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Malabsorption is exclusively a condition affecting the large intestine.
Answer: False
Explanation: Malabsorption is defined as an abnormality in the absorption of food nutrients across the gastrointestinal tract, which primarily involves the small intestine, not exclusively the large intestine.
Gastroenterology is the primary medical specialty that addresses malabsorption.
Answer: True
Explanation: The source explicitly states that Gastroenterology is the primary medical specialty associated with malabsorption, focusing on the digestive system and its disorders.
A typical Western adult diet, when normally processed, results in over 500g of stool per day.
Answer: False
Explanation: The normal human gastrointestinal tract reduces a typical Western adult diet to less than 200g of stool per day, not over 500g.
Selective malabsorption affects multiple nutrients due to widespread disease processes.
Answer: False
Explanation: Selective malabsorption is characterized by an abnormality limited to a single step in the absorptive process or one nutrient, whereas generalized malabsorption involves widespread disease processes affecting multiple nutrients.
Coeliac disease with widespread small intestine involvement is an example of generalized malabsorption.
Answer: True
Explanation: Generalized malabsorption occurs when an extensive disease process, such as coeliac disease with widespread small intestine involvement, disturbs multiple digestive and absorptive functions.
The main purpose of the gastrointestinal tract is solely mechanical breakdown of food.
Answer: False
Explanation: The main purpose of the gastrointestinal tract is to digest and absorb nutrients, involving both mechanical and enzymatic breakdown, not solely mechanical breakdown.
Malabsorption pathologically interferes with the normal sequence of digestion, absorption, and transport of nutrients.
Answer: True
Explanation: Malabsorption constitutes the pathological interference with the normal physiological sequence of digestion, absorption, and transport of nutrients.
Malabsorption can affect single or multiple nutrients.
Answer: True
Explanation: Malabsorption is a condition that can impair the absorption of single or multiple nutrients.
What is the primary consequence of malabsorption, as defined in the source?
Answer: Malnutrition and various forms of anemia.
Explanation: The source defines malabsorption as potentially leading to malnutrition and various forms of anemia as its primary consequences.
Which medical specialty is primarily associated with the diagnosis and treatment of malabsorption?
Answer: Gastroenterology
Explanation: Gastroenterology is the primary medical specialty associated with the diagnosis and treatment of malabsorption.
According to the source, what is the approximate normal daily stool mass for an adult on a typical Western diet?
Answer: Less than 200g
Explanation: The source states that a typical Western adult diet is normally reduced to less than 200g of stool per day.
What is the key characteristic that differentiates selective malabsorption from generalized malabsorption?
Answer: Selective malabsorption is limited to a single step in the absorptive process or one nutrient.
Explanation: Selective malabsorption is characterized by an abnormality limited to a single step in the absorptive process or one nutrient, distinguishing it from generalized malabsorption which involves extensive disease processes.
What is the primary pathological interference in malabsorption?
Answer: Pathological interference with digestion, absorption, and transport of nutrients.
Explanation: Malabsorption pathologically interferes with the normal physiological sequence of digestion, absorption, and transport of nutrients.
What is the role of mechanical processes in nutrient digestion?
Answer: Chewing, gastric churning, and mixing movements within the small intestine.
Explanation: Mechanical processes in digestion include chewing, gastric churning in the stomach, and the mixing movements within the small intestine.
Diphyllobothrium (fish tapeworm) is an infectious cause of B12 malabsorption.
Answer: True
Explanation: Diphyllobothrium (fish tapeworm) is listed as an infectious cause of malabsorption, specifically causing B12 malabsorption.
Bariatric surgery is a type of surgical change that can contribute to malabsorption.
Answer: True
Explanation: Surgical structural changes like bariatric surgery, gastrectomy, and vagotomy can contribute to malabsorption.
Fructose malabsorption is categorized as an enzyme deficiency leading to malabsorption.
Answer: False
Explanation: Fructose malabsorption is categorized as a mucosal abnormality, not an enzyme deficiency, although enzyme deficiencies are another category of malabsorption causes.
Lactase deficiency can be constitutional, secondary, or congenital.
Answer: True
Explanation: Lactase deficiency, which causes lactose intolerance, can indeed be constitutional, secondary, or rarely congenital.
Zollinger-Ellison syndrome is a cause of malabsorption due to digestive failure.
Answer: True
Explanation: Zollinger-Ellison syndrome is listed as a cause of malabsorption due to digestive failure.
Chronic Proton Pump Inhibitor use is mentioned as a possible cause of vitamin and mineral deficiencies leading to malabsorption.
