237 Chronic diarrhoea (Coeliac)

Question 1

Which electrolytes are absorbed in the duodenum?

Answer 1

Calcium
Zinc
Magnesium

Question 2

Where are carbohydrates (primarily) digested in the GIT?

Answer 2

Duodenum

Question 3

Startch + maltose —> ?

Answer 3

Glucose

Question 4

Lactose —-> (which 2 CHOs)?

Answer 4

Glucose and galactose

Question 5

Sucrose —> (which 2 CHOs)?

Answer 5

Glucose and fructose

Question 6

What is the main symptom of lactase deficiency?

Answer 6

Osmotic diarrhoea

Question 7

What is the mechanism behind the lactose breath test?

Answer 7

Unabsorbed lactose in the colon is fermented by bacteria which produces an acidic stool and hydrogen. Hydrogen is detected in the breath

Question 8

What type of bacteria are found pre-ileocecal valve?

Answer 8

lactobacilli

Question 9

Which fat soluble vitamins are produced in the liver?

Answer 9

ADEK

Question 10

What is the consequence of a Vit E deficiency?

Answer 10

Haemolysis
Peripheral neuropathy
Ataxia

Question 11

What is the consequence of Vit A deficiency?

Answer 11

Compromised mucosa
Xerophthalmia
Night blindness

Question 12

What is glucose-galactose malabsorption syndrome?

Answer 12

Osmotic diarrhoea caused by deficiency in an Na coupled glucose-galactose transporter - unable to digest glucose

Question 13

What is the treatment for glucose-galactose malabsorption syndrome?

Answer 13

Fructose only diet

Question 14

What is marasmus?

Answer 14

Marasmus is a form of severe malnutrition characterized by energy deficiency –> anaemia and anorexic

Question 15

What causes ascites in Kwarshiorkor?

Answer 15

Low albumin

Question 16

What fluid should be given to a severely malnourished patient?

Answer 16

Ringers lactate over NaCl as they are usually Na overloaded

Question 17

What kind of diarrhoea produces an ion gap of >100?

Answer 17

Osmotic diarrhoea

Question 18

What kind of diarrhoea produces an ion gap of

Answer 18

Secretory diarrhoea

Question 19

What is Tufting enteropathy?

Answer 19

Diarrhoea due to epithelial cell adhesion molecules

Question 20

What does a mutation in myosin 5b produce?

Answer 20

Microvillar atrophy causing diarrhoea which progresses to metabolic acidosis

Question 21

Which disease does Yersinia enterolytica mimic?

Answer 21

Crohns

Question 22

What is congenital lymphangectasia?

Answer 22

Dilated lymphatics causing lymph to leak into the GIT and malabsorption

Question 23

What disease is associated with HLA DQ2 and DQ8?

Answer 23

Coeliac

Question 24

What do the CD4+ cells in coeliac disease release to cause villous atrophy, crypt atrophy and increased intracellular epithelial lymphocytes?

Answer 24

Gamma IFN

Question 25

Which GIT disease is associated with dermatitis herpatoformis? (what is it?)

Answer 25

Coeliac | Rash primarily on back

Question 26

What is the treatment for coeliac?

Answer 26

Dapsone | Gluten free diet

Question 27

Name 2 conditions which mimic coeliac | 4 listed

Answer 27

Microscopic colitis Tropical sprue Ulcerative jejunitis Lymphoma