CMN 568 Unit 4 Test QUESTIONS AND ANSWERS
VERIFIED 100% CORRECT
What is celiac disease? - ANSWER an inherited autoimmune disorder
involving the small bowel that results from an inflammatory reaction to
gliadin (wheat, rye, and barley)
What occurs in the small intestine due to inflammation in celiac disease? -
ANSWER targets mucosa of the small intestine and leads to crypt
hyperplasia and villous atrophy causing decreased nutrient absorption and
increased solute and water excretion
What are typical symptoms of celiac disease? - ANSWER weight loss,
chronic diarrhea, abd. distention, and growth retardation
What is the only known tx. of celiac disease? - ANSWER gluten free diet
What conditions would warrant screening for celiac disease? - ANSWER
osteopenia, osteoporosis, and unexplained iron deficiency anemia,
autoimmune hepatitis, down syndrome, primary biliary cirrhosis
How is celiac disease diagnosed through serology? What is the gold
standard for dx? - ANSWER IgA tissue transglutiminase antibody testing
(tTG); Small intestinal mucosal biopsy
In children, what is more accurate that the glidian IgA when testing for
celiac? - ANSWER glidian IgG
In patients with severe protein deficiency, what is necessary to test for
celiac disease? - ANSWER biopsy
What should a patient with positive serology and normal biopsies have
done if celiac disease is suspected? - ANSWER be put on a gluten free
diet trial
, A person who tests neg. for serology and biopsy, but responds clinically to
a gluten free diet may have what? - ANSWER gluten sensitivity
Epigastric pain or burning, early satiety, or post-prandial fullness are s/s of
what? - ANSWER dyspepsia
What diagnostic procedure is warranted in patients with alarm features or
in those older than 55? - ANSWER endoscopy
In patients without alarm features,<55 y/o, and s/s of dyspepsia, what
should first be done? - ANSWER Testing for H. Pylori and a 4 week trial of
PPI
What is the most common cause of chronic dyspepsia? - ANSWER
functional dyspepsia
What is the typical profile of functional dyspepsia? - ANSWER younger,
report a variety of abdominal and extraGI complaints, show signs of anxiety
or depression, or has a hx. of psychotropic medication use
In patients older than 55 with c/o symptoms associated with dyspepsia,
what lab tests should initially be done? - ANSWER CBC, electrolytes, liver
enzymes, calcium, and thyroid tests, urea breath test (or other noninvasive
tests for H. Pylori)
In most clinical settings, a test for what should initially be done in patients
with c/o of dyspepsia? - ANSWER H. Pylori
What are 3 noninvasive tests for H. Pylori? - ANSWER urea breath test,
fecal antigen, and IgG serology
What are "alarm features"? - ANSWER weight loss, dysphagia, recurrent
vomiting, evidence of bleeding, or anemia
What is the study of choice to diagnose gastroduodenal ulcers, erosive
esophagitis, or upper GI malignancies? - ANSWER upper endoscopy
, what is warranted when symptoms of dyspepsia fail to respond to initial
empiric management strategies within 4-8 weeks or when frequent
symptoms relapse occurs after d/c of antisecretory therapy? - ANSWER
endoscopy
If a patient has symptom relapse after discontinuation of a 4 week empiric
trial of PPIs, what should be done next? - ANSWER test for H. Pylori and
tx if positive
What patient education should be included in the treatment and
management of patients with functional dyspepsia? - ANSWER Avoid
alchohol and caffeine. Consume small, low-fat meals
What pharmacologic agents are used to tx. functional dyspepsia? -
ANSWER 4-8 weeks of PPIs, low doses of antidepressants What
black
box warning is associated with metoclopramide when used for more than 3
months? who is at the most risk? - ANSWER high incidence of tardive
dyskinesia; the elderly
The acute onset of severe pain and vomiting suggests what? - ANSWER
peritoneal irritation, acute gastric or intestinal obstruction, or
pancreaticobiliary disease
What does persistent vomiting suggest? - ANSWER pregnancy, gastric
outlet obstruction, gastroparesis, intestinal dysmotility, psychogenic
disorders, or CNS or systemic disorders
Vomiting that occurs in the morning suggests what? - ANSWER
pregnancy, uremia, alcohol intake, and Increased ICP
What diagnostic tool is best used to determine the cause of gastric outlet
obstruction? - ANSWER upper endoscopy
What diagnostic tool is best used to determine small intestinal obstruction?
