Peptic Ulcer and Celiac Disease Overview

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Questions and Answers

Which of the following symptoms is specifically associated with Peptic Ulcer Disease?

Dermatitis herpetiformis

Epigastric pain (correct)

Weight loss

Diarrhea

What is the primary dietary management approach for Celiac Disease?

Paleo diet

High-protein diet

Gluten-free diet (correct)

Low-fat diet

Which test is most definitive for diagnosing Familial Adenomatous Polyposis (FAP)?

Blood test for iron levels

Small bowel biopsy

Urea breath test

Colonoscopy with biopsy (correct)

Which of the following treatments is primarily utilized for Ulcerative Colitis?

Steroids Signup and view all the answers

Which symptom is distinctive for Crohn's Disease compared to Ulcerative Colitis?

Fistulas Signup and view all the answers

Elevated levels of which specific antibodies are indicative of Celiac Disease?

Transglutaminase IgA Signup and view all the answers

Which treatment strategy is unique for the management of Familial Adenomatous Polyposis (FAP)?

Prophylactic colectomy Signup and view all the answers

Which test would likely be ordered to check for anemia in patients with Ulcerative Colitis?

Complete Blood Count (CBC) Signup and view all the answers

Which of the following is NOT a common sign or symptom of Tuberculosis (TB)?

Honey-colored pustules Signup and view all the answers

What is the recommended treatment for active Tuberculosis?

A multi-drug regimen including rifampin Signup and view all the answers

Which diagnostic test is utilized for confirming Lyme Disease?

ELISA and Western blot Signup and view all the answers

In the case of Herpes Zoster, what is an early recommended treatment option?

Oral antivirals Signup and view all the answers

What describes the common cause of Cat-Scratch Disease?

Bacterial infection from Bartonella henselae Signup and view all the answers

What is a typical sign of mucocutaneous candidiasis?

White plaques Signup and view all the answers

Which treatment is necessary for ocular involvement in Toxoplasmosis?

Systemic therapy and intravitreal therapy Signup and view all the answers

Which of the following is a potential complication of untreated Lyme Disease?

Facial paralysis Signup and view all the answers

What are common diagnostic tests for Histoplasmosis?

Serology for IgG/IgM antibodies and PCR Signup and view all the answers

What is a hallmark symptom of Impetigo?

Honey-colored pustules Signup and view all the answers

What are the primary symptoms associated with iron deficiency anemia?

Fatigue and difficulty swallowing Signup and view all the answers

Which diagnostic test is specifically associated with vitamin B12 deficiency?

Elevated homocysteine levels Signup and view all the answers

Which treatment is appropriate for managing acute pancreatitis?

NPO protocol with IV fluids and pain management Signup and view all the answers

What is the most common type of anemia related to pernicious anemia?

Macrocytic anemia due to vitamin B12 deficiency Signup and view all the answers

Which condition is characterized by a reduction in all blood cell types?

Pancytopenia Signup and view all the answers

What diagnostic finding is commonly associated with giant cell arteritis?

Histological signs of vasculitis in temporal artery biopsy Signup and view all the answers

Which of the following is a common treatment for radiation retinopathy?

Anti-VEGF injections Signup and view all the answers

What is the primary concern with chemotherapy-associated ocular toxicity?

Inflammatory responses causing retinal detachment Signup and view all the answers

What does a blood smear reveal in a patient with iron deficiency anemia?

Hypochromic microcytic red blood cells Signup and view all the answers

Which autoimmune condition is a leading cause of vitamin B12 deficiency?

Pernicious anemia Signup and view all the answers

What imaging technique is used to evaluate metastatic orbital tumors?

MRI Signup and view all the answers

What are the main symptoms of paraneoplastic ocular syndromes?

Visual loss, nyctalopia, and dyschromatopsia Signup and view all the answers

Which treatment is recommended for managing symptoms of giant cell arteritis?

High-dose steroids with gradual tapering Signup and view all the answers

Which autoimmune disorder is characterized by a butterfly rash and possible kidney issues?

Systemic Lupus Erythematosus Signup and view all the answers

What is the primary ocular complication associated with Rheumatoid Arthritis?