Answer: True
Explanation: Chronic Proton Pump Inhibitor use is mentioned as a possible cause of malabsorption, potentially leading to specific vitamin and mineral deficiencies.
Which of the following is NOT listed as a general cause of malabsorption in the source?
Answer: Appendicitis
Explanation: The source lists coeliac disease, short bowel syndrome, and exocrine pancreatic insufficiency as general causes of malabsorption, but not appendicitis.
Which of the following is an infectious cause of malabsorption mentioned in the source that causes B12 malabsorption?
Answer: Diphyllobothrium (fish tapeworm)
Explanation: Diphyllobothrium (fish tapeworm) is listed as an infectious cause of malabsorption, specifically causing B12 malabsorption.
Which of these surgical changes to the GI tract can contribute to malabsorption?
Answer: Bariatric surgery
Explanation: Bariatric surgery, gastrectomy, and vagotomy are surgical changes to the GI tract that can contribute to malabsorption.
Which of the following is classified as a mucosal abnormality causing malabsorption?
Answer: Fructose malabsorption
Explanation: Fructose malabsorption is classified as a mucosal abnormality that can cause malabsorption.
Which enzyme deficiency is specifically mentioned as causing lactose intolerance?
Answer: Lactase deficiency
Explanation: Lactase deficiency is specifically mentioned as an enzyme deficiency leading to lactose intolerance.
Which systemic disease is listed as a cause of malabsorption due to lack of intrinsic factor and B12 malabsorption?
Answer: Pernicious anemia
Explanation: Pernicious anemia is listed as a systemic disease causing malabsorption due to lack of intrinsic factor and subsequent B12 malabsorption.
Which of the following is a structural defect in the GI tract that can lead to malabsorption?
Answer: Blind loops
Explanation: Blind loops are listed as structural defects in the GI tract that can lead to malabsorption.
Which of the following is a cause of malabsorption due to digestive failure related to pancreatic function?
Answer: Carcinoma of the pancreas
Explanation: Carcinoma of the pancreas is listed as a cause of malabsorption due to pancreatic insufficiency, a form of digestive failure.
Diarrhea is the only gastrointestinal manifestation of malabsorption.
Answer: False
Explanation: Common gastrointestinal manifestations of malabsorption include diarrhea, weight loss, flatulence, abdominal bloating, abdominal cramps, and pain, indicating that diarrhea is not the sole manifestation.
Steatorrhea is characterized by the presence of excessive protein in the stools.
Answer: False
Explanation: Steatorrhea is defined as the presence of excessive fat, not protein, in the stools.
Unabsorbed fatty acids and bile acids contribute to diarrhea by inducing water and electrolyte secretion in the colon.
Answer: True
Explanation: Unabsorbed fatty acids (converted to hydroxy-fatty acids) and unabsorbed bile acids both impair absorption and induce the secretion of water and electrolytes by the colon, contributing to diarrhea.
Abdominal pain is consistently severe and present in all malabsorption-associated diseases, including coeliac disease.
Answer: False
Explanation: The prevalence, severity, and character of abdominal pain vary significantly among different malabsorption-associated diseases; for example, pain is often absent in coeliac disease.
Extraintestinal symptoms of malabsorption are rare and always overshadowed by classic gastrointestinal symptoms.
Answer: False
Explanation: A substantial number of patients with intestinal malabsorption initially present with symptoms or laboratory abnormalities related to other organ systems, often overshadowing or occurring in the absence of classic gastrointestinal symptoms.
Microcytic anemia in malabsorption typically reflects impaired absorption of vitamin B12.
Answer: False
Explanation: Microcytic anemia typically reflects impaired absorption of iron, whereas macrocytic anemia is associated with impaired absorption of folate or vitamin B12.
Vitamin K malabsorption can lead to hypoprothrombinemia, manifesting as purpura or bleeding.
Answer: True
Explanation: Vitamin K malabsorption can lead to purpura, subconjunctival hemorrhage, or frank bleeding, reflecting hypoprothrombinemia.
Osteopenia in malabsorption is primarily caused by excessive calcium absorption.
Answer: False
Explanation: Osteopenia in malabsorption is primarily caused by impaired calcium and vitamin D absorption, and the chelation of calcium by unabsorbed fatty acids, leading to fecal calcium loss, not excessive calcium absorption.
Prolonged malnutrition due to malabsorption can cause reproductive issues like amenorrhea and infertility.