- ANSWER
CT
VERIFIED 100% CORRECT
What is celiac disease? - ANSWER an inherited autoimmune disorder
involving the small bowel that results from an inflammatory reaction to
gliadin (wheat, rye, and barley)
What occurs in the small intestine due to inflammation in celiac disease? -
ANSWER targets mucosa of the small intestine and leads to crypt
hyperplasia and villous atrophy causing decreased nutrient absorption and
increased solute and water excretion
What are typical symptoms of celiac disease? - ANSWER weight loss,
chronic diarrhea, abd. distention, and growth retardation
What is the only known tx. of celiac disease? - ANSWER gluten free diet
What conditions would warrant screening for celiac disease? - ANSWER
osteopenia, osteoporosis, and unexplained iron deficiency anemia,
autoimmune hepatitis, down syndrome, primary biliary cirrhosis
How is celiac disease diagnosed through serology? What is the gold
standard for dx? - ANSWER IgA tissue transglutiminase antibody testing
(tTG); Small intestinal mucosal biopsy
In children, what is more accurate that the glidian IgA when testing for
celiac? - ANSWER glidian IgG
In patients with severe protein deficiency, what is necessary to test for
celiac disease? - ANSWER biopsy
What should a patient with positive serology and normal biopsies have
done if celiac disease is suspected? - ANSWER be put on a gluten free
diet trial
, A person who tests neg. for serology and biopsy, but responds clinically to
a gluten free diet may have what? - ANSWER gluten sensitivity
Epigastric pain or burning, early satiety, or post-prandial fullness are s/s of
what? - ANSWER dyspepsia
What diagnostic procedure is warranted in patients with alarm features or
in those older than 55? - ANSWER endoscopy
In patients without alarm features,<55 y/o, and s/s of dyspepsia, what
should first be done? - ANSWER Testing for H. Pylori and a 4 week trial of
PPI
What is the most common cause of chronic dyspepsia? - ANSWER
functional dyspepsia
What is the typical profile of functional dyspepsia? - ANSWER younger,
report a variety of abdominal and extraGI complaints, show signs of anxiety
or depression, or has a hx. of psychotropic medication use
In patients older than 55 with c/o symptoms associated with dyspepsia,
what lab tests should initially be done? - ANSWER CBC, electrolytes, liver
enzymes, calcium, and thyroid tests, urea breath test (or other noninvasive
tests for H. Pylori)
In most clinical settings, a test for what should initially be done in patients
with c/o of dyspepsia? - ANSWER H. Pylori
What are 3 noninvasive tests for H. Pylori? - ANSWER urea breath test,
fecal antigen, and IgG serology
What are "alarm features"? - ANSWER weight loss, dysphagia, recurrent
vomiting, evidence of bleeding, or anemia
What is the study of choice to diagnose gastroduodenal ulcers, erosive
esophagitis, or upper GI malignancies? - ANSWER upper endoscopy
, what is warranted when symptoms of dyspepsia fail to respond to initial
empiric management strategies within 4-8 weeks or when frequent
symptoms relapse occurs after d/c of antisecretory therapy? - ANSWER
endoscopy
If a patient has symptom relapse after discontinuation of a 4 week empiric
trial of PPIs, what should be done next? - ANSWER test for H. Pylori and
tx if positive
What patient education should be included in the treatment and
management of patients with functional dyspepsia? - ANSWER Avoid
alchohol and caffeine. Consume small, low-fat meals
What pharmacologic agents are used to tx. functional dyspepsia? -
ANSWER 4-8 weeks of PPIs, low doses of antidepressants What
black
box warning is associated with metoclopramide when used for more than 3
months? who is at the most risk? - ANSWER high incidence of tardive
dyskinesia; the elderly
The acute onset of severe pain and vomiting suggests what? - ANSWER
peritoneal irritation, acute gastric or intestinal obstruction, or
pancreaticobiliary disease
What does persistent vomiting suggest? - ANSWER pregnancy, gastric
outlet obstruction, gastroparesis, intestinal dysmotility, psychogenic
disorders, or CNS or systemic disorders
Vomiting that occurs in the morning suggests what? - ANSWER
pregnancy, uremia, alcohol intake, and Increased ICP
What diagnostic tool is best used to determine the cause of gastric outlet
obstruction? - ANSWER upper endoscopy
What diagnostic tool is best used to determine small intestinal obstruction?
- ANSWER
CT
