IBD & Malapsorption

Question 1

Which enzymes digest carbs

Answer 1

• salivary amylase
• pancreatic amylase
• small intestine maltase
• small intestine lactase

Question 2

Which enzymes digest proteins

Answer 2

• gastric pepsin
• pancreatic trypsin
• small intestine peptidases

Question 3

Which enzymes digest nucleic acids

Answer 3

• pancreatic nuclease
• small intestine nucleosidases

Question 4

Which enzyme digests fat

Answer 4

• pancreatic lipase

Question 5

Describe malabsorption

Answer 5

broad spectrum; associated with diminished intestinal absorption of one or more dietary nutrients

Question 6

Describe the 3 steps of nutrient absorption

Answer 6

1. luminal processing (breakdown)
2. absorption into intestinal mucosa
3. transport into circulation

Question 7

Describe global vs partial/isolated malabsorption

Answer 7

Question 8

Describe some causes & clinical manifestations of global malabsorption

Answer 8

Causes
- diffuse mucosal involvement
- reduced absorptive area

Manifestations
- steatorrhea
- weight loss

Question 9

Describe fat absorption

Answer 9

• normally +94% absorbed
• starts in upper GI with emulsification
• majority absorbed by pancreatic lipase & colipase
• influenced by type of dietary lipid & presence of other nutrients

Question 10

Describe the presentation and lab findings for fat malabsorption

Answer 10

presentation
- steatorrhea
- diarrhea without flatulence
- pale & voluminous

Labs
- >6% fractional fat excretion

Question 11

Describe carb absorption & malabsorption

Answer 11

• only absorbed in small intestine
• lactose malabsorption only clinically important disorder of carb absorption
• deficiency in pancreatic amylase, reduced disaccharidase activity & decreased intestinal surface area

Question 12

Describe the differences between primary & secondary carb malabsorption

Answer 12

Question 13

Describe the presentation of carb malnutrition

Answer 13

Question 14

Describe protein absorption

Answer 14

• begins in stomach with gastric pepsin (depends on other dietary constituents, gastric motility, pH)
• remainder absorbed in small intestine

Question 15

Describe a few causes of protein malabsorption

Answer 15

• Impaired pancreatic protease: chronic pancreatitis, CF
• Generalized reduction of intestinal surface area: hypoalbuminemia, protein malnutrition, kwashiorkor

Question 16

Describe the presentation and lab findings of protein malnutrition

Answer 16

Question 17

Vitamin/mineral/trace element malabsorption results in a deficiency in the following…

Answer 17

• calcium
• magnesium
• vit B12
• iron

(MC seen in bariatric surgery population)

Question 18

Describe the etiology of IBD

Answer 18

Question 19

Describe the etiology of Crohn’s disease

Answer 19

Question 20

Describe the etiology of ulcerative colitis

Answer 20

Question 21

Describe the presentation of crohn’s disease

Answer 21

Question 22

Describe the presentation of ulcerative colitis

Answer 22

Question 23

describe the diagnosis of ulcerative colitis

Answer 23

Question 24

Describe the treatment of IBD

Answer 24

Question 26

describe the diagnosis of crohn's

Answer 26