Small Intestine Flashcards
(35 cards)
Abetalipoproteinemia
-problem with TG absorption results in low TG/cholesterol, vitamin E deficiency and steatorrhea
-path is diagnostic if lipid laden enterocytes
What is agammaglobulinemia?
no B cells, i.e. no plasma cells
presents with baby boy infants with recurrent sinus infections and diarrhea (w/ giardia)
What are the GI manifestations of CVID?
-IBD like disease
-pernicious anemia
-SIBO
-protein wasting enteropathy
-recurrent GI infections
How do you diagnose Whipple’s disease?
Pathology from D3/jejunum with PAS (+) foamy macrophages
How do you diagnose Whipple’s disease?
Pathology from D3/jejunum with PAS (+) foamy macrophages
What are the GI and non-GI manifestations of Whipple’s disease?
Non-GI
-CNS
-cardia (mycarditis)
-arthralgias
GI
-diarrhea, weight loss, occult GI bleeding, protein-loosing enteropathy
How do you diagnose Whipple’s disease?
Pathology from D3/jejunum with PAS (+) foamy macrophages
How are folate and B12 levels different in celiac disease, topical sprue and SIBO? what about crypto?
CD (proximal small bowel)- low folate, normal B12
tropical sprue (distal small bowel)- low folate, low b12
SIBO- high folate, low B12
crypto- terminal ileum, low B12 (think HIV/AIDS)
In celiac disease which EIM improve with GFD?
What is the diagnostic algorithm for celiac disease?
What condition is this?
celiac disease
What condition is this?
celiac disease
What condition is this?
dermatitis herpetaformis
Low B12, high folate = what condition?
SIBO
Key Features of SIBO?
Indications for small bowel transplant in SBS
What are common small bowel tumors and their features?
- adenocarcinoma (most common proximal SB lesion)
- carcinoid (common distal SB lesion)
-lymphoma (enteropathy associated Tcell or Bcell from camplyobacter, mantle cell, folicular, burkets)
-PTLD - EBV associated highest risk in sb transplant then lung
-GIST- tyrosine kinase, CD117 positive
What are the differences between carcinoid and systemic mastocytosis?
both have flushing, palpitations
systemic mastocytosis- hepatomegaly, urticarial reaction with scratching the skin- get a small bowel biopsy to confirm diagnosis
glucagonoma
classic rash known as necrolytic migratory erythema and glucose intolerance/diabetes.
What supplementation is needed for extensive ileal resection +/- ostomy vs enterocolonic anastamosis
Vitamin B12, selenium, fat soluble vitamins
If enterocolonic anastamosis then, no need for paraenteral fluids
if ostomy, then will need paraenteral fluids
Primary intestinal lymphangiectasia (PIL) is a rare disorder characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein-losing enteropathy leading to lymphopenia, hypoalbuminemia and hypogammaglobulinemia.
Describe the different types of bile acid malabsorption.
Type I BAM related to primary ileal disease; ileum is unable to reabsorb bile salts
Type II BAM related to idiopathic BAM often seen in irritable bowel syndrome (IBS); idiopathic upregulation of bile acid synthesis
Type III BAM - continuous leakage of bile salts after CCY overwhelm ileal absorptive capacity
Type IV BAM - medication induced increased bile acid synthesis (ex. metformin use)
Treatment for dermatitis herpetiformis?
dapsone
IMO vs SIBO
presence of preceding chronic constipation (rather than diarrhea) makes intestinal methanogen overgrowth more likely, as methanogenic flora are associated with chronic constipation.
