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Subject:
Life Sciences
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Case Study
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English (U.S.)
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Topic:
Disease and Pathophysiology
Case Study Instructions:
I will add materials that use to Answer the 28 question according to the patient profile ( blood test) and you can use other additional source
Answer each question separate in few lines , please answer most of them if you can
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Celiac Disease
Disease and Pathophysiology
1 Changes in the anatomy of small intestines (flat mucosa with villus atrophy, and hyper plastic crypts)
The results show that the small intestines are damaged and that their anatomy has changed with regard to the key functions which are digestion and absorption of certain nutrients; the surface area is reduced leading to malabsorption (Marks)
2 Etiology of celiac disease, is Mrs. Gaines`s history typical of patients with celiac disease? Explain
Mrs Gaines history is typical of patients with celiac disease largely because the fact that her siblings and parents experience similar symptoms of celiac disease implying that their genetic make-up is susceptible and hence favorable for development of celiac disease. Celiac disease symptoms such as diarrhea and weight loss tend to increase with increased exposure to the causal factor (s) which in this case is gluten and Mrs. Aines has been experiencing the same over a long period because she didn`t refrain from foods containing gluten.
3 How Celiac disease is related to the damage of small intestines that the endoscopy and biopsy indicate
Damage of the small intestine in celiac disease occurs as a result of the excessive autoimmune response when the protein gluten is detected in the body; the body reacts by releasing lots of antibodies directed at the small intestine mucosa (Mayo Clinic) where the villi are found. Further exposure to gluten worsens the symptoms of celiac diseases as the immune response is accelerated further causing further damage of the villi and intestinal muciosa
4 What are AGA and EMA antibodies? Explain the connection between the presence of antibodies and the etiology of the celiac disease
AGA and EMA are types of antibodies that are commonly released by the body during the immune response towards gluten; AGA or anti-gliadin antibodies are a common serological test for celiac disease, there detection in high amounts is a confirmation of presence of the disease. EMA or Anti-Endomysial Antibodies are common in patient s with chronic celiac disease; they are a characteristic of continued intestinal mucosal damage (American Association for Clinical Chemistry).
5 What is 24-hour fecal fat test? What are the normal results for this test?
This is a test conducted to ascertain the level of fat in the bowels; <7g of fat in stool within a 24 hour period means the person is healthy and > 7 g in 24 hour period for three days is an indicator of a fat malborsption (TNC-CDAAR p1)
6 Mrs. Gaine`s fecal fat test shows 11.5g fat/24 hours what does this mean?
This means that Mrs. Gaines has Steatorrhea or fat malabsorption which is indicative of celiac disease.
7 Why was patient placed on 100g-fat diet when her diet history shows that her symptoms are much worse with fried foods?
This is a standard procedure meant to ensure that the results of the fecal fat test are purely due to an effect in the absorption process and not due to high fat diet intake
Nutritional Therapy
8 What is gluten and where is it found?
This is a protein commonly found in foods such as wheat, barley, rye and rarely in oats
9 Can patients on gluten-free diet tolerate oats?
Yes as long as the oats consumed are gluten free; these are mostly commercial and are specially manufactured to remove gluten (American Dietetic Association)
10 What sources other than foods might introduce gluten to patients
Other sources containing gluten include food additives, spices, and foods such as cakes, breads, pasta, cookies, drinks such as malt beer, hot dogs, and sausages, among others. Some drugs can also contain gluten. Contamination may also result to gluten intolerance; such as sharing jam, margarine or butter, utensils, toasters and other equipment that can be used by people who are tolerant to gluten.
Can patients with celiac disease be also lactose intolerant?
Not necessarily because lactose and gluten are two different proteins and they trigger different responses in the body but may be possible because it has been observed that some type of lactose intolerance develops when the intestinal mucosa (probably affecting the function of the Villi) is injured(Rusynyk & Still p S10)
Nutrition Assessment
Calculate the patient`s UBW and BMI and explain the nutritional risk associated with each value
BMI= Weight in Kg÷height in m2
1 metre= 3.28 feet
1 metre=39.27′′
1kg=2.2 lb
Mrs. Gaines is 5′ 3′ which will be equal to 1.6 metres and 92 lb which equals to 41.8 kg
Hence BMI= 41.8÷1.62= 16.3kg/M2
UBW= Actual weight÷ usual weight* 100
Mrs Gaines`s UBW= 92lb...
