Malabsorption

Question 1

Test for diagnosis of lactose intolerance

Answer 1

Hydrogen breath test

Question 2

Most common symptoms of celiac disease

Answer 2

Diarrhea (most common)

Weakness/fatigue

Borborygmi

(bloating and cramps are common, severe abdominal pain is not)

Question 3

Most common ages for celiac disease

Answer 3

10 to 40

Question 4

Difference between celiac disease and non-celiac gluten sensitivity

Answer 4

Celiac = autoimmune

NCGS = not autoimmune, no hypersensitivity, no antibodies

Question 5

Ethnicities most likely to have lactose intolerance

Answer 5

Blacks

Asians

Native Americans

Question 6

This condition is known as asthma of the gut

Answer 6

Eosinophilic gastroenteritis

Question 7

Skin changes seen in celiac disease

Answer 7

Dermatitis herpetiformis

Question 8

Extraintestinal symptoms of celiac disease

Answer 8

Anemia

Osteopenia/porosis (vit D down)

Neurologic symptoms (vit D down)

Skin disorders
- dermatitis herpetiformis

Bleeding (vit K down)

Question 9

True or false. Weight loss and nutritional deficiency is associated with lactose intolerance

Answer 9

False

(gut not getting attacked by immune system so no inflammation of small intestine leading to malabsorption)

Question 10

Treatment for short bowel syndrome

Answer 10

Eat small meals of quickly absorbed/finely chopped foods

Question 11

Complications of diseases of malabsorption

Answer 11

Vitamin K, A, D, E deficiencies
- may lead to osteoporosis

Anemia
- B12 deficiency
- Folate deficiency
- Iron deficiency

Dehydration

Question 12

A patient with a wasting illness (weight loss) characterized by arthralgias, fever, and diarrhea likely has this rare disease

Answer 12

Whipple disease

Question 13

Three antibodies present in celiac disease

Answer 13

Gliadin

Tissue transglutaminase

Endomysial - less important

Question 14

A short bowel syndrome patient who had their ileum removed would have this deficiency

Answer 14

B12

Question 15

Celiac disease is an inability to tolerate …

Answer 15

Gliadin

(a part of gluten)

Question 16

Diagnostic tests for celiac disease

Answer 16

Tissue transglutaminase antibody test (order this first)

Antigliadin antibody test

(Maybe fecal fat test for fat malabsorption)

Question 17

A short bowel syndrome patient who had their jejunum removed would have these deficiencies

Answer 17

Folate, calcium, iron

Question 18

A patient with short bowel syndrome likely has a history of …

Answer 18

Surgery

Question 19

Does a patient with lactose intolerance need to avoid lactose-containing medications?

Answer 19

No

They can tolerate up to two cups of milk per day, nowhere near that in meds

Question 20

Symptoms of lactose intolerance

Answer 20

Pain, bloating, borborygmi, flatulence, nausea, diarrhea within a few hours of digestion (of milk or ice cream typically)

Question 21

Age that eosinophilic gastroenteritis typically presents

Answer 21

30s to 50s

Question 22

Symptoms with eosinophilic gastroenteritis

Answer 22

Abdominal pain

Weight loss

Vomiting

Diarrhea

Question 23

Treatments for lactose deficiency

Answer 23

Reduce lactose in diet (don’t have to completely avoid)

Consider calcium and vit D supplementation

Lactase enzymes won’t hurt, may help

Question 24

40% of patients with eosinophilic gastroenteritis have these co-occurring conditions

Answer 24

Asthma

Food allergies

Eczema

Rhinitis

Question 25

Most commonly affected areas of GI tract in eosinophilic gastroenteritis

Answer 25

Stomach and duodenum

Question 26

Enzyme deficiency in lactose intolerance

Answer 26

Lactase

Question 27

Symptoms of diseases of malabsorption

Answer 27

Increased stool frequency

Often malodorous (bacterial byproducts)

Oil droplets in stool

Borborygmi (grumbling from bacteria digesting undigested foods)

Excess flatus, distended abdomen