Scleritis Signup and view all the answers

Which test is commonly used to diagnose Sjögren’s Syndrome?

Schirmer's test Signup and view all the answers

In Ankylosing Spondylitis, what genetic marker is often found positive?

HLA-B27 Signup and view all the answers

Which ocular symptom is most commonly associated with Stevens-Johnson Syndrome?

Conjunctivitis Signup and view all the answers

What is the first-line treatment for epidermal tumors like basal cell carcinoma?

Surgical excision Signup and view all the answers

Which antibody marker is typically positive in the diagnosis of Systemic Lupus Erythematosus?

Anti-Smith antibodies Signup and view all the answers

What is a common treatment strategy for managing uveitis in Ankylosing Spondylitis?

Corticosteroids Signup and view all the answers

Which systemic condition causes both dry eyes and dry mouth due to gland dysfunction?

Sjögren’s Syndrome Signup and view all the answers

Which skin cancer is typically associated with scaly and firm papules?

Cutaneous Squamous Cell Carcinoma Signup and view all the answers

What ocular symptom can arise from Cutaneous Melanoma?

Vision loss Signup and view all the answers

What imaging technique can be helpful in assessing chronic sinusitis?

CT scan Signup and view all the answers

Which of the following treatments is commonly prescribed for joint pain in Rheumatoid Arthritis?

Steroids Signup and view all the answers

What is a potential systemic treatment for the symptoms of Xanthoma?

Lipid-lowering medications Signup and view all the answers

Study Notes

Peptic Ulcer Disease

Chronic ulcers in the esophagus, stomach, or duodenum
Symptoms include epigastric pain (upper abdomen), indigestion (dyspepsia), gastric bleeding, coffee-ground-like vomit, melena (black stools), and anemia
Diagnosis involves upper GI X-ray, endoscopy (EGD) with biopsy, stool samples, antibody testing, and urea breath test
Treatment includes acid-suppressing drugs like Proton Pump Inhibitors (PPI) and Histamine 2 receptor antagonists (H2RA), antibiotics for H.pylori infection, and lifestyle changes such as reducing NSAID use and stress

Celiac Disease

Autoimmune disorder triggered by gluten, leading to intestinal damage
Symptoms include diarrhea, abdominal pain, bloating, nutrient deficiencies (iron, vitamins), and dermatitis herpetiformis (skin rash)
Diagnosis involves blood test for elevated transglutaminase or endomysial IgA, small bowel biopsy, and endoscopy (EGD)
Treatment involves a strict gluten-free diet and nutritional counseling

Familial Adenomatous Polyposis (FAP)

Genetic condition causing colon polyps, often leading to colon cancer by age 50
Symptoms include rectal bleeding, diarrhea, anemia, and often asymptomatic
Diagnosis involves genetic testing and colonoscopy with biopsy
Treatment involves annual colonoscopies, prophylactic colectomy, and genetic counseling for family.

Ulcerative Colitis (UC)

Autoimmune inflammation affecting the colon's lining
Symptoms include diarrhea (sometimes bloody), abdominal pain, fever, rectal pain, bloating, and weight loss
Diagnosis involves colonoscopy and blood tests such as CBC, low iron levels, and elevated CRP/ESR
Treatment includes steroids, sulfasalazine, immunosuppressants, and surgery in severe cases

Crohn’s Disease

Autoimmune inflammation that affects any part of the GI tract, mainly the small intestine and colon
Symptoms include the same as UC, plus vomiting, fistulas, pneumaturia (air in urine), pernicious anemia, and vitamin deficiencies
Diagnosis involves colonoscopy, EGD for upper symptoms, CBC, vitamin deficiency tests, and imaging (X-ray, CT)
Treatment includes steroids, immunosuppressants, monoclonal antibodies, and surgery for severe cases

Pancreatitis

Inflammation of the pancreas, either acute or chronic
Symptoms include abdominal pain radiating to the back, nausea, vomiting, fever, steatorrhea (fatty stool), and distention
Diagnosis involves elevated serum lipase/amylase levels, CT scan, and CBC showing high WBC
Treatment involves hospitalization with NPO (nothing by mouth) protocol, IV fluids, and pain management

