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?

    <p>Steroids</p> Signup and view all the answers

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

    <p>Fistulas</p> Signup and view all the answers

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

    <p>Transglutaminase IgA</p> Signup and view all the answers

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

    <p>Prophylactic colectomy</p> Signup and view all the answers

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

    <p>Complete Blood Count (CBC)</p> Signup and view all the answers

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

    <p>Honey-colored pustules</p> Signup and view all the answers

    What is the recommended treatment for active Tuberculosis?

    <p>A multi-drug regimen including rifampin</p> Signup and view all the answers

    Which diagnostic test is utilized for confirming Lyme Disease?

    <p>ELISA and Western blot</p> Signup and view all the answers

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

    <p>Oral antivirals</p> Signup and view all the answers

    What describes the common cause of Cat-Scratch Disease?

    <p>Bacterial infection from Bartonella henselae</p> Signup and view all the answers

    What is a typical sign of mucocutaneous candidiasis?

    <p>White plaques</p> Signup and view all the answers

    Which treatment is necessary for ocular involvement in Toxoplasmosis?

    <p>Systemic therapy and intravitreal therapy</p> Signup and view all the answers

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

    <p>Facial paralysis</p> Signup and view all the answers

    What are common diagnostic tests for Histoplasmosis?

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

    What is a hallmark symptom of Impetigo?

    <p>Honey-colored pustules</p> Signup and view all the answers

    What are the primary symptoms associated with iron deficiency anemia?

    <p>Fatigue and difficulty swallowing</p> Signup and view all the answers

    Which diagnostic test is specifically associated with vitamin B12 deficiency?

    <p>Elevated homocysteine levels</p> Signup and view all the answers

    Which treatment is appropriate for managing acute pancreatitis?

    <p>NPO protocol with IV fluids and pain management</p> Signup and view all the answers

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

    <p>Macrocytic anemia due to vitamin B12 deficiency</p> Signup and view all the answers

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

    <p>Pancytopenia</p> Signup and view all the answers

    What diagnostic finding is commonly associated with giant cell arteritis?

    <p>Histological signs of vasculitis in temporal artery biopsy</p> Signup and view all the answers

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

    <p>Anti-VEGF injections</p> Signup and view all the answers

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

    <p>Inflammatory responses causing retinal detachment</p> Signup and view all the answers

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

    <p>Hypochromic microcytic red blood cells</p> Signup and view all the answers

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

    <p>Pernicious anemia</p> Signup and view all the answers

    What imaging technique is used to evaluate metastatic orbital tumors?

    <p>MRI</p> Signup and view all the answers

    What are the main symptoms of paraneoplastic ocular syndromes?

    <p>Visual loss, nyctalopia, and dyschromatopsia</p> Signup and view all the answers

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

    <p>High-dose steroids with gradual tapering</p> Signup and view all the answers

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

    <p>Systemic Lupus Erythematosus</p> Signup and view all the answers

    What is the primary ocular complication associated with Rheumatoid Arthritis?

    <p>Scleritis</p> Signup and view all the answers

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

    <p>Schirmer's test</p> Signup and view all the answers

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

    <p>HLA-B27</p> Signup and view all the answers

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

    <p>Conjunctivitis</p> Signup and view all the answers

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

    <p>Surgical excision</p> Signup and view all the answers

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

    <p>Anti-Smith antibodies</p> Signup and view all the answers

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

    <p>Corticosteroids</p> Signup and view all the answers

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

    <p>Sjögren’s Syndrome</p> Signup and view all the answers

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

    <p>Cutaneous Squamous Cell Carcinoma</p> Signup and view all the answers

    What ocular symptom can arise from Cutaneous Melanoma?

    <p>Vision loss</p> Signup and view all the answers

    What imaging technique can be helpful in assessing chronic sinusitis?

    <p>CT scan</p> Signup and view all the answers

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

    <p>Steroids</p> Signup and view all the answers

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

    <p>Lipid-lowering medications</p> 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.

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