Clinical Presentation
Diagnosis
Complications
Common Food Allergens
Surprise Sources of Gluten and Lactose
100

This is the type of diarrhea present in many patients with lactose intolerance 

What is osmotic diarrhea 

100

What are the three components necessary for a diagnosis of celiac disease

What are clinical history, serology and duodenal biopsy (must have all three!)

100

People with untreated celiac disease can also develop this other food sensitivity

What is lactose intolerance (explanation: the small intestine isn't functioning properly leading to the inability to digest lactose)

100

Most common food allergen amongst U.S. children

What is cow’s Milk?

100

I was just diagnosed with celiac and I am sorting through my cupboard when I find crisped rice. It has: Rice, Sugar, Salt, Glucose-Fructose Syrup, Barley Malt Flavoring, Caramel Color and vitamins. This ingredient is not gluten free.

What is Barley Malt Flavoring

200

Many patients with celiac disease would describe their stools in this way

What are foul smelling, greasy and bulky (AKA- steatorrhea) 

200

If history and physical exam are inconclusive for the diagnosis of lactose intolerance, this test is the gold standard for diagnosis

What is the hydrogen breath test 

Explanation: Measures hydrogen concentration on breath after lactose ingestion.  Lactate metabolism by gut bacteria gives off hydrogen which is expelled through the lungs. GOLD standard after history/inconclusive. 

200

This complication can develop in those with lactose intolerance and/or celiac disease

What is osteopenia/osteoporosis (explanation: this is due to poor nutrient uptake in the small intestines due to inflammation)

200

This ingredient has higher rates of allergy related anaphylaxis than that of milk or wheat allergies. It tends to persist through adulthood.

What is peanut allergy?

200

This commonly used hair-care product can contain gluten

What is shampoo

300

This skin condition is common in patients with celiac disease 

What is dermatitis herpetiformis 

300

These findings on duodenal biopsy are indicative of celiac disease 

What are atrophic villi and hyperplasia of the crypts

300

Expecting mothers with untreated celiac disease put their unborn child at risk for this due to poor nutrient absorption

What is low birth-weight

300

This allergen is found in many vegetable products such as edamame, miso, and tempeh. 

What is soy?

300

Your patient with celiac disease tells you they've been having trouble eating sushi. This commonly used ingredient is likely causing their symptoms.

What is imitation crab meat? 


400

Due to its attack on the small intestine, patients with celiac disease are often deficient in these nutrients

What are folate, iron and calcium 

400

These HLA markers are necessary for the development of celiac disease 

What are HLA DQ2 and DQ8

Explanation: Most patients with Celiac disease test positive for DQ2. All patients with celiac disease test positive for one of these alleles however, you can be positive for these alleles and never develop celiac disease. 

400

A person with untreated celiac disease may suffer from malnutrition as a result of this process

What is an autoimmune reaction: immune system reacts to gluten and damages the small intestines, which reduces nutrient absorption

400

This allergen tends to develop in adulthood and be more severe. Uncommon sources include Caesar salad dressing and BBQ sauce.

What is fish? 

400

Your are lactose intolerant and want to make a salad for lunch. This is a good alternative to salad dressing that does not contain lactose

What is vinaigrette

500

Celiac disease may be present comorbidly with these disorders

What are Hashimoto's thyroiditis, Type I Diabetes, and IgA Nephropathy 

Explanation- These are all autoimmune disorders 

500

This is the serological marker of choice to confirm diagnosis of celiac disease 

What is IgA Anti tissue transglutaminase 

500

Celiac disease that has been untreated for a long period of time may result in this type of cancer due to an overreactive immune system

What is lymphoma (explanation: celiac disease is an immune system condition, which involves lymphocytes.  When the immune system doesn't function properly, it can lead to immune cells dysfunction.  NOTE: while those with celiac disease may be at an increased risk of developing lymphoma compared to people without celiac disease, it is still a very rare condition)

500

This food allergen is more commonly developed in childhood and can be found in the flu and MMR vaccines.

What is egg?

500

Your patient recently began the keto diet. This sugar alternative is likely causing their increase in symptoms

What is artificial sweetener

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