Food allergies & insensitivities, metabolic disorders Flashcards
(26 cards)
Sx of food intolerance
Gas
Bloating
Abd pain
Diarrhea
Sx of food allergy
Immediate
Pruritis, urticaria, flushing, angioedema, N/V/D, cramping, wheezing, syncope, hypotension
What is lactase?
Enzyme that breaks down lactose to glucose & galactose
Where is glucose & galactose typically absorbed? What if lactose is not absorbed?
In the small intestine
Passes into colon
In the colon, what is lactose converted into?
Fatty acid & hydrogen gas by intestinal bacteria
How does lactose intolerance present?
Abd pain Bloating Flatulence Diarrhea Borborygmi
How do you dx lactose intolerance?
Sx after lactose ingestion
Sx resolve w/ avoidance
Lactose hydrogen breath test
How do you treat lactose intolerance?
Lactose free diet
Lactase replacement
Monitor Ca, Vit D
What is G6PD deficiency?
Genetic defect in G6PD (a RBC enzyme that generates NADPH & protects RBCs from oxidative injury)
X-linked
What is G6PD deficiency a/w?
Hemolytic anemia
How does G6PD deficiency present?
Asx until a trigger causes hemolysis
Jaundice, pallor, dark urine, abd pain, back pain
Normocytic anemia
What does G6PD deficiency look like on peripheral smear?
“Bite cells”, Heinz bodies
How do you treat G6PD deficiency?
Avoid oxidative stress
Remove offending agent
Hydrate
Tranfusion for severe anemia
What is paget disease of the bone?
localized area of increased bone turnover –> overgrowth
Increases osteoclast & osteoblast activity
What causes paget disease of the bone?
Idiopathic
Genetic
What is the clinical presentation of paget disease of the bone?
Usually asx
Pain (worse in PM & w/ WB)
Bowed tibias, kyphosis, “chalkstick” fx, HA, increased hat size
How do you dx paget disease of the bone?
Alk phos: elevated Bone turnover markers Ca 25-OH vit D Bone scintigraphy
How do you treat paget disease of the bone?
Asx: monitor
Bisphosphonates (IV zoledronate)
What are complications of paget disease of the bone?
Hypercalcemia Renal calculi High output HF Arthritis CN palsies Vascular steal syndrome Radiculopathy or paralysis Bone tumors
What are rickets?
Deficiency of Ca or phosphate –> altered bone growth
What are the typical locations where rickets is noticed?
Distal forearm
Knee
Costochondral junction
What causes rickets?
Decreased intake
Malabsorption
Increased excretion of Ca, phosphate, or vit D
How does rickets present?
Bowing of extremities
Fx
Proximal myopathy
What labs are used for dx of rickets?
Alk phos: elevated Phosphorus: low Ca: low or normal PTH: elevated 25-OH vit D