University:
Course:
Date:
Celiac Disease
Disease and Pathophysiology
1 Changes in the anatomy of small intestines (flat mucosa with villus atrophy, and hyper plastic crypts)
The results show that the small intestines are damaged and that their anatomy has changed with regard to the key functions which are digestion and absorption of certain nutrients; the surface area is reduced leading to malabsorption (Marks)
2 Etiology of celiac disease, is Mrs. Gaines`s history typical of patients with celiac disease? Explain
Mrs Gaines history is typical of patients with celiac disease largely because the fact that her siblings and parents experience similar symptoms of celiac disease implying that their genetic make-up is susceptible and hence favorable for development of celiac disease. Celiac disease symptoms such as diarrhea and weight loss tend to increase with increased exposure to the causal factor (s) which in this case is gluten and Mrs. Aines has been experiencing the same over a long period because she didn`t refrain from foods containing gluten.
3 How Celiac disease is related to the damage of small intestines that the endoscopy and biopsy indicate
Damage of the small intestine in celiac disease occurs as a result of the excessive autoimmune response when the protein gluten is detected in the body; the body reacts by releasing lots of antibodies directed at the small intestine mucosa (Mayo Clinic) where the villi are found. Further exposure to gluten worsens the symptoms of celiac diseases as the immune response is accelerated further causing further damage of the villi and intestinal muciosa
4 What are AGA and EMA antibodies? Explain the connection between the presence of antibodies and the etiology of the celiac disease
AGA and EMA are types of antibodies that are commonly released by the body during the immune response towards gluten; AGA or anti-gliadin antibodies are a common serological test for celiac disease, there detection in high amounts is a confirmation of presence of the disease. EMA or Anti-Endomysial Antibodies are common in patient s with chronic celiac disease; they are a characteristic of continued intestinal mucosal damage (American Association for Clinical Chemistry).
5 What is 24-hour fecal fat test? What are the normal results for this test?
This is a test conducted to ascertain the level of fat in the bowels; <7g of fat in stool within a 24 hour period means the person is healthy and > 7 g in 24 hour period for three days is an indicator of a fat malborsption (TNC-CDAAR p1)
6 Mrs. Gaine`s fecal fat test shows 11.5g fat/24 hours what does this mean?
This means that Mrs. Gaines has Steatorrhea or fat malabsorption which is indicative of celiac disease.
7 Why was patient placed on 100g-fat diet when her diet history shows that her symptoms are much worse with fried foods?
This is a standard procedure meant to ensure that the results of the fecal fat test are purely due to an effect in the absorption process and not due to high fat diet intake
Nutritional Therapy
8 What is gluten and where is it found?
This is a protein commonly found in foods such as wheat, barley, rye and rarely in oats
9 Can patients on gluten-free diet tolerate oats?
Yes as long as the oats consumed are gluten free; these are mostly commercial and are specially manufactured to remove gluten (American Dietetic Association)
10 What sources other than foods might introduce gluten to patients
Other sources containing gluten include food additives, spices, and foods such as cakes, breads, pasta, cookies, drinks such as malt beer, hot dogs, and sausages, among others. Some drugs can also contain gluten. Contamination may also result to gluten intolerance; such as sharing jam, margarine or butter, utensils, toasters and other equipment that can be used by people who are tolerant to gluten.
Can patients with celiac disease be also lactose intolerant?
Not necessarily because lactose and gluten are two different proteins and they trigger different responses in the body but may be possible because it has been observed that some type of lactose intolerance develops when the intestinal mucosa (probably affecting the function of the Villi) is injured(Rusynyk & Still p S10)
Nutrition Assessment
Calculate the patient`s UBW and BMI and explain the nutritional risk associated with each value
BMI= Weight in Kg÷height in m2
1 metre= 3.28 feet
1 metre=39.27′′
1kg=2.2 lb
Mrs. Gaines is 5′ 3′ which will be equal to 1.6 metres and 92 lb which equals to 41.8 kg
Hence BMI= 41.8÷1.62= 16.3kg/M2
UBW= Actual weight÷ usual weight* 100
Mrs Gaines`s UBW= 92lb...
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