Malabsorption: Clinical (To be retired)
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Malabsorption: Clinical (To be retired)
Medicine and surgery
Allergy and immunology
Antihistamines for allergies
Glucocorticoids
Cardiology, cardiac surgery and vascular surgery
Coronary artery disease: Clinical (To be retired)
Heart failure: Clinical (To be retired)
Syncope: Clinical (To be retired)
Hypertension: Clinical (To be retired)
Hypercholesterolemia: Clinical (To be retired)
Peripheral vascular disease: Clinical (To be retired)
Leg ulcers: Clinical (To be retired)
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
Thiazide and thiazide-like diuretics
Calcium channel blockers
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Dermatology and plastic surgery
Hypersensitivity skin reactions: Clinical (To be retired)
Eczematous rashes: Clinical (To be retired)
Papulosquamous skin disorders: Clinical (To be retired)
Alopecia: Clinical (To be retired)
Hypopigmentation skin disorders: Clinical (To be retired)
Benign hyperpigmented skin lesions: Clinical (To be retired)
Skin cancer: Clinical (To be retired)
Endocrinology and ENT (Otolaryngology)
Diabetes mellitus: Clinical (To be retired)
Hyperthyroidism: Clinical (To be retired)
Hypothyroidism and thyroiditis: Clinical (To be retired)
Dizziness and vertigo: Clinical (To be retired)
Hyperthyroidism medications
Hypothyroidism medications
Insulins
Hypoglycemics: Insulin secretagogues
Miscellaneous hypoglycemics
Gastroenterology and general surgery
Gastroesophageal reflux disease (GERD): Clinical (To be retired)
Peptic ulcers and stomach cancer: Clinical (To be retired)
Diarrhea: Clinical (To be retired)
Malabsorption: Clinical (To be retired)
Colorectal cancer: Clinical (To be retired)
Diverticular disease: Clinical (To be retired)
Anal conditions: Clinical (To be retired)
Cirrhosis: Clinical (To be retired)
Breast cancer: Clinical (To be retired)
Laxatives and cathartics
Antidiarrheals
Acid reducing medications
Hematology and oncology
Anemia: Clinical (To be retired)
Anticoagulants: Warfarin
Anticoagulants: Direct factor inhibitors
Antiplatelet medications
Infectious diseases
Pneumonia: Clinical (To be retired)
Urinary tract infections: Clinical (To be retired)
Skin and soft tissue infections: Clinical (To be retired)
Protein synthesis inhibitors: Aminoglycosides
Antimetabolites: Sulfonamides and trimethoprim
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Cell wall synthesis inhibitors: Penicillins
Miscellaneous protein synthesis inhibitors
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Metronidazole
DNA synthesis inhibitors: Fluoroquinolones
Herpesvirus medications
Azoles
Echinocandins
Miscellaneous antifungal medications
Anti-mite and louse medications
Nephrology and urology
Chronic kidney disease: Clinical (To be retired)
Kidney stones: Clinical (To be retired)
Urinary incontinence: Pathology review
ACE inhibitors, ARBs and direct renin inhibitors
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Neurology and neurosurgery
Stroke: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Headaches: Clinical (To be retired)
Migraine medications
Pulmonology and thoracic surgery
Asthma: Clinical (To be retired)
Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)
Lung cancer: Clinical (To be retired)
Antihistamines for allergies
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Rheumatology and orthopedic surgery
Joint pain: Clinical (To be retired)
Rheumatoid arthritis: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Glucocorticoids
Opioid agonists, mixed agonist-antagonists and partial agonists
Antigout medications
Non-biologic disease modifying anti-rheumatic drugs (DMARDs)
Osteoporosis medications
Assessments
Malabsorption: Clinical (To be retired)
USMLE® Step 2 questions
0 / 9 complete
Questions
USMLE® Step 2 style questions USMLE
of complete
| Anti-tissue transglutaminase antibodies (IgA, IgG) | Negative |
| Anti-endomysial antibody (IgA) | Negative |
| Deamidated gliadin peptide (IgG) | Negative |
| HIV-1/2 PCR | Negative |
Upper endoscopy reveals flattening of the duodenal folds. Biopsy of the small intestine shows blunted villi and elongated crypts with increased inflammatory cells. A peripheral blood smear shows hypersegmented neutrophils. Which of the following is the most appropriate treatment for this patient?
Memory Anchors and Partner Content
Transcript
Contributors
Anca-Elena Stefan, MD
Alex Aranda
Elizabeth Nixon-Shapiro, MSMI, CMI
With malabsorption, nutrients are no longer effectively absorbed in the small intestines. Nutrients can either be macronutrients, such as fats, proteins and carbs or micronutrients like vitamins and minerals. Malabsorption can either be global meaning that the absorption of all nutrients is affected or it can be partial meaning that only specific nutrients cannot be absorbed. Malabsorption presents differently based on which nutrients are being malabsorbed, the severity of the disease, and the underlying cause. Global malabsorption can present with chronic or recurrent diarrhea with pale, greasy, voluminous and terrible smelling stools and unintentional weight loss. In contrast, partial malabsorption causes symptoms specific to the nutrient involved.
With fat malabsorption, symptoms include steatorrhea - meaning fatty stools. To confirm that it’s really steatorrhea, a fecal fat test can be done to check for fat. If it’s negative and fat malabsorption is still suspected, then a 72 hours stool collection should be done because that’s the gold standard for diagnosing fat malabsorption. To do that, an individual has to have a diet that includes 70 to 120 grams of dietary fat per day, which is the equivalent of eating about 300 grams of cheese per day. Stool is collected for 72 hours, and if there’s more than 6 grams of fat per day, then it’s considered fat malabsorption. Typically if there’s steatorrhea, the stool fat exceeds 20 grams per day.
If fat malabsorption is present, then the fat soluble vitamins - A, D, E, and K, might also not be getting absorbed. Vitamin A deficiency causes symptoms like night blindness and thickened skin due to hyperkeratosis. Vitamin D deficiency causes symptoms like paresthesias, and fractures due to osteomalacia. Vitamin E deficiency can cause symptoms like muscle weakness. And finally, vitamin K deficiency causes symptoms like easy bruising, excessive bleeding from wounds, gastrointestinal bleeds, or hematuria.
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