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Flashcards in Malabsorpton Deck (39):
1

Define malabsorption

Defective mucosal absorption

2

What are common causes of malabsorption

Coeliac
Chron's
Post Infectious
Biliary obstruction
Cirrhosis

3

What are uncommon causes of malabsorption

Pancreatic cancer
Parasites
Bacterial Overgrowth
Drugs
Short Bowel

4

Digestive causes of protein malabsorption

Partial or total gastrectomy
Exocrine pancreatic insufficiency
Trypsinogen deficiency
Congenital deficiency of enterokinase

5

Absorptive causes of protein malabsorption

Coeliac disease
Methionine malabsorption
Short bowel
Jejunoilial bypas
Hartsnup disease (defects in neutral AA transporter)
Cystinuria I-III
Occulucerebral syndrome of Lowe

6

Digestive causes of fat malabsorption

Less time to mix- resection, neuropathy, amyloidosis

Decreased micelle formation- biliary obstruction, SIBO, CCK deficiency

Decreased lipolysis- chronic pancreatitis, cystic fibrosis, lipase deficiency

7

Absorptive causes of fat malabsorption

Decreased chylomicron formation and or mucosal absorption

8

Post absorptive causes of fat malabsorption

Defective lymphatic transprt- lymphoma, whipples

9

Digestive causes of carb malabsorption

Severe pancreatic insufficiency

10

Absorptive causes of carb malabsorption

Primary or acquired lactase deficiency
-post infective
-celiac
-chrons
-trehalase deficiency

11

Cause of VB12 deficiency

Atrophic gastritis

Intrinsic factor deficiency- pernicious anaemia

Pancreatic insufficiency- zolinger ellis- reduced release of B12 from R binding protein

Helminth infections/SIBO

Ileal/crhon's disease/resection

12

Cause of folic acid deficiency

Disease affecting proximal/small bowel

Celiac disease

Whipple

tropical sprue

Alcoholism

13

Calcium deficiency

Renal disease, genetic, Celiac, bile acid deficiency

14

Magnesium deficiency

Loss of mucosal surface

15

Iron deficiency

Reduced mucosal surface area, GI bleed

16

Zinc deficiency

Acrodermatitis enterohepathica

17

Copper deficiency

Menkes disease (kinky hair disease

18

Describe the cause of Celiac

Intestinal antigen presenting cells in people expressing HLA-DQ2 or HLA-DQ8 bind with dietary gluten peptides in their antigen-binding grooves activate specific mucosal T lymphocytes cytokines which cause mucosal damage

19

Symptoms of Celiac

Spectrum: asymptomatic to nutritional deficiencies weight loss, diarrhoea, excess flatus, and abdominal discomfort

20

Diagnosis of Celiac

IgA anti-tissue transgulatminase test (tTGA)

Biopsy is confirmative

21

Cause of lactose malabsorption

Deficiency of lactase

22

lactose malabsorption presenting complaint

Induction of diarrhoea, abdominal discomfort and flatulence following ingestion of dairy products

23

Diagnosis of lactose malabsorption

Clinical, confirmed by hydrogen breath test

24

Cause of tropical sprue

Colonisation of investing by an infectious agent or alterations to intestinal bacterial flora induces by exposure to another environmental agent

25

Clinical findings in tropical sprue

Diarrhoea, steatorrhoea, weight loss, nausea, anorexia, anaemia

26

Diagnosis and treatment of tropical sprue

Biopsy
Tetracycline and folic acid

27

Causes of whipple's disease

Torpheryma whipplei. Multi system involvement, increase in the frequency of HLA-B27

28

Clinical findings in whipples disease

Weight loss, steatorrhoea, abdominal distension, arthritis, fever, nutritional deficiency symptoms

29

Diagnosis of whipple's disease

Demostration of T.whipplei in involved tissues by microscopc=y

30

Treatment of T.whipplei

Antimicrobial

31

Causes of parasitic infections

Giardia lamblia

32

Risk factors of giardiasis

Travel to areas where the water supply ma be contaminated, swimming in ponds

33

Clinical findings of giardiasis

Diarrhoea, flatulence, abdo cramps, epigastric pain, nausea,
1/3rd vomit
steatorrhea, weight loss

34

Testing for parasitic infections

Stool examination for ova and parasites, three separate stools is ideal

35

Treatment of parasitic infections

Metronidazole- 1 week

36

Symptoms of SIBO

Diarrhoea, steattorhea, microcytic anaemia

37

Causes of SIBO

E.coli, bacteroides

Diverticula, fistulas, strictures relating to chron's disease
Bypass surgeries functional stasis

38

Lab testing of SIBO

Low cobalamin and high folate
Aerobic/ anaerbic colonic type bacteria in jejunal aspirate obtained by intubation. Established by schillings test

39

treatment of SIBO

Surgical correction of anatomical blind loop

tetracyclines 2-3 week