Name: Eitan Mirvis

Theme: Malabsorption

OPTION LIST

A	Amyloidosis	I	Small bowel bacterial overgrowth
B	Beri-beri	J	Scurvy
C	Coeliac disease	K	Tropical sprue
D	Crohn’s disease	L	Whipple’s disease
E	Giardiasis	M
F	Hypolactasia	N
G	Pancreatic insufficiency	O
H	Pellagra	P

For each scenario below, choose the most appropriate cause of malabsorption from the list above. Each option may be used once, more than once or not at all.

1. A 32-year-old female presents to her GP with fatigue, weight loss and an itchy rash. On examination she has koilonychia and a blistering eruption on her knees, elbows and scalp which the GP recognises as dermatitis herpetiformis.

2. A 10-year-old Caucasian boy with a history of recurrent lung infections is brought to A+E by his mother after developing steatorrhea. His blood glucose is 12mmol/L.

3. A 31-year-old male goes to his GP complaining of bloating, diarrhoea and wind when he eats dairy products. His lactose breath test is positive for hydrogen.

4. A 67-year-old female presents with nausea, bloating and steatorrheoa. Lactulose breath test is positive and barium follow-through demonstrates a jejunal diverticulum.

5. A 48-year-old female presents to A+E with steatorrhoea and weight loss. She says it started two weeks ago with an attack of acute diarrhoea, fever and malaise during a trip to visit relatives in the Caribbean. Serology is negative for anti-tissue transglutaminase antibodies. Barium swallow shows thickened small bowel folds. Duodenal biopsy shows villous atrophy.

ANSWERS

1. C

2. G

3. F

4. I

5. K