131b malabsorption Flashcards

1
Q

what is the end result of malabsorbtion? what does that mean?

A

steatorrhea

loss of fecal fat (normally absorb 95%+)

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2
Q

what do bacteria do to bile salts? why does this matter?

A

deconjugate

wont form micelles

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3
Q

lactose deficiency?

A

most common disaccharidase deficiency

lactase isn’t present

bacteria ferment lactose to form gas

short chain fatty acids are the preferred fuel of colon???

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4
Q

protein digestion - is acid required? what marks low protein absorption?

A

acid not required (hypochlorhydria)

low protein –> hypoalbuminemia –> edema

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5
Q

vit D deficiency symptoms?

A

osteoporesis; osteopenia

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6
Q

vit k deficiency symptoms?

A

bleeding

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7
Q

steatorrhea amount of fat/24hrs?

A

5 grams

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8
Q

where are bile salts absorbed?

A

terminal ileum

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9
Q

where is Fe absorbed?

A

duodenum

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10
Q

what is aborbed proximally?

A

iron
water soluble vitamins/minerals
fats, fat soluble vitamin (ADEK)
carbs, amino acids, small peptides

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11
Q

sudan stain

A

good specificity for steatorrhea, low sensitivty

stains fat - doesn’t tell maldigestion vs malabsorption

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12
Q

schiling test - how is it done? what does various results mean?

A

B12 shot to saturate all sites + radioactive PO B12

R-protein + IF + B12 –> splitting off R-protein in order to absorb requires pancreas enzymes –> if bad pancreas then can’t split off and absorb B12

measure how much comes out in urine

  • if low then give IF to test; if corrects then pernicious anemia
  • if corrects with pancreatic enzymes –> pancreatic insufficiency
  • if corrects with antibiotics –> bacterial overgrowth
  • never corrects –> ilieum resection/disease
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13
Q

CCK-Secretin duodenal drainage test

A

measure output following CCK and secretin admin

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14
Q

d-xylose - how is test done? what is normal? If abnormal, what does it indicate?

A

25 grams sugar PO that is passively absorbed in intestine

renal clearance (urine + blood test) should be > 5 grams

if < 5 grams –> malabsorption or bacterial overgrowth

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15
Q

early peak of hydrogen breath test?

A

bacterial overgrowth

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16
Q

small bowel bacterial overgrowth is indicated by what?

A

low serum B12

high serum folate