Iron Deficiency Anemia

Low iron levels causing decreased hemoglobin production and oxygen transport
Symptoms include fatigue, weakness, difficulty swallowing, and cardiovascular strain
Diagnosis involves serum ferritin, serum iron, total iron binding capacity (TIBC), and blood smear showing microcytic red blood cells
Treatment involves iron supplementation (oral or IV), dietary changes, and monitoring ferritin and hemoglobin levels

Vitamin B12 Deficiency (Pernicious Anemia)

Autoimmune destruction of gastric parietal cells or malabsorption, leading to B12 deficiency
Symptoms include anemia, fatigue, neurological issues: memory loss, gait disturbances, and visual field defects (Centrocecal VF)
Diagnosis involves blood smear showing macrocytic red blood cells, hypersegmented neutrophils, low serum B12, elevated homocysteine and methylmalonic acid, and anti-intrinsic factor antibodies present in autoimmune pernicious anemia
Treatment involves B12 supplementation (oral or intramuscular), addressing underlying autoimmune issues if present, and monitoring neurological symptoms

Pancytopenia (due to B12 Deficiency)

A reduction in red blood cells, white blood cells, and platelets, often linked to vitamin B12 deficiency
Symptoms include generalized weakness, bruising, infections, pale skin, and shortness of breath
Diagnosis involves blood count showing low levels of all types of blood cells and bone marrow biopsy if severe
Treatment involves B12 supplementation, monitoring blood counts regularly, and addressing any associated autoimmune conditions

Cancer Basics

Uncontrolled cell division, genetic or environmental causes
Symptoms vary by cancer type but involve abnormal growths, fatigue, and weight loss
Diagnosis involves clinical exams, imaging, biopsy, and TNM staging to assess severity and prognosis
Treatment includes surgery, radiation, chemotherapy, targeted therapies, immunotherapy, and hormonal therapy

Radiation Retinopathy

A complication of radiation treatment, affecting retinal blood vessels
Symptoms include microaneurysms, hemorrhages, telangiectasias, macular edema, cotton-wool spots, neovascularization, and retinal detachment
Diagnosis involves OCT-A, Fluorescein Angiography (FA), and Fundus Autofluorescence (FAF)
Treatment includes anti-VEGF injections, laser photocoagulation, and prevention by using lower radiation doses, hyper-fractionation, and eye protection

Chemotherapy-Associated Ocular Toxicity

Eye toxicity from systemic chemotherapy
Symptoms include keratitis, corneal deposits, conjunctivitis, uveitis, retinal toxicity, and optic nerve toxicity
Diagnosis varies based on symptoms
Treatment depends on specific ocular toxicities

Metastatic Orbital Tumors

Tumors metastasizing to the eye, most commonly from breast, lung, or prostate cancer
Symptoms include sudden pain, diplopia, vision loss, mass on palpation, optic nerve edema, and ophthalmoplegia
Diagnosis involves MRI for orbital mass
Treatment involves oncology referral, surgery, radiation, or chemotherapy based on cancer stage

Paraneoplastic Ocular Syndromes

Autoimmune reaction to cancer affecting the eyes (e.g., melanoma-associated retinopathy, cancer-associated retinopathy)
Symptoms include vision loss, nyctalopia, dyschromatopsia (color vision issues), uveitis, macular edema, and retinal vasculitis
Diagnosis involves OCT, ERG (electroretinogram) showing dysfunction, and blood tests for autoantibodies
Treatment involves systemic steroids, immunotherapy, and referral to oncology if no cancer diagnosis is present

Giant Cell Arteritis (GCA)

Inflammation of the temporal arteries, often affecting vision
Symptoms include headache, scalp tenderness, jaw claudication, and visual disturbances or sudden vision loss (arteritic anterior ischemic optic neuropathy - AAION)
Diagnosis involves elevated ESR (≥50 mm/hr), often >100 mm/hr, temporal artery biopsy (TAB) showing vasculitis, and CRP levels
Treatment involves high-dose steroids, taper over months to years, and biologics or DMARDs for those contraindicated for long-term steroids

