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Celiac disease (celiac sprue)
Allergic response to gluten (wheat flour) causes reduction of microvilli. This in turn compromises absorption in the small intestine. Symptoms: bloating, diarrhea, vomiting, weight loss
Lactose Intolerase or Lactase Deficiency and why might hydrogen be detected on the breath?
Lactase is the only enzyme which breaks down Lactose ----> Glucose + Galactose. This enzyme activity can decrease overtime so many adults lose the ability to digest lactose (found in diary products). Genetic component, people of thai origin are prone to LI. Furthermore, when lactose is broken down by bacteria in the large intestine, hydrogen is a byproduct. Since most of the lactose in a LI patient ends up in the colon, they tend to produce detectible amounts of hydrogen in the breath.
Congenital Sucrase-Isomaltase deficiency (CSID)
Sucrase-Isomaltase is not tethered to the glycocalyx. Mutation in the enzyme (although the enzyme itself is still active). Cannot create a local increase in glucose concentration.
Congenital Glucose-Galactose Malabsorption (CGM)
No SGLT1 transporter (Na+/Glu Co-transporter). Very serious. Failure to thrive, diarrhea, watery diarrhea. Patient fed on fructose enriched diet develope normally. (Fructose uses a Glut 5 transporter)
No GLUT2 transporter (Glu and Galactose uptake). Intestinal glucose absorption is alright due to SGLT1 transporter. Hypoglycemia and glycosuria due to absence of GLUT2 in other tissues.
Defective neutral amino acid transporter in the brush border. Autosomal recessive desease.
Cystic Fibrosis (effects in GI)
Inability to transport material from the pancrease into the intestine due to mucus blockage in a pancreatic duct. Proteases buildup in the pancrease (begins to digest the pancreatic tissue) and leaks out into the bloodstream. Treatment: pancrease supplements taken with the meal.
Zollinger-Ellison Syndrome (ZE)
Tumor of the G cells cause oversecretion of gastrin and therefore high levels of stomach acid released from parietal cells of the stomach. Causes stomach ulcer and inactivation of pancreatic lipase. Symptoms: Steatorrhea or fatty stool. All the lipids come out in the stool because they cannot be absorbed in the intestine. Treatment: Omeprazole (H/K ATPase inhibitor)
What is steatorrhea? What types of diseases can cause it?
Fatty stool. Anything that causes low pancreatic lipase in the duodenum. Low secretion (Chronic pancreatitis, cyctic fibrosis). Low function (gastrinoma, ZE). Intestineal membrane degeneration (celiac sprue).
Genetic disorder in which the body absorps excess amounts of calcium. Treatment: blood letting
Biliary tract obstruction
supersaturated or precipation of cholesterol
Denervation of the megacolon (rectum and internal anal sphincter). Denervated area has increased tone and causes severe constipation.
Irritable colon syndrome
Increased or decreased sigmoidal segmentation. Abdominal pain with constipation and diarrhea. Stress can produce increased segmentation---> constipation in some people while decreased segmentation --->diarrhea in others.
Outpouchings of the mucosa through the muscular wall of the colon. Due to chronic high intraluminal pressure.
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