Clinical Approach Flashcards

1
Q

You should suspect malabsorption in known disease states such as those involving: 3

A

Liver
Pancreas
Small bowel

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2
Q

what could be important in the PMH? 4

A
  • Gastric or small bowel resection
  • Gastrointestinal diversion (bariatric surgery
  • Radiation exposure
  • Travel
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3
Q

you want to know about ____ - where to how long , ____ consumption and ____ (new, illicit)

A

travel, alcohol, drugs

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4
Q

what do you want to know about the stool? 5

A
  • Duration
  • Malabsorptive stool
  • Fat globules
  • Floating - hard to flush away
  • Smelly
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5
Q

what are some signs of malabsorption?

A

easy bruising

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6
Q

what does easy bruising suggest?

A

vitamin K and C deficiency (vitamin C - scurvy)

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7
Q

what things can be noted on examination of the skin? 4

A
  • acrodermatitis enteropathica
  • dematitis herpetiformis
  • glottis and angular stomatitis
  • spooning of nails
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8
Q

acrodermatitis enteropathica is a ____ ____ condition

A

autosomal recessive

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9
Q
  • acrodermatitis enteropathica

causes impaired ___ uptake

A

zinc

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10
Q

what are the symptoms and signs of - acrodermatitis enteropathica ? 4

A
  • Rash
  • Perioral
  • Acral
  • Alopecia
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11
Q

what is the treatment for acrodermatitis enteropathica

A

life long zinc supplements

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12
Q

Dermatitis Herpetiformis may indicate ____ disease?

A

coeliac

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13
Q

what happens in Dermatitis Herpetiformis? 3

A

get itchy blisters, extensor surfaces and sub epithelial IgA deposition

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14
Q

____ and ____ _____ results from deficiency in B vitamins and iron

A

glottitis and angular stomatitis

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15
Q

what can cause spooning of the nails?

A

iron, thyroid problems

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16
Q

what are the baseline investigations in someone with a deficiency ? 6

A
  • FBC
  • Coagultaion - looking for increase
  • LFT’s
  • Albumin
  • Calcium/magnesium
  • Stool culture
17
Q

what are you looking for in stool cultures? 3

A
  • alpha 1 antitrypsin
  • fat globules
  • elastase
18
Q

what stain is used for fat globules

A

sudan stain

19
Q

what anatomical investigations are done?

A

endoscopy and ERCP

imaging

  • barium contrast
  • CT
  • MRI
20
Q

what can be diagnosed through endoscopy? 2

A

biliary obstruction and chronic pancreatitis

21
Q

what are the management aims?

A
  • Treat the underlying cause
  • Replace the deficiency
  • Support nutritionally