Answer: True
Explanation: Prolonged malnutrition resulting from malabsorption may induce amenorrhea, infertility, and impotence.
Edema and ascites in malabsorption are associated with hypoproteinemia from protein-losing enteropathy.
Answer: True
Explanation: Edema and ascites in some malabsorption cases can reflect hypoproteinemia associated with protein-losing enteropathy.
The clinical hallmark of overt malabsorption is infrequent, small, and well-formed stools.
Answer: False
Explanation: The clinical hallmark of overt malabsorption is characterized by watery, diurnal and nocturnal, bulky, frequent stools, often steatorrhea, not infrequent, small, and well-formed stools.
Growth retardation and delayed puberty are potential signs of malabsorption in children.
Answer: True
Explanation: In children, malabsorption can manifest as growth retardation, failure to thrive, and delayed puberty.
Persistent cramping pain after defecation in malabsorption suggests an obstructive intestinal segment.
Answer: True
Explanation: Cramping pain that persists after defecation usually suggests an obstructive intestinal segment, for example, in Crohn's disease.
What is steatorrhea?
Answer: Excessive fat in the stools.
Explanation: Steatorrhea is defined as the presence of excessive fat in the stools.
How do unabsorbed fatty acids contribute to diarrhea in malabsorption?
Answer: They are converted to hydroxy-fatty acids by colonic flora, inducing water and electrolyte secretion.
Explanation: Unabsorbed fatty acids are converted to hydroxy-fatty acids by colonic flora, which then induce the secretion of water and electrolytes by the colon, contributing to diarrhea.
Which of the following conditions is specifically mentioned as often presenting with anemia and osteopenia, even without classic GI symptoms?
Answer: Coeliac disease
Explanation: The source states that many patients with coeliac disease initially present with anemia and osteopenia, even without significant classic gastrointestinal symptoms.
What type of anemia is typically associated with impaired absorption of iron due to malabsorption?
Answer: Microcytic anemia
Explanation: Microcytic anemia typically reflects impaired absorption of iron due to malabsorption.
What is a potential consequence of vitamin K malabsorption, as described in the source?
Answer: Hypoprothrombinemia
Explanation: Vitamin K malabsorption can lead to hypoprothrombinemia, manifesting as purpura or bleeding.
What factors contribute to osteopenia in malabsorption, especially with steatorrhea?
Answer: Impaired calcium and vitamin D absorption, and chelation of calcium by unabsorbed fatty acids.
Explanation: Osteopenia in malabsorption is common, especially with steatorrhea, due to impaired calcium and vitamin D absorption, and the chelation of calcium by unabsorbed fatty acids.
Prolonged malnutrition resulting from malabsorption may induce which of the following reproductive and endocrine issues?
Answer: Amenorrhea and impotence
Explanation: Prolonged malnutrition resulting from malabsorption may induce amenorrhea, infertility, and impotence.
Edema and ascites in some malabsorption cases can reflect what underlying issue?
Answer: Hypoproteinemia
Explanation: Edema and ascites can reflect hypoproteinemia associated with protein-losing enteropathy in malabsorption cases.
What is considered the clinical hallmark of overt malabsorption?
Answer: Watery, diurnal and nocturnal, bulky, frequent stools, often steatorrhea.
Explanation: The clinical hallmark of overt malabsorption is characterized by watery, diurnal and nocturnal, bulky, frequent stools, often steatorrhea.
Which of the following is a common gastrointestinal manifestation of malabsorption?
Answer: Abdominal bloating and flatulence
Explanation: Abdominal bloating and flatulence are listed among the common gastrointestinal manifestations of malabsorption.
What causes excessive flatus and abdominal bloating in malabsorption, particularly with disaccharidase deficiencies?
Answer: Fermentation of unabsorbed carbohydrates.
Explanation: Excessive flatus and abdominal bloating in malabsorption can reflect increased gas production due to the fermentation of unabsorbed carbohydrates, especially in patients with disaccharidase deficiencies.
A detailed dietary history is crucial because patients with malabsorption may mask weight loss by increasing oral intake.
Answer: True
Explanation: A detailed dietary history is crucial because some patients with significant intestinal malabsorption may compensate for nutrient loss by substantially increasing their oral intake, thereby masking weight loss.
Low albumin in routine blood tests can indicate the presence of an underlying organic disease in malabsorption.
Answer: True
Explanation: Low albumin in routine blood tests shows a high correlation for the presence of an underlying organic disease in malabsorption.
A prolonged prothrombin time can be an indicator of vitamin K deficiency in fat malabsorption.
