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  #1  
Old 07-11-2011
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GIT Resected ileum consequence

A patient presented with an acute abdomen including fever, marked abdominal distension, acidosis, and leukocytosis. Laparoscopy revealed that large parts of the small intestine were necrotic and as a consequence, the entire ileum of the patient was resected. It is expected that very soon after the surgery the patient will have considerable problems resulting from the malabsorption of which of the following?

(A) iron
(B) bile acids
(C) sodium
(D) vitamin B12
(E) protein
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Old 07-11-2011
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D) Vitamin B12

It is absorbed in the terminal ileum.
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Old 07-12-2011
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Quote:
Originally Posted by Hope2Pass View Post
D) Vitamin B12

It is absorbed in the terminal ileum.
Pretty sure Bile acid is absorbed in the ileum as well as part of the recycling process. Perhaps the answer lies in the wording (i.e. immediate effect).
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Old 07-12-2011
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I think the answer is B) (very soon after the surgery)
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Old 07-12-2011
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B12 is mainly reabsorbed with bile. Over time, you will also see B12 deficiency.
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Old 07-12-2011
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Correct Answer B- bile salt reabsorbtion

(B) After a meal about 90 percent of the bile acids and bile salts are absorbed from the lower ileum by way of active transport. They are directed to the liver, from where they can be released again via bile into the intestine. This enterohepatic circulation of bile acids between intestine and liver is physiologically very important for normal absorption of fat and fat- soluble vitamins, and if distorted, will lead to GI and other symptoms.

Although vita- min B12 (choice D), complexed with intrinsic factor, binds to a transmembrane receptor in the ileum for absorption, a large amount of vitamin B12 (up to 5 mg) is stored in the liver. This liver storage is thought to be sufficient for 36 years so that symptoms from vitamin B12 deficiency will be expected at a later time, but not soon after removal of the ileum.
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Old 07-19-2011
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Default how do i check the true answer??

B or D.......
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Old 07-19-2011
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I think the answer is A.
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