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GI - 2 > 17-5 -- Malabsorption > Flashcards

17-5 -- Malabsorption Flashcards

1
Q

What is a stool sign of malabsorption?

A

Steatorrhea

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2
Q

Steatorrhea

A

Fatty, greasy, stools

- sign of malabsorption

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3
Q

Diarrhea can occur due to what 4 mechanisms being impaired?

A
  • Intraluminal digestion
  • Terminal digestion
  • Transepithelial Transport
  • Lymphatic Transport
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4
Q

Diarrhea can occur due to what 4 mechanisms being impaired?

A
  • Intraluminal digestion
  • Terminal digestion
  • Transepithelial Transport
  • Lymphatic Transport
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5
Q

What is absorbed with Intraluminal digestion and what 3 conditions is it impaired with?

A

Breakdown of carbs, fats and proteins

= IBD, Pancreatitis and Cystic Fibrosis

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6
Q

What is absorbed with Lymphatic Transport and what condition is it impaired with?

A

Lipid absorption

= Whipple disease

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7
Q

Increased stool mass/frequency/fluidity > 200 mg per day

A

Diarrhea

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8
Q

4 types of Diarrhea?

A
  1. Secretory
  2. Osmotic
  3. Malabsorptive
  4. Exudative
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9
Q

4 types of Diarrhea?

A
  1. Secretory
  2. Osmotic
  3. Malabsorptive
  4. Exudative
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10
Q

Isotonic diarrhea; persists during fasting

A

Secretory Diarrhea

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11
Q

Diarrhea fluid is more concentrated than plasma; stops with fasting

A

Osmotic Diarrhea

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12
Q

Steatorrhea diarrhea; relieved by fasting

A

Malabsorptive Diarrhea

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13
Q

Purulent, bloody diarrhea due to inflammatory disease; persists during fasting

A

Exudative Diarrhea

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14
Q

How does Cystic Fibrosis cause diarrhea?

A
  • pancreatic abnormalities that cause an accumulation of mucous
  • Impaired secretions = impaired digestion
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15
Q

What may be seen in a child with Cystic Fibrosis that causes a bowel obstruction?

A

Meconium Ileus

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16
Q

What is an immune disease triggered by the ingestion of gluten?

A

Celiac disease

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17
Q

Describe the pathogenesis of Celiac Disease

A
  • Gluten broken down to Gliadin
  • Gliadin induces cells to express IL-15
  • IL-15 triggers CD8+ T cell activation
  • T cells express NKG2D
  • NKG2D recognizes MIC-A on enterocytes and T cells attack
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18
Q

What HLA molecules does Gliadin interact with to cause more tissue damage with Celiac Disease?

A

HLA-DQ2 and HLA-DQ8

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19
Q

What physical changes to the intestines are seen with Celiac Disease?

A

Villous atrophy
Crypt hyperplasia
Loss of mucosal surface area

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20
Q

What cell type is increased intraepithelially with Celiac Disease?

A

Lymphocytes

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21
Q

Celiac disease involves IgA antibodies. What specific antibodies can diagnose Celiac disease?

A

EMA

tTG

22
Q

EMA and tTG antibodies can diagnose?

A

Celiac Disease

23
Q

What are some classic symptoms of Celiac Disease?

A

Diarrhea and bloating
Malabsorption which causes Anemia
Dermatitis Herpetiformis (blisters from IgA deposits)

24
Q

What are some classic symptoms of Celiac Disease?

A

Diarrhea and bloating
Malabsorption which causes Anemia
Dermatitis Herpetiformis (blisters from IgA deposits)

25
Q

Those with Celiac disease have an increased risk for what malignancy?

A

T cell lymphoma

26
Q

What causes Environmental Enteropathy?

A

Poor sanitation/hygiene or

Defective mucosal immune function

27
Q

3 symptoms of Environmental Enteropathy?

A

Malabsorption
Malnutrition
Stunted growth

28
Q

Malabsorption and stunted growth are seen with which Enteropathy?

A

Environmental Enteropathy

29
Q

How is Autoimmune Enteropathy inherited?

A

X-linked Recessive

30
Q

Autoimmune Enteropathy involves loss of?

A

FOXP3

==> defective development of CD4 T REG cells

31
Q

Autoimmune Enteropathy involves loss of?

A

FOXP3

==> defective development of CD4 T REG cells

32
Q

Autoimmune Enteropathy involves antibodies to what cells?

A

Enterocytes
Goblet cells
Parietal cells
Islet cells

33
Q

What cell type infiltrates the intestinal mucosa with Autoimmune Enteropathy?

A

Neutrophils

34
Q

What are the symptoms of Autoimmune Enteropathy?

A

Persistent diarrhea
Autoimmune disease
** in CHILDREN **

35
Q

What age group does Autoimmune Enteropathy primarily affect and what are the symptoms?

A

CHILDREN

- Persistent diarrhea and autoimmune disease

36
Q

With Abetalipoproteinemia, what can the body NOT make?

A

Unable to assemble triglyceride-rich lipoproteins

37
Q

With Abetalipoproteinemia, what can the body NOT make?

A

Unable to assemble triglyceride-rich lipoproteins

38
Q

Abetalipoproteinemia involves a mutation in?

A

MTP

39
Q

With Abetalipoproteinemia, where do lipids accumulate?

A

Intracellularly

40
Q

Symptoms of Abetalipoproteinemia and when it presents?

A

Presents in INFANCY

= failure to thrive, diarrhea, steatorrhea

41
Q

Symptoms of Abetalipoproteinemia and when it presents?

A

Presents in INFANCY

= failure to thrive, diarrhea, steatorrhea

42
Q

What 4 molecular things are seen with Abetalipoproteinemia?

A

NO apolipoprotein B
Decreased Vitamins
Acanthocytes
Spiky RBCs

43
Q

What 4 molecular things are seen with Abetalipoproteinemia?

A

NO apolipoprotein B
Decreased Vitamins
Acanthocytes
Spiky RBCs

44
Q

Describe how diarrhea arises with Lactase Deficiency

A

Lactose cannot be converted to glucose + galactose
= Lactose remains in lumen and attracts fluid
== Diarrhea

45
Q

2 types of Lactase Deficiency?

A

Congenital

Acquired

46
Q

Congenital Lactase Deficiency

A

Mutation in gene encoding lactase

47
Q

Symptoms of Congenital Lactase Deficiency?

A

When milk ingested in infancy:

= explosive diarrhea and abdominal distention

48
Q

Acquired Lactase Deficiency?

A

Downregulation of lactase gene expression due to not ingesting milk after weaning or infections

49
Q

Symptoms of Acquired Lactase Deficiency?

A

Diarrhea and flatulence

50
Q

Milk ingested in infancy which causes explosive diarrhea and abdominal distention is likely?

A

Congenital Lactase Deficiency

GI - 2 (61 decks)

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