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If you patient had history of diverticular disease but at present there was not an acute inflammatory condition, what dietary recommendations would you make and why? (p.27)
- High fiber diet - increase transit through GI tract
- Wheat bran, fruits, vegetables, legumes
- Women = 25g/day, Men = 38g/day
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Clinical manifestations of Appendicitis (p.31)
- Epigastric, periumbilical, cramping pain
- - may be diffuse
- - initially RLQ
- Nausea and vomiting
- Low-grade fever
- Pain shifting to RLQ with point tenderness
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Inflammatory Bowel Diseases (p.27)
- Term used for Crohn's disease and ulcerative colitis.
- Common features:
- - inflammation of bowel
- - no proven causal agent
- - pattern of familial occurrence
- - systemic manifestation
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How does Crohn’s contribute to malabsorption, malnutrition, and weight loss? (p.27-28)
- Any portion of GI tract may be affected - most often small intestine and colon
- Transmural - all 3 layers of bowel involved
- Segments of inflamed tissue separated by normal tissue - cobblestone and patchy - interferes with absorption leading to malnutrition and weight loss
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What is distinction between Crohn's disease and ulcerative colitis based on anatomic localization and histologic appearance? (p.29)
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Identify symptoms and theories of Irritable Bowel Syndrome (IBS). (p.29)
- Symptoms:
- - chronic abdominal pain - crampy sensations with periodic exacerbations
- - associated with episodes of diarrhea and constipation
- Theories:
- - visceral hypersensitivity
- - abnormal GI motility (esp. colon)
- - emotional stress
- - cholecystectomy (perpetual drip of bile into duodenum)
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What are the risk factors, sign/symptoms of Celiac disease? (p.34)
- Risk factors - genetic predisposition – HLA-DQ2 and HLA-DQ8 gene alleles
- Signs and symptoms:
- - Chronic diarrhea
- - Abdominal distention
- - Painful stomach bloating
- - Foul-smelling stools
- - Fatigue, extreme lethargy
- - Weight loss
- - Muscle wasting
- - Vomiting
- - Irritability
- - Children – not grow normally, not absorbing nutrients
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What is the pathogenic process considered to initiate intestinal damage in Celiac disease?
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If you suspected celiac disease in your patient, what initial test would be most appropriate to perform?
- Serologic screening for IgA transglutaminase antibody test (IgATTG)
- Followed by endoscopic biopsy of duodenal mucosa
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Once confirmed, what is the treatment for celiac disease?
- Lifetime gluten-free diet
- CAN eat: fish, chicken, milk, veggies, corn, rice, eggs, fresh meats, unprocessed cheeses, dry beans, fruits
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