18 Questions
What is a common gastrointestinal manifestation of Giardia lamblia infection?
Foul-smelling diarrhea
Which symptom of Giardia lamblia infection can last for weeks to months?
Abdominal distention
What is a long-term consequence of untreated Giardia lamblia infection in children?
Growth retardation
What is a common consequence of brush border enzyme destruction in Giardia lamblia infection?
Steatorrhea
What is the treatment of choice for both symptomatic and asymptomatic patients with Giardia lamblia infection?
Either metronidazole or furazolidone
What is a common challenge in diagnosing Giardia lamblia infection?
Falsely negative stool specimens
What is a common cause of bile acid deficiency?
Ileal resection
Which of the following disorders is characterized by the presence of microvillus inclusions in enterocytes?
Microvillus inclusion disease
What is the underlying cause of Celiac disease?
Permanent sensitivity to gluten in genetically susceptible individuals
Which of the following is a clinical manifestation of Celiac disease?
All of the above
What is the underlying cause of Giardia-induced diarrhea?
Infectious agent that lives in swimming pools
What is a common complication of short bowel syndrome?
Reduced mucosal surface area
What is a common symptom of protein-losing enteropathy due to intestinal lymphangiectasia?
Edema
What is a gastrointestinal manifestation of intestinal lymphangiectasia?
Malabsorption of fat and proteins
Why are medium-chain triglycerides (MCT) used in the treatment of intestinal lymphangiectasia?
Because they are easily absorbed in the gut
What is the primary cause of secondary immunodeficiency in intestinal lymphangiectasia?
Loss of immunoglobulins in the gut
What is the flagellated protozoan that causes diarrhea, especially in travelers to endemic areas?
Giardia lamblia
What is the primary mechanism of fat malabsorption in intestinal lymphangiectasia?
Leakage of fat into the gut lumen
Study Notes
Giardiasis
- Caused by Giardia lamblia, a flagellated protozoan that can be found in contaminated water
- Clinical manifestations: foul-smelling diarrhea, nausea, anorexia, abdominal cramps, bloating, belching, flatulence, and weight loss
- Abdominal distension and cramps can last for weeks to months
- Self-limited illness, lasting 2-6 weeks, but can become chronic
- Chronic symptoms: fatigue, nervousness, weight loss, steatorrhea, lactose intolerance, and growth retardation
- Diagnosis: identifying cysts in stool specimen, antigen detection tests, endoscopic examination of upper small intestine, mucosal biopsy, or jejunal contents collection
- Treatment: furazolidone or metronidazole for both symptomatic and asymptomatic patients
Intestinal Brush Border Disorders
- Congenital causes: microvillus inclusion disease
- Inflammatory causes: celiac disease, Crohn disease, tufting disease, postinfectious diarrhea
- Autoimmune causes: autoimmune enteropathy
- Enzyme deficiencies: primary lactase deficiency, sucrase-isomaltase deficiency, glucose/galactose malabsorption
Conditions Leading to Bile Acid Deficiency
- Chronic cholestasis
- Bile acid pool depletion
- Ileal resection
Protein-Losing Enteropathy (PLE)
- Intestinal lymphangiectasia: characterized by dilatation of lymph vessels in the mucosa and submucosa
- Causes: protein and fat malabsorption, edema, hypoproteinemia, low serum albumin and gammaglobulin levels
- Treatment: lifelong dietary modification with high protein and low fat substituted with medium-chain triglycerides (MCT)
This quiz covers the relationship between Giardia lamblia infection and immune deficiencies, including IgA deficiency and hypogammaglobulinemia. It explores the clinical manifestations of the infection, including gastrointestinal symptoms, and the potential for chronic illness. Test your knowledge of this important topic in immunology and microbiology.
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