wk 2 6 Malabsorbtion COPY

Question 1

define malabsorbtion and 3 catergories which can cause it

Answer 1

defective mucosal absorption

caused by defective luminal digestion, mucosal disease, structural disordersq

Question 2

5 common causes of malabsorbtion

Answer 2

coeliac 
crohns
post infectious
biliary obstruction 
cirrhosis

Question 3

list 4 reasons that protein may not be digested

Answer 3

partial/total gastrectomy
exocrine pancreatic insufficiency
trypsinogen deficiency
congenital deficiency of intestinal enterokinase

Question 4

Cystinuria I-III
Oculocerebral syndrome of Lowe
SSB
these can cause protein malabsorption, list another 4

Answer 4

celiac disease
blue diaper syndrome
defects in neutral AA transporters
Jejunoileal bypass

Question 5

fat malabsorption can occur in the digestive, absorptive and post absorptive phase. give a couple examples of what causes this for each

Answer 5

digestive - reduced mixing time, amyloidosis, biliary obsturction, decreased lipolysis, incr calcium

absorptive - decr chylomicron formed, celiac, abetaliproproteinemia (AR)

post - trauna, retroperitoneal fibrosis, defective lymphatic transport

Question 6

alpha amylase defiency will cause malabsorption of

Answer 6

carbohydrates

Question 7

celiac and crohns disease can cause malabsorption of carbohydrates. What phase would they both affect the body

Answer 7

absorptive

Question 8

another name for VitB12

Answer 8

cobalamin

Question 9

impaired peptin or acid secretion will cause atrophic gastritis, due to a defiency in what vitamin

Answer 9

vit B12

Question 10

t/f helminths infection can cause defiency in folic acid

Answer 10

false

helminths infection will cause defiency in B12

Question 11

which vitamin binds to R-protein, excreted by salivary glands

Answer 11

vitb12

Question 12

alcoholism/celiac disease and diseases affecting the proximal small bowel can lead to a defiency in

Answer 12

folic acid

Question 13

what will happen if there is a defiency in Fat soluble Vitamins (ADEK)

Answer 13

multiple defiencies

Question 14

renal disease, hypoparathyroidism can lead do defiency of what mineral

Answer 14

calcium

Question 15

celiac disease and bile acid disease may reduce intestinal surface area t/f

Answer 15

true
lead to calcium deficiency
may form long insoluble calcium soaps +fatty acid chains

Question 16

magnesium deficiency caused by

Answer 16

loss of mucosal surface area

luminal binding by malabsorbed fatty acids

Question 17

most common cause of iron deficiency

Answer 17

GI bleeding

mucosal surface area may also cause iron defciency

Question 18

acrodermatitis enteropathica is a defect in

Answer 18

zinc transport

Question 19

inherited disorder of cellular copper transport

Answer 19

menkes disease

Question 20

coeliac disease is due to presenting of HLA-DQ2/8, explain what occurs

Answer 20

binds with dietary gluten peptides, activates T cells causing mucosal damage

Question 21

typical symptoms of coeliac

Answer 21

weight loss
diarrhoea
excess flatus
abdominal discomfort

Question 22

diagnosis and treamtment for coeliac disease

Answer 22

tTGA test
biopsy confirms

Gluten free diet

Question 23

lactose malabsorption symptoms

Answer 23

diarrhoea
abdominal discomfort
flatulance following ingestion of dairy

Question 24

test used too diagnose lactose malabsorption

Answer 24

lactose breath hydrogen test

Oral lactose intolerance test may be used

Question 25

tropical sprue is the colonisatioin of the intestine by an infectious agent. Explain the symptoms and treatment

Answer 25

symptoms - diarrhoea steatorrhea, weight loss, nausea, anorexia, anaemia treatment - tetracycline + folic acid

Question 26

define steatorrhea

Answer 26

abnormal excretion of fat

Question 27

which antigen causes whipples disease

Answer 27

tropheryma whipplei | incr HLA-B27

Question 28

t/f whipples affects multiple systems

Answer 28

true

Question 29

``` weight loss abdominal distension arthritis fever nutritional deficiency renal failure which one is most likely to occur as a late stage in whipples disease ```

Answer 29

renal failure

Question 30

how is whipples disease diagnosed and treated

Answer 30

T.Whipplei in tissue antimicrobial

Question 31

intestinal resections, enterocolic fistulas sm. intestine bacrerial overgrowth these may cause

Answer 31

crohns disease

Question 32

in crohns disease, the abdominal tenderness is usually located

Answer 32

RLQ

Question 33

other than endoscopy, CT, MRI, what can be done to diagnose crohns disease

Answer 33

barium iimaging of small bowel mucosal disease, including stricutres, ulcerations and fistulae colonosscopy

Question 34

strictures

Answer 34

narrowing of body canal

Question 35

4 types of drugs given for crohns

Answer 35

steroids immunosuppresants anti-TNF azathioprine 6-MPO

Question 36

likely area of pain associated with parasitic infection

Answer 36

epigastrium

Question 37

how is a parasitic infection diagnosed

Answer 37

stool examination (3)

Question 38

treatment of parasitic infections

Answer 38

metronidazole for 1 weekk

Question 39

likely bacteria found in small bowel bacterial overgrowth

Answer 39

e coli | bacteriodes

Question 40

2 features of lab results associated with small bowel bacterial overgrowth

Answer 40

low cobalamin | high folate levels

Question 41

signs of small bowel bacterial overgrowth

Answer 41

diverticula (bulges in lining of intestine) | fistula and strictures related to crohns disease

Question 42

treatment for smalll bacrerial overgrowth

Answer 42

surgical correction of anatomical blind loop | tetracyclines 2/3weeks

Question 43

areas which a GI history should cover

Answer 43

``` Gi symptoms past med travel social drug dietary ```

Question 44

if the patient has had ...... (past med) may suspect malabsorption

Answer 44

gastric/ small bowel resection GI diversion (bariatric) radiation exposure travel

Question 45

associations for diarrhoea

Answer 45

``` duration malabsorbtive stool fat globules floating hard to flush away foul ```

Question 46

malabsorption may be indicated on examination due too... what 2 deficiencies cause tis

Answer 46

easy bruising ``` vit c (scurvy) vit k ```

Question 47

areas which acrodermatitis enteropthica affetc, what causes

Answer 47

rash which is perioral and acral (alopecia too) | impaired zinc uptake

Question 48

which skin disease may indicate coeliac

Answer 48

dermartitis herpetiformis

Question 49

sub epiithelial IgA deposition is seen in which skin disease, causing itchy blisters

Answer 49

dermatitis herpetiformis

Question 50

glossitis and angular stromatitis is due to B vitamins and Iron, where would you see this on examination

Answer 50

red rash around mouth

Question 51

spooning of nails is due to

Answer 51

iron deficiency

Question 52

6 baseline investigations

Answer 52

``` FBC coagulation Liver function test albumin (carrier for hormones, from liver) calcium/magnesium stool culture ```