NUR 529 EXAM 3 BLUEPRINT EXAM
2025/2026 QUESTIONS AND ANSWERS
100% PASS
Major Functions of Gut Microflora
- Metabolic activities that salvage energy and absorbable nutrients
- Trophic effects on intestinal epithelial cells
- Protection of the colonized host against invasion by pathogenic organisms
Stomach/ Small Intestine
- Few species of bacteria due to the composition of luminal contents (acids, biles, pancreatic
secretions) that kill most ingested microorganisms, and the propulsive movements of this area,
which impedes their colonization.
Large Intestine
- Large/ complex microbial ecosystem
- Approx 300-500 different species of intestinal bacteria (more anaerobic than aerobic)
Colonization of the GI tract begins
shortly after birth
Colonization of the GI tract is influenced by
passage through the birth canal and diet the infant receives (breastmilk vs. formula)
Environmental factors that can affect the GI flora in infants
neonatal care
stress
pH
immunologic status
1 @COPYRIGHT 2025/2026.
,What is one metabolic function of colonic flora?
Fermentation of undigestible residue and endogenous mucus produced by the epithelial cells.
What is a major source of energy in the colon?
Fermentation of nondigestible carbohydrates, including resistant starches, cellulose, pectins,
and unabsorbed sugars.
What role do colonic flora play in nutrient absorption?
They assist in the absorption of calcium, magnesium, and iron.
What vitamin is synthesized by colonic flora?
Vitamin K.
Why do newborns have low levels of vitamin K initially?
They do not make an adequate amount of vitamin K for the first week until normal colonic
bacterial flora becomes established.
How do resident gut flora protect against pathogens?
They provide a crucial line of resistance to colonization by exogenous microbes.
What is the effect of colonic flora on opportunistic bacteria?
They restrict the growth of opportunistic bacteria that are present in the gut.
The administration of broad-spectrum antibiotics can disrupt the microbial balance and allow
overgrowth of species with potential pathogenicity, such as
Clostridium difficile
What are probiotics?
Live microorganisms that, when ingested, can modify the composition of enteric microflora.
What are some commonly used probiotics?
Lactobacilli, bifidobacteria, and nonpathogenic E. coli.
How can probiotics affect ulcerative colitis (UC)?
They can help maintain remission in ulcerative colitis.
What is another name for Celiac Disease?
Celiac sprue or Gluten-sensitive enteropathy
What type of disease is Celiac Disease?
2 @COPYRIGHT 2025/2026.
,Immune mediated
Is Celiac Disease more common in males or females?
Females
What causes Celiac Disease in genetically predisposed individuals?
An inappropriate T-cell-mediated immune response against ingested α-gliadin
Celiac Disease is characterized by
- small intestinal enteropathy, symptoms r/t malabsorption and/ or immune activation, and
auto antibodies to tissue transglutaminase (TTG)
Almost all people with celiac disease share what major histocompatibility complex?
- class II allele HLA-DQ2 or HLA-DQ8.
Celiac disease is triggered by
dietary gluten-containing grains ( wheat, barley, rye);
People with Celiac disease have increased antibodies to a variety of antigens such as:
- transglutaminase
- endomysium
- gliadin
The resultant immune response with Celiac disease produces
- an intense inflammatory reaction that results in the loss of absorptive villi from the small
intestine.
When lesions are extensive in celiac disease what can happen?
they can impair the absorption of macronutrients (proteins, carbs, fats) and micronutrients
(vitamins and minerals).
Where is gluten exposure the greatest?
small bowel, in the proximal part of the small intestine
At risk populations for celiac disease
- T1DM
- Autoimmune endocrinopathies
- Dermatitis herpetiformis
- 1st and 2nd degree relatives of people with celiac disease
- Turner syndrome
3 @COPYRIGHT 2025/2026.
, - Malignancies (head and neck squamous cell carcinoma, small intestinal adenocarcinoma, non-
Hodgkin lymphoma)
Clinical manifestations of celiac disease that presents in infancy
Failure to thrive (FTT)
Diarrhea
Muscle wasting
Abdominal distention
Sometimes severe malnutrition
Clinical manifestations of celiac disease in older children
Anemia
Short stature
Dental enamel defects
Constipation
Clinical manifestations of celiac disease in adults
Diarrhea
Constipation
Bloating
Flatus
Belching
Diagnosis of celiac disease
- Clinical manifestations
- Serologic tests (Ig A antihuman TTG and IgA endomysial antibody immunofluorescence tests)
- Confirmed by an intestinal biopsy of the proximal small bowel
- Additional tests to determine if it has resulted in nutritional disorders like IDA
What diet eliminates barley, rye, oats, and wheat for celiac disease treatment?
BROW diet
What types of foods are gluten-free as long as they are not contaminated during processing?
Meats, fruits, vegetables, and dairy products
What is the effect of a gluten-free diet on the intestinal mucosa in celiac disease?
It results in rapid and complete healing.
What type of medications can cause GI lesions like peptic ulcers?
NSAIDs (like ASA)
4 @COPYRIGHT 2025/2026.
