Ibs, Celiac

Question 1

What is celiac disease

Answer 1

Malabsorptive disease in response to gluten

Small intestinal mucosa damage

Villous atrophy

Question 2

Gluten found in _____

Answer 2

Wheat barley and rye

Question 3

What is the problem with gluten what component.

Answer 3

Gliadin

Question 4

Symptoms of celiac

Answer 4

Some asymptomatic or symptoms of malabsorption
- diarrhea
Weight loss
Weakness
Abdominal distention

In children, failure to thrive, delayed puberty

Question 5

Celiac symptoms may relate to nutrition deficient

Answer 5

Iron deficiency anemia, fatigue, and pallor

Vit k deficiency, easy bruises
B12, neuropathy

Question 6

Celiac disease skin manifestation

Answer 6

Dermatitis herpetiformis

Question 7

What is dermatitis herpetiformis

Answer 7

Pruritis papulovesicles, over extensors, and extremities, trunk, scalp and neck

Question 8

Dermatitis herpetiformis tx

Answer 8

Dapsone, lesion will respond to a gluten free diet, but response is slower, want to avoid a secondary skin infection

Question 9

For celiac serology testing, patient is required to be on gluten for at least _____ weeks

Answer 9

6

Question 10

Celiac disease gold standard test

Answer 10

Small intest8jal biopsy taken from distal duodenum shows villous atrophy

Celiac serology, but must not be on a gluten free diet to assess accurately

Question 11

Tx for celiac

Answer 11

Strict elimination of gluten from diet

Dietician refer all,
Rice, corn and potatoes, are safe

Correct nutrition deficiency

Question 13

What is ibs

Answer 13

Chronic functional disorder no organic caus e

Question 14

Ibs characterized by

Answer 14

Abdominal pain and altered bowel habits

Question 15

Ibs is characterized by reccurent abdominal pain at least 1 day a week in last 3 months and two or more of the following

Answer 15

Change in the frequency
Pain that related to defecation
Change in form of stool

Question 16

Etiology and pathophys for Ibs

Answer 16

Usually involves underlying depression and anxiety
Can develop post gastroenteritis, or after viral or parasitic infection

Ask in social history, or ask any psychiatric hospitilizations

Question 17

Clinical feautures of Ibs

Answer 17

Intermittent and crampy pain in the lower abdomen

Diarrhea, frequent stools
Constipation, days to months

Red flag is being woken in the night to have a bowel movement

Constipation

Question 18

Ibs testing

Answer 18

Use Rome criteria.
CBC
Stool o and p, if recent travel

Colonoscopy is alarm Symptom, and family history colon cancer, over 45

Question 19

Alarm symptoms Ibs

Answer 19

Acute onset over 50
Blood in stool
Weight loss
Family history colon cancer

Question 20

Treatment for Ibs

Answer 20

Educate and support the patient

Reinforce chronic nature
Cope with symptoms
Lifestyle,
- exercise, sleep, avoid large meals, use fod maps

Question 21

Ibs pharmacotherapy aimed at pt with severe symptoms and o treating symptoms

Answer 21

Diarrhea, Imodium

Constipation, miralax , linzess

Psychotropic agent
, antidepressant

Question 22

Lactose intolerance is the inability to digest lactose due to shortage of _____

Answer 22

Lactase

Question 23

Lactose intolerance affects what population

Answer 23

Native Americans, Asian Americans, African Americans

Question 24

Etiology for lactose intolerance

Answer 24

Acquired, and genetically regulated

Second to gi surgery or disease, such as chrons or celiac

Question 25

Pathophys for lactose intolerance

Answer 25

Malabsorbed lactose is fermented and produces gas, increases stool load and result in diarrhea goes straight to large intestine, skips small intestine

Question 26

Feature of lactose intolerance e

Answer 26

Bloat, gas, diarrhea, cramping

Question 27

Red flag lactose intolerance

Answer 27

If patient is now losing weight need to evaluate further

Question 28

Testing for lactose intolerance

Answer 28

Lactose free diet Hydrogenated breath test, given 50 gm lactose, positive test is a rise in breath hydrogen (>20 ppm within 90 mins)

Question 29

Lactose intolerance treatment

Answer 29

Make patient comfortable Lactose free diet Use lactaid, milk ensyme replacement Calcium and vitamin d supplement

Question 30

What is polyp

Answer 30

Clump of cells, in the colon, stalk like

Question 31

Risk for polyps,

Answer 31

Diet high with red meat Low fiber Obesity Men greatest risk

Question 32

Can u distinguish between hyperplasticity polyp, and adenomatous polyp

Answer 32

No must biopsy

Question 33

Hyperplastic polyp what are they

Answer 33

Small, in rectum or sigmoid Less than 5 mm No malignancy potential

Question 34

Adenomatous polyp

Answer 34

2/3 are this kind Some cancer potential Larger the lesion the more likely the risk for cancer, >1 cm

Question 35

Best way to visualize polyps

Answer 35

Colonoscopy, And polypectomy