Nutrition

Question 1

What are the classifications of malabsorption disorders?

Answer 1

1. Impaired intraluminal digestion dominant
2. Impaired mucosal digestion, uptake and transport dominant
3. Impaired post-mucosal transport dominant

Question 2

Name three specific malabsorption disorders.

Answer 2

1. Lactose intolerance
2. Celiac disease
3. Tropical sprue

Question 3

What is the primary cause of lactose intolerance?

Answer 3

Lack of brush border enzyme lactase

Question 4

What are common symptoms of lactose intolerance?

Answer 4

• Abdominal cramps
• Bloating
• Diarrhea
• Flatus

Question 5

How is lactose intolerance diagnosed?

Answer 5

Hydrogen breath test

Question 6

What is Celiac disease also known as?

Answer 6

Gluten enteropathy

Question 7

What is the prevalence of Celiac disease among Caucasians of European descent?

Answer 7

1%

Question 8

List two autoimmune diseases associated with Celiac disease.

Answer 8

• Dermatitis herpetiformis
• Diabetes mellitus type 1

Question 9

What is the characteristic immune sensitivity in Celiac disease?

Answer 9

IgA directed against gliadins, hordeins, secalins, and triticale

Question 10

What are the common diagnostic tests for Celiac disease?

Answer 10

• Anti-tissue transglutaminase IgA
• Antiendomysial antibody IgA
• Small bowel biopsy

Question 11

What is the main treatment for Celiac disease?

Answer 11

Dietary gluten restriction

Question 12

What defines tropical sprue?

Answer 12

Generalized malabsorption syndrome associated with geographic exposure

Question 13

What are symptoms of tropical sprue?

Answer 13

• Diarrhea
• Steatorrhea
• Weight loss
• Nausea
• Anorexia

Question 14

How is Whipple’s disease diagnosed?

Answer 14

Biopsy showing infiltration of lamina propria with glycoprotein-laden, ‘foamy’ macrophages

Question 15

What is the primary causative agent of Whipple’s disease?

Answer 15

Tropheryma whipplei

Question 16

What are common symptoms of Whipple’s disease?

Answer 16

• Fever
• Weight loss
• Abdominal pain
• Diarrhea
• Skin pigmentation

Question 17

What are some tests for diagnosing malabsorption?

Answer 17

• Qualitative fecal fat
• Stool ova & parasites
• Complete blood count and smear
• Serum albumin
• Serum iron, ferritin

Question 18

What does a D-xylose absorption test measure?

Answer 18

Differentiates small intestinal mucosal disease from impaired intraluminal digestion/lymphatic obstruction

Question 19

What is the purpose of the Schilling test?

Answer 19

Measures B12 absorption and intrinsic factor deficiency

Question 20

What is a possible cause of significant malabsorption related to infections?

Answer 20

Giardiasis, cryptosporidiosis, microsporidiosis

Question 21

What type of anemia can result from Celiac disease?

Answer 21

• Microcytic anemia (iron deficiency)
• Macrocytic anemia (folate or B12 deficiency)

Question 22

What is the typical management for Whipple’s disease?

Answer 22

Ceftriaxone followed by Trimethoprim-sulfamethoxazole for 1-3 years

Question 23

What is a common complication for untreated Celiac disease?

Answer 23

Increased incidence of lymphoma

Question 24

Fill in the blank: The most common symptoms of Celiac disease are _______.

Answer 24

nonspecific ill health