Systemic Lupus Erythematosus (SLE)

A systemic autoimmune disorder affecting multiple organs
Symptoms include butterfly rash, joint pain, kidney issues, and visual changes (lupus retinopathy)
Diagnosis involves positive ANA, Anti-dsDNA, Anti-Smith antibodies, elevated ESR, and CRP
Treatment involves immunosuppressive drugs, regular eye exams for lupus retinopathy, and systemic management for organ involvement

Rheumatoid Arthritis (RA)

Chronic autoimmune arthritis affecting the joints
Symptoms include joint pain, swelling, stiffness, and ocular complications: dry eye, scleritis
Diagnosis involves rheumatoid factor (RF), Anti-CCP antibodies, elevated CRP, and ESR
Treatment involves DMARDs (e.g., methotrexate), biologics, and managing ocular symptoms with artificial tears and anti-inflammatory treatments

Sjögren’s Syndrome (SS)

Autoimmune disorder affecting moisture-producing glands
Symptoms include dry eyes, dry mouth, joint pain, and fatigue
Diagnosis involves positive Anti-SSA/Ro, Anti-SSB/La, Schirmer's test (≤5mm in 5 minutes), and ocular staining score
Treatment involves artificial tears, saliva substitutes, and hydroxychloroquine for systemic symptoms

Ankylosing Spondylitis (AS)

A type of spondyloarthropathy primarily affecting the spine
Symptoms include chronic back pain, stiffness, and uveitis
Diagnosis involves HLA-B27 positive and X-rays showing sacroiliac joint changes
Treatment involves NSAIDs, biologics (e.g., TNF inhibitors), and management of uveitis with corticosteroids

Rosacea

Chronic inflammatory skin condition, often on the face
Symptoms include erythema (redness), telangiectasia, papules, pustules, and ocular symptoms: pain, dryness, tearing, conjunctival injection
Diagnosis involves clinical examination
Treatment includes topical treatments, oral antibiotics, and laser surgery for telangiectasia or phymatous changes

Stevens-Johnson Syndrome (SJS)

Severe, life-threatening mucocutaneous reaction, often medication-induced
Symptoms include skin desquamation, mucositis, fever, respiratory symptoms, and ocular effects: conjunctivitis, corneal erosions, neovascularization
Diagnosis involves history of medication use or infection and clinical exam
Treatment involves discontinuing offending medication, supportive care, and ocular management

Xanthoma/Xanthelasma

Lipid-laden plaques, often related to abnormal lipid levels
Symptoms include yellowish plaques on skin or around eyes (xanthelasma)
Diagnosis involves lipid profile to assess cholesterol and triglyceride levels
Treatment involves surgical removal of plaques and managing underlying lipid disorders

Basal Cell Carcinoma (BCC)

Skin cancer affecting keratinocytes in the basal layer of the epidermis
Symptoms include nodular: translucent nodule with telangiectasias, rolled border, pigmented or morpheaform subtypes possible
Diagnosis involves clinical exam, dermoscopy, and biopsy
Treatment involves surgical excision (Mohs surgery for high-risk cases), cryotherapy, radiation, and 5-fluorouracil cream

Cutaneous Squamous Cell Carcinoma (cSCC)

Cancer of squamous cells, typically in sun-exposed areas
Symptoms include scaly, firm papules, or plaques, ulceration possible, itching, pain, or altered sensation
Diagnosis involves biopsy and clinical examination
Treatment involves surgical excision, Mohs surgery for high-risk areas, and epidermal growth factor inhibitors for advanced cases

Cutaneous Melanoma

Melanoma, a cancer of melanocytes, often fatal if untreated
Symptoms include irregular moles (asymmetry, border irregularity, color variation) and changes in size, color, or shape of moles
Diagnosis involves biopsy, dermoscopy, and sentinel lymph node biopsy
Treatment involves surgical excision with margins, monoclonal antibodies for metastasis, and regular skin exams and follow-up