Answer: True
Explanation: A prolonged prothrombin time can indicate vitamin K deficiency, which is particularly affected in fat malabsorption.
Stool microscopy is primarily used to assess pancreatic insufficiency.
Answer: False
Explanation: Stool microscopy is primarily useful for identifying protozoa, ova, cysts, and other infective agents in diarrhea, while fecal pancreatic elastase is used to assess pancreatic insufficiency.
The 75SeHCAT test is used to diagnose lactose intolerance.
Answer: False
Explanation: The 75SeHCAT test is used to diagnose bile acid malabsorption, whereas the lactose hydrogen breath test is used for lactose intolerance.
The D-xylose absorption test is still widely used clinically to diagnose mucosal disease.
Answer: False
Explanation: The D-xylose absorption test is explicitly stated as an obsolete test for malabsorption that is no longer used clinically.
Why is a detailed dietary history considered crucial when evaluating suspected malabsorption?
Answer: Patients may compensate for nutrient loss by increasing oral intake, masking weight loss.
Explanation: A detailed dietary history is crucial because patients with significant intestinal malabsorption may compensate for fecal nutrient wastage by substantially increasing their oral intake, which can mask weight loss.
What routine blood test abnormality shows a high correlation for the presence of an organic disease in malabsorption?
Answer: Low albumin
Explanation: Low albumin in routine blood tests shows a high correlation for the presence of an organic disease in malabsorption.
Which specific serological tests are used to diagnose coeliac disease?
Answer: IgA Anti-transglutaminase antibodies or IgA Anti-endomysial antibodies
Explanation: IgA Anti-transglutaminase antibodies or IgA Anti-endomysial antibodies are specific serological tests used to diagnose coeliac disease.
What does a low fecal pancreatic elastase level indicate?
Answer: Pancreatic insufficiency
Explanation: A low fecal pancreatic elastase level is indicative of pancreatic insufficiency.
What characteristic finding in a small bowel biopsy is indicative of coeliac disease?
Answer: Blunting of villi, crypt hyperplasia, and lymphocyte infiltration of crypts.
Explanation: A small bowel biopsy indicative of coeliac disease typically reveals blunting of villi, crypt hyperplasia, and lymphocyte infiltration of crypts.
Which specialized test is used to diagnose bile acid malabsorption?
Answer: 75SeHCAT test
Explanation: The 75SeHCAT test is specifically used to diagnose bile acid malabsorption.
Which of the following tests for malabsorption is explicitly stated as obsolete and no longer used clinically?
Answer: D-xylose absorption test
Explanation: The D-xylose absorption test is explicitly stated as an obsolete test for malabsorption that is no longer used clinically.
What can be indicated by low cholesterol or triglyceride levels in routine blood tests for malabsorption?
Answer: Fat malabsorption
Explanation: Low cholesterol or triglyceride levels in routine blood tests may suggest fat malabsorption.
Management of malabsorption primarily focuses on treating the symptoms rather than the underlying cause.
Answer: False
Explanation: Management of malabsorption is largely directed towards treating the underlying cause, not primarily the symptoms.
A gluten-free diet is a crucial dietary modification for patients with lactose intolerance.
Answer: False
Explanation: A gluten-free diet is crucial for coeliac disease, while lactose avoidance is for lactose intolerance.
Cholestyramine is used to treat small bowel bacterial overgrowth.
Answer: False
Explanation: Cholestyramine is used to treat bile acid malabsorption, while antibiotic therapy is used for Small Bowel Bacterial Overgrowth.
What is a key principle of malabsorption management, according to the source?
Answer: Treating the underlying cause.
Explanation: A key principle of malabsorption management is to treat the underlying cause of the condition.
For patients with severely limited intestinal absorptive surface, what long-term nutritional support may be necessary?
Answer: Long-term total parenteral nutrition.
Explanation: For patients with severely limited intestinal absorptive surface, long-term total parenteral nutrition may be necessary.
What dietary modification is crucial for managing coeliac disease?
Answer: Gluten-free diet
Explanation: A gluten-free diet is a crucial dietary modification for managing coeliac disease.
What pharmacological treatment is used for Small Bowel Bacterial Overgrowth (SIBO)?
Answer: Antibiotic therapy
Explanation: Antibiotic therapy is used to treat Small Bowel Bacterial Overgrowth (SIBO).
What is the primary goal of management for malabsorption?
Answer: To treat the underlying cause of the condition.
Explanation: The primary goal of management for malabsorption is largely directed towards treating the underlying cause of the condition.