small intestine resection Flashcards

1
Q

what does leaving less than 1m of small bowel cause

A

short bowel syndrome

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2
Q

where in the small intestine is resection best tolerated

A

jejunum

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3
Q

what is glucagon-like peptide 2

A

specific growth hormone for the enterocyte

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4
Q

what can short bowel syndrome lead to

A
  • depleted of electrolytes

- develop malnutrition

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5
Q

what can treatment of short bowel syndrome

A
  • loperamide
  • codeine
  • high dose PPI to reduce gastric secretion
  • oral rehydration solution
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6
Q

what is the ileum the site of

A

specific mechanisms for the absorption of bile salts and vitamin B12

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7
Q

what does the loss of the ileal break lead to

A

diarrhoea

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8
Q

what happens when bile salts and fatty aids enter the colon

A

cause malabsorption of matter and electrolytes

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9
Q

what does bile salts in the colon cause

A

increased oxalate absorption

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10
Q

investigations for short bowel syndrome

A
  • imaging
  • measure B12
  • bile salt retention
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11
Q

treatment if steatorrhoea

A

low fat diet

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12
Q

what compensate for loss of jejunal absorptive function

A

ileum

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13
Q

what can jejunal resection lead to

A
  • gastric hyper secretion

- high gastrin levels

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14
Q

what does intestinal failure result from

A
  • obstruction
  • dysmotility
  • surgical resection
  • congenital defect
  • loss of absorption
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15
Q

when does intestinal failure usually occur

A

following resection from Crohn’s, mesenteric vessel occlusion, radiation enteritis or trauma

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16
Q

what can sodium losses be minimised by

A

increasing salt intake

17
Q

what is Whipple’s disease

A

rare infectious bacterial disease caused by Tropheryma whipplei

18
Q

who most likely gets Whipple’s disease

A

men

white middle-aged

19
Q

what does Whipple’s present with

A
  • arthritis
  • arthralgia
    over the years:
  • weight loss
  • diarrhoea
  • abdominal pain
  • fever
20
Q

what do blood tests show for Whipple’s disease

A

chronic inflammation and malabsorption

21
Q

what does endoscopy show in Whipple’s

A
  • pale, shaggy duodenal mucosa

- eroded, red, friable patches

22
Q

how is Whipple’s diagnosed

A

small bowel biopsy

23
Q

treatment of Whipple’s

A

antibiotics that cross the blood-brain barrier

e.g. trimethoprim daily for 1 year