Malabsorption Pathology Flashcards
What is a characteristic histologic pathologic finding of malabsorption due to celiac sprue/gluten-sensitive enteropathy?
villous blunting
What do you see in the epithelium on histology in celiac sprue?
intra-epithelial CD8 lymphocytes, not normally located in epi. so their presence here is suggestive of problems
Explain the molecular pathology of celiac sprue - gluten-sensitive enteropathy
APC cells to CD4 cells, immune response with CD8 intraepithelial lymphocytes and CD4 lamina propria cells
What genetic mut is common in gluten-sensitivity?
95% have HLA-DQ2, while the remainder have DQ8
T or F: viral gastroenteritis can cause temporary dissacharidase deficiency
true
What is whipple disease?
rare intestinal lymph nodal, cerebral cardiac and joint infection with tropheryma whippellii
what is tropheryma whippelii
the rare bacteria leading to whipple dz, a PAS-stain positive actinomycetere, presenting as purple bacilli
Who presents with whipple dz?
late middle-aged white males
Who commonly has lactase deficiency?
adults, AAs
What breath test can you do to detect lactase deficiency?
Breath hydrogen levels becuase of the xs cho in lumen due to bacterial overgrowth
What is ascaris?
roundworm infection
What is your ddx for malabsorption syndrome?
gluten-sensitive enteropathy
chronic pancreatitis
zebras
what malabsorption syndrome is associtated with type i diabetes?
gluten-sensitive enteropathy
24 yo wm from wisscons with diarrhea T41.2, orthostatic hypotension, malaise, fatigue, doesn’t eat for week. Recovers then drinks milk. Problem returns, due to:
lactase deficiency
64 bm musician 10 lb weight loss, insidious steatorrhea, recent hospitalization for abdominal pain and retroperitoneal calcifications behind mid and luq abdom due to:
???? my guess, chronic pancreatitis
24 yo wf chronic diarrhea and hosp for abd pain. short think and pale. due to:
celiac sprue
24 latina farmer from mexico 10 weight loss, chronic diarrhea hospitalized for abd pain. hgb 4, plts 500 wbc 15, with 75 segs, 5 bands, 10 eos, 6 lymphocytes and 4 monos. due to:
ascarias (because eos which are not present in giardia)
