318 - Disorders of Absorption *Celiac Disease*

Question 1

What are the two disease in which there’s a higher absorption of nutrients?

Answer 1

1. Hemochromatosis (iron)

2. Wilson’s disease (cupper)

Question 2

Most of the absorption disorders are associated with ______, beside two disorders: ___,____

Answer 2

Steatorrhea
Primary lactase deficiency
Pernicious anemia (B12 absorption disorder)

Question 3

Define diarrhea

Answer 3

Water volume or feces weight > 200-225 ml or gr / 24h

Question 4

_____ diarrhea is caused by absorption disorder, while ____ diarrhea is caused by an increase of fluid and electrolytes into the ileum or colon

Answer 4

Osmotic

Secretory

Question 5

How can you differentiate between osmotic and secretory diarrhea?

Answer 5

1. Fasting

2. Feces electrolytes

Question 6

What is the hallmark in CD (Celiac Disease)?

Answer 6

Abnormal ileum biopsy and symptoms + histological findings improvement after gluten free diet is initiated

Question 7

Where are the most severe histological findings in CD?

Answer 7

Proximal ileum > distal ileum

Question 8

There is ___ correlation between ____ and symptoms

Answer 8

No

Histological

Question 9

Name 4 CD symptoms

Answer 9

1. Anemia
2. Diarrhea
3. Weight loss
4. Edema

Question 10

Why now days there are more CD patients diagnosis of the atypical/sub clinical type?

Answer 10

Due to more serological tests

Question 11

What are the common antibodies in CD?

Answer 11

Anti tTG
Antiendomysial
IgA antigliadin

Question 12

Patients with CD are in almost all cases present either _____ or _____, and when non of them is expressed we can rule our CD

Answer 12

HLA-DQ2

HLA-DQ8

Question 13

All celiac disease patients express ____ or_____ allele although only a ____ expressing them suffer from the disease. Therefore their absence excludes the diagnosis of celiac disease

Answer 13

HLA-DQ2
HLA-DQ8
1/8

Question 14

Diagnosis of CD is based on two findings:

Answer 14

1. Abnormal ileum biopsy- performed in the presence of abnormal clinical findings/ absorption disorder/ anti- tTG IgA in the serum.
2. Clinical and histological response to gluten free diet and disappearance of anti tTG IgA and antiendomysial

Question 15

What are the classic changes found in duodenum/ jejunum biopsy of symptomatic CD patients? (4)

Answer 15

1. Intra epithelial lymphocytosis
2. Decrease in height/ number of villi
3. Cuboidal epithelium with non-basal nucleus
4. Increase in lymphocytes and plasm cells in the lamina propria

Question 16

What diseases are found in association with CD? (5)

Answer 16

1. Dermatitis herpetiformis
2. DM1
3. IgA deficiency
4. Down syndrome
5. Turner’s syndrome

Question 17

The most common complication of CD is ____ and ____ together with _____

Answer 17

GI cancer
Non GI cancer
Lymphoma