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DU PA Diarrhea/malab

Duke PA Chronic Diarrhea, Malabsorption, and Celiac Disease

QuestionAnswer
you never see blood with __ secretory or osmotic diarrhea
chronic diarrhea + weight loss + nutritional deficiencies = __ malabsorption
chronic blood diarrhea = __ ulcerative colotis
chronic diarrhea without nutritional deficiencies = __ lactose intolerance, IBS, laxative overuse/abuse
always consider __ in patients 40 years and older with chronic diarrhea colon cancer
malabsorption can be caused by __ impaired digestion/absorption/transit
steatorrhea is a hallmark symptom of __ malabsorption
__ is ideal screen for malabsorption (gold standard) stool test for fat
most useful for diagnosing lactase deficiency hydrogen breath test
aka, non-tropical sprue, gluten-sensitive enteropathy celiac disease
inflammatory response of small bowel to ingestion of gluten proteins found in wheat, rye and barley celiac disease
protein malabsorption have wasting, edema
carbohydrate malabsorption have ab cramping and bloating, weight loss/growth retardation, soft diarrhea
classic malabsorption fat malabsorption
complication of untreated celiac disease lymphoma
clinical syndromes associated with malabsorption lactase def., giardiasis, celiac dz, tropical sprue, amyloidosis, lymphoma, whipple's dz, bacterial overgrowth, short gut syndrome
classic test for malabsorption is __ fecal fat
drugs and foods associated with malabsorption cholestyramine, high fiber diets, tetracycline, antacids, sorbitol, fructose, Xenical, metformin, colchicine, methotrexate, sulfasalazine, phenytoin
celiac disease is an __ disorder. It also has a genetic component HLA-DQ2, HLA-DQ8 association autoimmune disorder
this disease can often present with everything but GI symptoms Celiac disease
classical presentation of __ is diarrhea with steatorrhea, weight loss, nutritional deficiencies Celiac disease
celiac disease extra-intestinal manifestations short stature, fatigue, amenorrhea, decrease fertility, arthropathy, iron def. anemia, folate/vit K def, osteopenia, osteoporosis, muscle atrophy, neurologic, dental enamel hypoplasia
celiac disease patients with mild proximal disease may have only __ without any GI symptoms anemia and osteoporosis
celiac disease patients with significant distal disease involvement usually have __ persistent diarrhea
cutaneous variant of celiac disease. Only seen in 10% of those with celiac but everyone with this has celiac dermatitis herpetiformis
intensely pruritic papulovesicular rash of trunk, scalp, and extremities associated with celiac disease dermatitis herpetiformis
physical exam for celiac disease-check teeth for enamel loss, muscle atrophy, kyphosis, bruises, increased abdominal signs
laboratory evaluation of celiac disease CBC, PT, iron, B12, folate, calcium, alk phosphatase, albumin, beta carotene, ESR
accurate serological tests for __ are now widely available. anti-endomysial IGA (most specific), anti-tTGA (cheaper, less difficult, test of choice) celiac disease
still the gold standard confirmation test for celiac disease duodenal mucosal biopsy
pathognomonic findings with duodenal mucosal biopsy in celiac disease villous atrophy, crypt hyperplasia, lympocytic infiltration of lamina propria, increased intraepithelial lymphocytes
__ cures celiac disease symptoms gluten free diet
complications of celiac disease malignancy (lymphoma, but also squamous cell ca of esophagus, colon and hepatocellular ca), other autoimmune disease, nutritional def., musculoskeletal injuries, deformities
inflammatory disease of small bowel secondary to overgrowth of coliforms
Created by: bwyche
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