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6
Q

What is Gut Associated Lymphoid Tissue (GALT)?

A

Occurs throughout the intestine, but in the small intestine it contains Peyer’s Patches

GALT is made up of several types of lymphoid tissue that store immune cells, such as T and B lymphocytes, that carry out attacks and defend against pathogens

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7
Q

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

A

Due to toxic environment due to digestive enzymes, bile salts and presence of IgA

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8
Q

Where does digestion commence?

A

In the mouth via salivary amylase and chewing. Then, HCl and pepsin (digests protein) is released from the stomach via controlled breakdown to avoid osmotic shifts in the gut lumen

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9
Q

How are proteins digested?

A

Broken down to oligopeptide and amino acids by trypsin or chymotrypsin. Then they are undergo a final hydrolysis by brush border enzymes for absorption

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10
Q

How is fat digested?

A

Broken down by pancreatic lipase –> glycerol and free fatty acids for absorption via the lacteal and lymphatic system

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11
Q

How are carbohydrates digested?

A

Broken down by pancreatic amylase –> breakdown to disaccharides and final digestion occurs by brush border disaccharidase

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12
Q

What causes steatorrhoea?

A

Fat malabsorption causing high fat content in the stool making them less dense and float

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13
Q

Name 5 symptoms of small intestine disorders?

A
  • Weight loss
  • Increased appetite
  • Diarrhoea (usually watery, or steatorrhoea)
  • Bloating
  • Fatigue
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14
Q

Name two signs of small intestine disorders?

A
  • Weight loss

* Low to falling BMI

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15
Q

What are markers in the blood of specific deficiencies?

A
  • Iron
  • B12, folate
  • Ca, Mg
  • Vit A, B, C, D, K
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16
Q

What are conditions of deficiency in Ca, Mg and Vit D?

A

Tetany and osteomalacia

17
Q

What can deficiency in Vit A cause?

A

Blindness

18
Q

What can deficiency in Vit K cause?

A

Raised PTR (increased time to form blood clot)

19
Q

Give examples of Vit B complexes and what deficiencies in them can cause?

A
  • Thiamine -> dementia

* Niacin -> dermatitis, unexplained heart failure

20
Q

What can deficiency in Vit D cause?

A

Scurvy

21
Q

What are non-specific signs of specific illnesses?

A
  • Clubbing: coeliac and crohns
  • Scleroderma: systemic sclerosis
  • Aphtheous ulceration: coeliac, crohns
22
Q

What is dermatitis herpetiformis?

A

A cutaneous manifestation of coeliac disease

23
Q

What are four symptoms of dermatitis herpetiformis?

A
  • Blistering
  • Intense itch
  • Affects scalp, shoulders, elbows, knees
  • IgA deposit in the skin
24
Q

Name six different investigations to test the structure of the small intestine

A
  • Endoscopy
  • Barium swallow
  • CT scan
  • MRI enterography
  • Capsule enterography
  • White cell count
25
Q

Name two investigations to test for bacterial overgrowth

A
  • H2 Breath Test

* Culture a duodenal or jejunal aspirate

26
Q

What is coeliac disease?

A

An autoimmune disorder characterised by immune response to gluten and a protein in wheat. It leads to inflammation of small intestine and damages and destroys villi of intestinal wall -> malnutrition and malabsorption

27
Q

What are seven causes of malabsorption?

A
  • Inflammation
  • Infection
  • Whipples disease
  • Infiltration (amyloid)
  • Impaired motility
  • Iatrogenic (medical treatment related)
  • Pancreatic
28
Q

What are three infective agents that cause malabsorption?

A
  • Tropical sprue: folate deficiency and responds to antibiotics
  • HIV
  • Gardia Lambia
29
Q

What is gardia lambia?

A
  • Unicellular parasite
  • Spreads through contaminated water
  • Risk factor: hypogammaglobulinaemia (reduction is antibodies that fight infection)
30
Q

What antibiotic does gardia lambia respond to?

A

Metronidazole

31
Q

What does gardia lambia infection cause?

A

Giardiasis - attached to lining of small intestines and cause villous atrophy

32
Q

What is Whipple’s disease?

A

Inhibits digestion by impairing the breakdown of foods, causing:
• Malabsorption
• Weight loss
• Abdominal pain

Histologically: PAS stain in villi

33
Q

What organism causing Whipple’s Disease?

A

Tropheryma whippelii

34
Q

What three conditions cause impaired motility (-> malabsorption)?

A
  • Systemic sclerosis
  • Diabetes
  • Pseudo obstruction
35
Q

What are iatrogenic causes of malabsorption?

A
  • Gastric surgery
  • Short bowel syndrome
  • Radiation
36
Q

What are pancreatic causes of malabsorption?

A
  • Chronic pancreatitis

* Cystic fibrosis

GI System (28 decks)

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