Question | Answer |
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 | |