wk 2 6 Malabsorbtion COPY Flashcards
define malabsorbtion and 3 catergories which can cause it
defective mucosal absorption
caused by defective luminal digestion, mucosal disease, structural disordersq
5 common causes of malabsorbtion
coeliac crohns post infectious biliary obstruction cirrhosis
list 4 reasons that protein may not be digested
partial/total gastrectomy
exocrine pancreatic insufficiency
trypsinogen deficiency
congenital deficiency of intestinal enterokinase
Cystinuria I-III
Oculocerebral syndrome of Lowe
SSB
these can cause protein malabsorption, list another 4
celiac disease
blue diaper syndrome
defects in neutral AA transporters
Jejunoileal bypass
fat malabsorption can occur in the digestive, absorptive and post absorptive phase. give a couple examples of what causes this for each
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
alpha amylase defiency will cause malabsorption of
carbohydrates
celiac and crohns disease can cause malabsorption of carbohydrates. What phase would they both affect the body
absorptive
another name for VitB12
cobalamin
impaired peptin or acid secretion will cause atrophic gastritis, due to a defiency in what vitamin
vit B12
t/f helminths infection can cause defiency in folic acid
false
helminths infection will cause defiency in B12
which vitamin binds to R-protein, excreted by salivary glands
vitb12
alcoholism/celiac disease and diseases affecting the proximal small bowel can lead to a defiency in
folic acid
what will happen if there is a defiency in Fat soluble Vitamins (ADEK)
multiple defiencies
renal disease, hypoparathyroidism can lead do defiency of what mineral
calcium
celiac disease and bile acid disease may reduce intestinal surface area t/f
true
lead to calcium deficiency
may form long insoluble calcium soaps +fatty acid chains
magnesium deficiency caused by
loss of mucosal surface area
luminal binding by malabsorbed fatty acids
most common cause of iron deficiency
GI bleeding
mucosal surface area may also cause iron defciency
acrodermatitis enteropathica is a defect in
zinc transport
inherited disorder of cellular copper transport
menkes disease
coeliac disease is due to presenting of HLA-DQ2/8, explain what occurs
binds with dietary gluten peptides, activates T cells causing mucosal damage
typical symptoms of coeliac
weight loss
diarrhoea
excess flatus
abdominal discomfort
diagnosis and treamtment for coeliac disease
tTGA test
biopsy confirms
Gluten free diet
lactose malabsorption symptoms
diarrhoea
abdominal discomfort
flatulance following ingestion of dairy
test used too diagnose lactose malabsorption
lactose breath hydrogen test
Oral lactose intolerance test may be used
tropical sprue is the colonisatioin of the intestine by an infectious agent. Explain the symptoms and treatment
symptoms - diarrhoea steatorrhea, weight loss, nausea, anorexia, anaemia
treatment - tetracycline + folic acid
define steatorrhea
abnormal excretion of fat
which antigen causes whipples disease
tropheryma whipplei
incr HLA-B27
t/f whipples affects multiple systems
true
weight loss abdominal distension arthritis fever nutritional deficiency renal failure which one is most likely to occur as a late stage in whipples disease
renal failure
how is whipples disease diagnosed and treated
T.Whipplei in tissue
antimicrobial
intestinal resections, enterocolic fistulas
sm. intestine bacrerial overgrowth
these may cause
crohns disease
in crohns disease, the abdominal tenderness is usually located
RLQ
other than endoscopy, CT, MRI, what can be done to diagnose crohns disease
barium iimaging of small bowel mucosal disease, including stricutres, ulcerations and fistulae
colonosscopy
strictures
narrowing of body canal
4 types of drugs given for crohns
steroids
immunosuppresants
anti-TNF
azathioprine 6-MPO
likely area of pain associated with parasitic infection
epigastrium
how is a parasitic infection diagnosed
stool examination (3)
treatment of parasitic infections
metronidazole for 1 weekk
likely bacteria found in small bowel bacterial overgrowth
e coli
bacteriodes
2 features of lab results associated with small bowel bacterial overgrowth
low cobalamin
high folate levels
signs of small bowel bacterial overgrowth
diverticula (bulges in lining of intestine)
fistula and strictures related to crohns disease
treatment for smalll bacrerial overgrowth
surgical correction of anatomical blind loop
tetracyclines 2/3weeks
areas which a GI history should cover
Gi symptoms past med travel social drug dietary
if the patient has had …… (past med) may suspect malabsorption
gastric/ small bowel resection
GI diversion (bariatric)
radiation exposure
travel
associations for diarrhoea
duration malabsorbtive stool fat globules floating hard to flush away foul
malabsorption may be indicated on examination due too… what 2 deficiencies cause tis
easy bruising
vit c (scurvy) vit k
areas which acrodermatitis enteropthica affetc, what causes
rash which is perioral and acral (alopecia too)
impaired zinc uptake
which skin disease may indicate coeliac
dermartitis herpetiformis
sub epiithelial IgA deposition is seen in which skin disease, causing itchy blisters
dermatitis herpetiformis
glossitis and angular stromatitis is due to B vitamins and Iron, where would you see this on examination
red rash around mouth
spooning of nails is due to
iron deficiency
6 baseline investigations
FBC coagulation Liver function test albumin (carrier for hormones, from liver) calcium/magnesium stool culture
