GI APM

Question 1

Celiac disease autoantibodies

Answer 1

anti-tTG IgA, anti-endomysium, anti-deaminated gliadin

Question 2

Celiac genetics

Answer 2

HLA-DQ2 and/or

HLA-DQ8

Question 3

Possible Celiac diagnosis (antibodies)

Answer 3

low total IgA
positive anti-tTG IgG
positive anti-dGP IgG

Question 4

Possible Celiac diagnosis children <3 years (antibodies)

Answer 4

positive anti-dGP

positive or negative anti-dGP IgG

Question 5

two biomarkers similar in distinguishing IBS/IBD and predicting relapse

Answer 5

calprotectin and lectoferrin

Question 6

malnutrition in SIBO

Answer 6

Ca and Mag
vitamin B12 (serum folate usu normal)
protein
IDA rare

Question 7

DIGIN

Answer 7

Digestion
Intestinal permeability
Gut microbiota
Inflammation/Immune
Nervous system

Question 8

Hypochlorohydria can result in

Answer 8

SIBO
Dysbiosis
Candida
Mineral def
B21 def
low ferritin/anemia

Question 9

Vitamin that can modulate tight junctions, reducing risk of IP

Answer 9

vit D

Question 10

Antibodies in IP

Answer 10

actomysin
zonulin
LPS

Question 11

when to order pancreatic elastase

Answer 11

unexplained diarrhea, weight loss, abdominal pain

fatty stools

Question 12

Exocrine pancreatic insuff occurs secondary to

Answer 12

chronic pancreatitis, celiac, IBD, CF, alcohol use, gallstone disease

Question 13

putrefactive SCFAs

Answer 13

valerate, iso-valerate, iso-butyrate

Question 14

putrefactive SCFA causes

Answer 14

hypoCl, low pancreatic enzymes, poor absorption (Celiac, Crohns, SIBO), poor protein digestion

Question 15

EPX

Answer 15

elevated in IBD, Celiac, parasites, allergies

Question 16

5 R

Answer 16

Remove - triggers, bugs, elim diet, medications that promote leaky gut
Replace - HCl, enzymes, bile salts, fiber
Reinoculate - pro, prebiotics, synbiotics, SCFA
Repair - omega 3 FAs, lactoferrin, whey Igs, glutamine, anti-inflamm, vit A, vit D, vit E, phosphatidylcholine
Rebalance - mindful eating, MBSR, psychotherapy, HRV

Question 17

Type 1 HSN

Answer 17

IgE, allergy

Question 18

Type 3 HSN

Answer 18

IgA or IgG, food sensitivity

Question 19

Type 4 HSN

Answer 19

non-IgE allergic heterogenous group
Celiac
EoE
Eo gastroenteritis

Question 20

Food Intolerances

Answer 20

NOT IMMUNE
lactose
tyramine, histamine
MSG, aspartame, sulfites
salicylates
lectins

Question 21

Gluten sensitivity diagnoses

Answer 21

gluten ingestion elicits rapid occurrence of intestinal and extraintestinal sxs
sxs disappear rapidly after gluten removal
reintroduction causes sxs
IgE/skin prick to wheat/gluten negative
Celiac disease serology negative
antigliadin Abs positive in about 50%
normal mucosa or mild increase in lymphocytes

Question 22

Histamine intolerance

Answer 22

worsened by analgesics, narcotics

Vit C and B6 help (support DAO)

Question 23

Six food elimination diet for EoE

Answer 23

milk, egg, wheat, soy, peanut/tree nuts, seafood

Question 24

Food allergies assoc with constipation

Answer 24

cow milk, egg, soy

Question 25

causes of low gastric acid

Answer 25

meds, age, stress, fasting, H pylori, surgery, AI gastritis, severe IDA, viral/bacterial infection

Question 26

botanicals to support pancreatic enzymes

Answer 26

ginger, curcumin, coriander, onion, ginger, fennel, mint

Question 27

nutrients to support bile

Answer 27

ox bile, dandelion, taurine, limonene, coffee, radishes, chicory, artichoke

Question 28

nutrients to support motility

Answer 28

the ones we know + vit D, triphala

Question 29

urinary OAT biomarker suggesting pathogenic Candida

Answer 29

D-arabinitol

Question 30

test for recent gluten exposure

Answer 30

anti-DGP IgG

Question 31

Non-Celiac wheat sensitivities

Answer 31

FODMAPs
NCGS
amylase-trypsin inhibitors
wheat germ agglutination (lectin)

Question 32

Four Food elimination diet

Answer 32

wheat, eggs, dairy, legumes/peanutes