Evacuation Disorders

Question 1

1:100 whites of Northern European ancestry have this dietary disorder caused by an immunologic response to gluten

Answer 1

celiac disease

Question 2

If you see this skin finding, you can be pretty confident in thinking celiac disease.

Answer 2

dermatitis herpetiformis

pruritic papulovesicles over the extensor surfaces of the extremities and over the trunk, scalp, and neck.

Question 3

Your 22 year old patient is complaining of unwanted weight loss, chronic diarrhea, fatigue, and abdominal distention. What are you thinking?

Answer 3

celiac disease

Question 4

What lab findings are characteristic of celiac disease?

Answer 4

Depends on which nutrient is being malabsorbed. Could be fatty acids, carbs, protein, iron, B12, folic acid, calcium, vit D, magnesium, vit K, lactose

Question 5

What serologic finding has a 90+% sensitivity and 95+% specificity for celiac disease?

Answer 5

IgA EMA or IgA tTg antibodies

Question 6

What is the standard method of confirmation of celiac diagnosis in patients with a positive serologic test?

Answer 6

endoscopic mucosal biopsy of the proximal duodenum

Question 7

What is the treatment for celiac disease?

Answer 7

Lifelong diet free of gluten (wheat, rye, barley, foods containing gluten additives)

Question 8

_______ diarrhea resolves during fasting.

_______ diarrhea persists during fasting.

Answer 8

osmotic diarrhea resolves during fasting

secretory diarrhea persists during fasting

Question 9

Your patient is a 51 year old white male presenting with weight loss, chronic diarrhea, arthralgias, and fever. You obtain a duodenal biopsy and find PAS macrophages. What is it? What causes it?

Answer 9

Whipple disease, caused by the bacillus Tropheryma whippelii

Question 10

Name three invasive bacteria that cause inflammatory diarrhea.

Answer 10

Shigella
Salmonella
Campylobacter
Yersinia

Question 11

What is the most frequent cause of factitious diarrhea?

Answer 11

laxative abuse