2025/2026 QUESTIONS AND ANSWERS
100% PASS
Major Functions of Gut Microflora
- Metabolic activities that salvage energy and absorbable nutrients
- Trophic effects on intestinal epithelial cells
- Protection of the colonized host against invasion by pathogenic organisms
Stomach/ Small Intestine
- Few species of bacteria due to the composition of luminal contents (acids, biles, pancreatic
secretions) that kill most ingested microorganisms, and the propulsive movements of this area,
which impedes their colonization.
Large Intestine
- Large/ complex microbial ecosystem
- Approx 300-500 different species of intestinal bacteria (more anaerobic than aerobic)
Colonization of the GI tract begins
shortly after birth
Colonization of the GI tract is influenced by
passage through the birth canal and diet the infant receives (breastmilk vs. formula)
Environmental factors that can affect the GI flora in infants
neonatal care
stress
pH
immunologic status
1 @COPYRIGHT 2025/2026.
,What is one metabolic function of colonic flora?
Fermentation of undigestible residue and endogenous mucus produced by the epithelial cells.
What is a major source of energy in the colon?
Fermentation of nondigestible carbohydrates, including resistant starches, cellulose, pectins,
and unabsorbed sugars.
What role do colonic flora play in nutrient absorption?
They assist in the absorption of calcium, magnesium, and iron.
What vitamin is synthesized by colonic flora?
Vitamin K.
Why do newborns have low levels of vitamin K initially?
They do not make an adequate amount of vitamin K for the first week until normal colonic
bacterial flora becomes established.
How do resident gut flora protect against pathogens?
They provide a crucial line of resistance to colonization by exogenous microbes.
What is the effect of colonic flora on opportunistic bacteria?
They restrict the growth of opportunistic bacteria that are present in the gut.
The administration of broad-spectrum antibiotics can disrupt the microbial balance and allow
overgrowth of species with potential pathogenicity, such as
Clostridium difficile
What are probiotics?
Live microorganisms that, when ingested, can modify the composition of enteric microflora.
What are some commonly used probiotics?
Lactobacilli, bifidobacteria, and nonpathogenic E. coli.
How can probiotics affect ulcerative colitis (UC)?
They can help maintain remission in ulcerative colitis.
What is another name for Celiac Disease?
Celiac sprue or Gluten-sensitive enteropathy
What type of disease is Celiac Disease?
2 @COPYRIGHT 2025/2026.
,Immune mediated
Is Celiac Disease more common in males or females?
Females
What causes Celiac Disease in genetically predisposed individuals?
An inappropriate T-cell-mediated immune response against ingested α-gliadin
Celiac Disease is characterized by
- small intestinal enteropathy, symptoms r/t malabsorption and/ or immune activation, and
auto antibodies to tissue transglutaminase (TTG)
Almost all people with celiac disease share what major histocompatibility complex?
- class II allele HLA-DQ2 or HLA-DQ8.
Celiac disease is triggered by
dietary gluten-containing grains ( wheat, barley, rye);
People with Celiac disease have increased antibodies to a variety of antigens such as:
- transglutaminase
- endomysium
- gliadin
The resultant immune response with Celiac disease produces
- an intense inflammatory reaction that results in the loss of absorptive villi from the small
intestine.
When lesions are extensive in celiac disease what can happen?
they can impair the absorption of macronutrients (proteins, carbs, fats) and micronutrients
(vitamins and minerals).
Where is gluten exposure the greatest?
small bowel, in the proximal part of the small intestine
At risk populations for celiac disease
- T1DM
- Autoimmune endocrinopathies
- Dermatitis herpetiformis
- 1st and 2nd degree relatives of people with celiac disease
- Turner syndrome
3 @COPYRIGHT 2025/2026.
, - Malignancies (head and neck squamous cell carcinoma, small intestinal adenocarcinoma, non-
Hodgkin lymphoma)
Clinical manifestations of celiac disease that presents in infancy
Failure to thrive (FTT)
Diarrhea
Muscle wasting
Abdominal distention
Sometimes severe malnutrition
Clinical manifestations of celiac disease in older children
Anemia
Short stature
Dental enamel defects
Constipation
Clinical manifestations of celiac disease in adults
Diarrhea
Constipation
Bloating
Flatus
Belching
Diagnosis of celiac disease
- Clinical manifestations
- Serologic tests (Ig A antihuman TTG and IgA endomysial antibody immunofluorescence tests)
- Confirmed by an intestinal biopsy of the proximal small bowel
- Additional tests to determine if it has resulted in nutritional disorders like IDA
What diet eliminates barley, rye, oats, and wheat for celiac disease treatment?
BROW diet
What types of foods are gluten-free as long as they are not contaminated during processing?
Meats, fruits, vegetables, and dairy products
What is the effect of a gluten-free diet on the intestinal mucosa in celiac disease?
It results in rapid and complete healing.
What type of medications can cause GI lesions like peptic ulcers?
NSAIDs (like ASA)
4 @COPYRIGHT 2025/2026.
