Small Bowel

Question 1

Primary site of chemical digestion

Answer 1

duodenum

Question 2

Main site of nutrient absorption

Answer 2

jejunum

Question 3

SIBO treatment

Answer 3

rifaximin 550 mg TID for 14 days

Question 4

SIBO diagnosis

Answer 4

positive lactulose breath test

Question 5

Lactose intolerance diagnosis

Answer 5

positive hydrogen breath test

Question 6

Lab positive in celiac

Answer 6

tTG IgA

Question 7

Celiac diagnostic step

Answer 7

small bowel biopsy

Question 8

Depth of inflammation for Crohn’s

Answer 8

transmural

Question 9

Tropical sprue treatment

Answer 9

250 mg tetracycline QID for 2-3 months, then TID up to 6 months

Question 10

B12 level that is diagnostic for B12 deficiency

Answer 10

< 150

Question 11

MMA and homocysteine in B12 deficiency

Answer 11

elevated, elevated

Question 12

MMA and homocysteine in folate deficiency

Answer 12

normal, elevated

Question 13

Whipple disease diagnosis (2)

Answer 13

PAS-positive macrophages in tissue biopsy
PCR for Tropheryma whipplei

Question 14

Whipple disease treatment

Answer 14

1) ceftriaxone (or penicillin)
2) then TMP-SMX for 1-2 years

Question 15

Jejunal aspirate CFU in SIBO

Answer 15

> 105 CFU

Question 16

Lab to differentiate folate and B12 deficiency

Answer 16

MMA (elevated w/ B12, normal w/ folate)

Question 17

Part of small bowel where most nutrient absorption occurs

Answer 17

jejunum