3 - Paeds - Gastro - Malabsorption + Parasitic Infections Flashcards
6 general causes for malabsorption
- cholestatic liver disease/biliary atresia
- lymphatic leakage of obstruction
- short bowel syndrome
- loss of terminal ileal function
- small intestinal mucosal disease
- exocrine pancreatic dysfunction eg CF
Why would
-lymphatic leakage or obstruction
-exocrine panc dysfx
cause malabsorption?
- lymph - chylomicrons (carry absorbed lipids) unable to reach thoracic duct and circulation
- panc - absent lipase proteases and amylase > defective digestion of TGs, protein, starch
what specific malnutrition would you see in loss of terminal ileal function? why may this occur?
absent bile acid and vitamin B12 absorption
Crohns or resection
Sx of malabsorption?
abnormal stools - difficult to flush and stinks the whole house out
FTT/poor growth
specific nutrient deficiency
Ix?
dietician review stool samples urinalysis bloods endoscopy biopsy
what are you looking for in stool? what about urinalysis?
stool - pH, bile acids, large proteins, parasites
urinalysis - evidence of infection, transporter dysfunction
Why are children vulnerable to picking up parasites? 3 commonest parasites?
poor hygiene and time on floor
worms, giardia lamblia, cryptosporidium
Worms - most common in who? Sx? treatment?
most common in kids
usually aSx - may give itchy anus/vagina, disturbs sleep
trt whole house - good hygiene and medication (mebendazole or piperazine)
Giardia Lamblia - more common where/who? transmission? main source?
reduced immunity, poor sanitation, endemic areas
faecal-oral trans, main source = contaminated water
Giardia Lamblia - Ix? Sx?
stool microscopy to Ix
Sx - travellers diarrhoea (>10d), wt loss, FTT, nausea, abdo pain, anorexia
Cryptosporidium - common in kids with.. ? source? Sx?
with AIDS
contamination from animals -> livestock, petting zoos, nursery, food, water
sx - low grade fever, malaise, sudden onset watery diarrhoea ~2wks