Sinusitis

Inflammation of the sinus epithelium, often bacterial
Symptoms include unilateral facial pain, headache, eye pain, toothache, post-nasal discharge, cough, inflamed nasal mucosa
Diagnosis involves clinical exam and imaging for severe or recurrent cases
Treatment involves OTC analgesia, decongestants, and antibiotics for infections lasting longer than 10 days

Cellulitis

Bacterial infection of the dermis and subcutaneous fat, often from Staph or Strep species
Symptoms include red, warm skin, localized edema, fever, chills, and can spread to deeper tissues like muscle
Diagnosis involves clinical exam, culture if severe
Treatment involves oral or IV antibiotics, surgical drainage in severe cases

Impetigo

Superficial bacterial infection of the skin, often in children
Symptoms include non-bullous: honey-colored pustules, bullous: thin-walled vesicles in warm, moist areas
Diagnosis is clinical
Treatment involves cleaning lesions, topical antibiotics, and oral antibiotics for extensive cases

Tuberculosis (TB)

Mycobacterium tuberculosis infection, primarily affecting the lungs
Symptoms include fever, fatigue, weight loss, persistent cough, pleuritic chest pain, and can spread to kidneys, spine, adrenal glands
Diagnosis involves tuberculin skin test (TST) or IGRA blood test, and chest X-ray to differentiate latent vs.active TB
Treatment involves multi-drug regimen for active TB, isoniiazid monotherapy for latent TB, and systemic TB treatment and care for eye complications for ocular TB

Cat-Scratch Disease

Infection from Bartonella henselae, transmitted by cat bites or scratches
Symptoms include vesicular lesion, unilateral lymphadenopathy, low-grade fever, muscle/joint pain
Diagnosis involves history of cat interaction, and serology for Bartonella antibodies
Treatment involves supportive care, antibiotics for severe cases, and antibiotics for ocular involvement

Lyme Disease

Tick-borne bacterial infection from Borrelia burgdorferi
Symptoms include erythema migrans (bullseye rash), headache, arthralgia, fatigue, and can progress to systemic complications
Diagnosis involves clinical history, ELISA, and Western blot for confirmation
Treatment involves doxycycline for early disease, doxycycline for disseminated disease, and IV antibiotics for severe cases

Herpes Zoster (Shingles)

Reactivation of varicella zoster virus (VZV), often affecting a specific dermatome
Symptoms include unilateral vesicular rash, severe pain, itching, malaise, facial nerve palsy, abdominal pain if visceral involvement
Diagnosis is clinical based on rash and history of VZV infection
Treatment involves oral antivirals within 72 hours, antibacterial ointments for skin lesions, and vaccination for prevention

Histoplasmosis

Fungal infection caused by Histoplasma capsulatum, associated with bird/bat droppings
Symptoms include flu-like symptoms, respiratory distress, hypoxia, and presumed ocular histoplasmosis: punched-out "histo" spots, choroidal neovascularization
Diagnosis involves antigen/antibody testing, biopsy for confirmation
Treatment involves oral/IV antifungals for systemic infection, and anti-VEGF injections and laser photocoagulation for ocular involvement

Mucocutaneous Candidiasis

Yeast infection from Candida albicans, affecting mouth (thrush), esophagus, or genitals
Symptoms include white plaques, itching, redness, discomfort
Diagnosis involves surface scraping, culture, or biopsy
Treatment involves oral/IV antifungals and treating underlying conditions

Toxoplasmosis

Parasitic infection caused by Toxoplasma gondii, transmitted through cat feces or undercooked meat
Symptoms include acquired: headache, myalgia, lymphadenopathy, congenital: hydrocephalus, brain calcifications, retinochoroiditis
Diagnosis involves serology for IgG/IgM antibodies, PCR for severe cases
Treatment involves no treatment needed for immunocompetent, pyrimethamine, sulfadiazine, leucovorin for immunocompromised, and systemic and intravitreal therapy for severe cases for ocular involvement

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This quiz covers the essentials of Peptic Ulcer Disease and Celiac Disease, including their symptoms, diagnosis, and treatment options. Understand the chronic conditions affecting digestion and the autoimmune response triggered by gluten in patients with Celiac Disease. Test your knowledge on these gastrointestinal disorders.