Ch. 338

Question 1

Specific findings on examination can guide toward a specific malabsorption disorder: Edema

Answer 1

Protein-losing enteropathy

Question 2

Specific findings on examination can guide toward a specific malabsorption disorder: Digital clubbing

Answer 2

CF and celiac disease

Question 3

Specific findings on examination can guide toward a specific malabsorption disorder: Perianal excoriation and gastric abdominal distension

Answer 3

Carb malabsorption

Question 4

Specific findings on examination can guide toward a specific malabsorption disorder: Perianal and circumoral rash

Answer 4

Acrodermatitis enteropathica

Question 5

Specific findings on examination can guide toward a specific malabsorption disorder: Abnormal hair

Answer 5

Menke syndrome

Question 6

Clinitest reagent is used for screening carb malabsorption which identifies reducing substances such as carbs in stool. A positive test is

Answer 6

An acidic stool with >2+ reducing substance

Question 7

___ is used to identify the specific carbohydrate that is malabsorbed

Answer 7

Breath hydrogen test

Question 8

Procedure in Breath hydrogen test

Answer 8

After an overnight fast, the suspected sugar is administered as an oral solu­tion. A rise in breath hydrogen of 20 ppm above the baseline is considered a positive test. The child should not be on antibiotics at the time of the test, because colonic flora is essential for fermenting the sugar.

Question 9

a sensitive test to assess exocrine pan­ creatic function in chronic cystic fibrosis and pancreatitis

Answer 9

Fecal elastase-1

Question 10

Main clinical expression of malabsorption

Answer 10

Diarrhea

Question 11

Investigation for carb malabsorption: Can measure mucosal disaccharidase concentrations directly

Answer 11

Small bowel mucosal biopsies

Question 12

MCC of hypoalbuminemia in children

Answer 12

Renal disorder

Question 13

Measurement of ___ is a useful screening test for protein-losing enteropathy

Answer 13

alpha1-antitrypsin

Question 14

MCC of exocrine pancreatic insufficiency

Answer 14

Cystic fibrosis

Question 15

Gold standard for exocrine pancreatic function

Answer 15

Direct analysis of duodenal aspirate (volume, bicarb, trypsin, and lipase upon secretin and pancreozymin/cholecystokinin stimulation)

Question 16

Gluten-sensitive enteropathy

Answer 16

Celiac disease

Question 17

Immune-mediated disorder characterized by chronic inflammation of the small intestine

Answer 17

Celiac disease

Question 18

Antibodies seen in Celiac disease

Answer 18

Antibodies to TG2

Question 19

MC extraintestinal manifesration of celiac disease

Answer 19

IDA unresponsive to iron therapy

Question 20

Ultimate diagnosis of celiac disease relies on

Answer 20

Demonstration of specific but not pathognomonic histopathologic abnormalities in the small bowel mucosa

Question 21

ESPHAN Criteria for celiac disease

Answer 21

1) Villous atrophy with hyperplasia of the crypts and abnormal surface epithelium while patient is eating adequate amounts of gluten 2) Full clinical remission after withdrawal of gluten from diet

Question 22

The only treatment for celiac disease

Answer 22

Lifelong strict adherence to a gluten-free diet

Question 23

Short bowel syndrome is the loss of >___% of small bowel with or without a portion of the large intestine

Answer 23

50

Question 24

Main site for carb, protein, iron, water-soluble vitamin absorption

Answer 24

Proximal 100-200cm of jejunum

Question 25

Vitamin B12 and bile salts are only absorbed in

Answer 25

Distal ileum

Question 26

Primary adult type hypolactasia is caused by

Answer 26

Physiologic decline in lactase activity that occurs following weaning in most mammals

Question 27

Secondary lactose intolerance is caused by

Answer 27

Small bowel mucosal damage, usually transient improving with mucosal healing