Malabsorpton Flashcards

(39 cards)

1
Q

Define malabsorption

A

Defective mucosal absorption

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2
Q

What are common causes of malabsorption

A
Coeliac
Chron's
Post Infectious
Biliary obstruction 
Cirrhosis
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3
Q

What are uncommon causes of malabsorption

A
Pancreatic cancer
Parasites
Bacterial Overgrowth
Drugs
Short Bowel
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4
Q

Digestive causes of protein malabsorption

A

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

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5
Q

Absorptive causes of protein malabsorption

A
Coeliac disease
Methionine malabsorption 
Short bowel
Jejunoilial bypas
Hartsnup disease (defects in neutral AA transporter)
Cystinuria I-III
Occulucerebral syndrome of Lowe
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6
Q

Digestive causes of fat malabsorption

A

Less time to mix- resection, neuropathy, amyloidosis

Decreased micelle formation- biliary obstruction, SIBO, CCK deficiency

Decreased lipolysis- chronic pancreatitis, cystic fibrosis, lipase deficiency

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7
Q

Absorptive causes of fat malabsorption

A

Decreased chylomicron formation and or mucosal absorption

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8
Q

Post absorptive causes of fat malabsorption

A

Defective lymphatic transprt- lymphoma, whipples

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9
Q

Digestive causes of carb malabsorption

A

Severe pancreatic insufficiency

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10
Q

Absorptive causes of carb malabsorption

A

Primary or acquired lactase deficiency

  • post infective
  • celiac
  • chrons
  • trehalase deficiency
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11
Q

Cause of VB12 deficiency

A

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

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12
Q

Cause of folic acid deficiency

A

Disease affecting proximal/small bowel

Celiac disease

Whipple

tropical sprue

Alcoholism

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13
Q

Calcium deficiency

A

Renal disease, genetic, Celiac, bile acid deficiency

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14
Q

Magnesium deficiency

A

Loss of mucosal surface

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15
Q

Iron deficiency

A

Reduced mucosal surface area, GI bleed

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16
Q

Zinc deficiency

A

Acrodermatitis enterohepathica

17
Q

Copper deficiency

A

Menkes disease (kinky hair disease

18
Q

Describe the cause of Celiac

A

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
Q

Symptoms of Celiac

A

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

20
Q

Diagnosis of Celiac

A

IgA anti-tissue transgulatminase test (tTGA)

Biopsy is confirmative

21
Q

Cause of lactose malabsorption

A

Deficiency of lactase

22
Q

lactose malabsorption presenting complaint

A

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

23
Q

Diagnosis of lactose malabsorption

A

Clinical, confirmed by hydrogen breath test

24
Q

Cause of tropical sprue

A

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