Pathology of Malabsorption

Question 1

What is the classic clinical presentation of Whipple Disease?

Answer 1

Male, 30-40yo, farmer, malabsorption, CNS symptoms, polyarthritis, hyperpigmentation

Question 2

Describe the pathophysiology of gliadin in causing Celiac Disease.

Answer 2

Gliadin induces the proliferation of CD8 T cells & activation of NK cells that causes hepatocyte injury. Gliadin may also activate T cells.

Question 3

What serum antibodies have been associated with Celiac disease?

Answer 3

Antitissue transglutaminase (antitTg)

Antiendomysial antibody (EMA)

Antigliadin antibodies (AGA)

Question 4

What class of antibodies is produced in response to Celiac Disease?

Answer 4

IgA antibodies

Question 5

This is a rare autosomal recessive disorder characterized by an inability to secrete triglyceride-rich lipoproteins.

Answer 5

Abetalipoproteinemia

Question 6

What is the classic presentation of Celiac disease in infancy?

Answer 6

Failure to thrive, abdominal distention, diarrhea, developmental delays

Question 7

What are the two types of lactase deficiency?

Answer 7

Congenital (gene mutation), Acquired (downregulation of gene expression)

Question 8

What pathological GI complications may arise from cystic fibrosis?

Answer 8

Constipation (due to thick, viscous stool), chronic pancreatitis (due to blockage of ducts)

Question 9

What is Whipple Disease?

Answer 9

Obstruction of lymph flow and transport due to macrophages infected with tropheryma whippelii

Question 10

With what symptoms may a patient with malabsorption present?

Answer 10

Chronic diarrhea, steatorrhea that is foul-smelling, weight loss, fatigue, anemia,

Question 11

A patient presents with chronic diarrhea and excessive flatulence. An intestinal biopsy is ordered. The pathology report finds lymphocytic infiltration, crypt elongation, epithelial cell mitosis, and atrophy of villi. What is the diagnosis?

Answer 11

Celiac disease

Question 12

Abetalipoproteinemia is characterized by an inability to secrete triglyceride-rich lipoproteins. How does the disorder present?

Answer 12

Accumulation of triglycerides in epithelial cells, acantholytic red blood cells, steatorrhea, failure to thrive

Question 13

This disease presents similar to Celiac Disease, but generally develops days after an acute enteric diarrheal infection and includes only partial atrophy of villi with lymphocytic infiltration.

Answer 13

Tropical Sprue

Question 14

What is the active component of gluten responsible for causing symptoms associated with Celiac Disease?

Answer 14

Gliadin

Question 15

Patients with Celiac disease are at increased risk of developing what cancers?

Answer 15

T Cell Lymphoma and small intestine adenocarcinoma

Question 16

This malabsorption disorder is X-linked and causes the development of autoantibodies to enterocytes and goblet cells.

Answer 16

Autoimmune enteropathy

Question 17

What is the treatment for Tropical Sprue?

Answer 17

Folic acid, Vitamin B12, Tetracycline

Question 18

This itchy, blistering rash is associated with Celiac Disease.

Answer 18

Dermatitis herpetiformis

Question 19

True/False. A biopsy is needed to diagnose lactase deficiency.

Answer 19

False - histology is generally unremarkable