Malnutrition and Malabsorption Flashcards
Define malabsorption
Defective mucosal absorption, caused by:
- Defective luminal digestion
- Mucosal disease
- Structural disorders
Coeliac Disease What is it? Aetiology? Symptoms? Diagnosis? Treatment?
Exposure to wheat, barley, or rye induces a characteristic mucosal lesion.
Aetiology – intestinal antigen presenting cells in people presenting HLA-DQ2, or HLA-DQ8, bind with dietary gluten peptides in their antigen-binding grooves activate specific mucosal T lymphocytes cytokines mucosal damage.
Symptoms – spectrum asymptomatic to nutritional deficiencies weight oss, diarrhoea, excess flatus and abdominal discomfort.
Diagnosis – IgA anti-tissue transglutaminase test (tTGA).
Treatment – gluten free diet.
Lactose Malabsorption Aetiology? Presentation? Diagnosis? Management?
Aetiology- deficiency of lactase.
C/F – history of the induction of diarrhoea, abdominal discomfort, and flatulence following the ingestion of dairy products.
Diagnosis – confirmed by the lactose breath hydrogen test. An alternative is the oral lactose intolerance test.
Management – lactose free diet.
Tropical Sprue Aetiology? Symptoms? Diagnosis? Treatment?
Aetiology – colonisation if the intestine by an infectious agent or alterations in the intestinal bacterial flora induced by the exposure to another environmental agent(?).
Symptoms – diarrhoea, steatorrhea, weight loss, nausea, anorexia, anaemia.
Diagnosis – by biopsy.
Treatment – tetracycline + folic acid.
Whipple's disease Aetiology? Symptoms? Diagnosis? Treatment?
Aetiology – GI malabsorption caused by Tropheryma whippelli, combined with defective cell-mediated immunity, producing a systemic disease. It occurs most commonly in middle aged males and can be fatal if untreated.
Symptoms – weight loss, arthralgia (in peripheral joints), abdominal distension, diarrhoeam steatorrhea, fever, nutritional deficiency symptoms.
Diagnosis – based on demonstration of T.whippelli in involved tissues by microscopy.
Treatment – currently IV ceftriaxone for 2/52, then oral co-trimolxazole for some months.
Giardia lamblia Risk factors? Presentation? Diagnosis? Treatment?
Risk factors – faecal oral spread, travel to areas where the water supply may be contaminated e.g. swimming in ponds.
C/F – diarrhoea, flatulence, abdominal cramps, epigastric pain, nausea. Approx 1/3 symptomatic patient experience vomiting. Significant malabsorption with steatorrhoea and weight loss may develop.
Lab – stool examination for ova and parasites.
Treatment – metronidiazole 1/52.
Scurvy
Due to lack of what?
Signs?
Treatment?
Vitamin C 1. Anorexia, cachexia 2. Gingivitis, loose, teeth, halitosis 3. Bleeding from gums, nose, hair follicles 4. Muscle pain/weakness 5. Oedema Ascorbic acid
