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Celiac disease: Helping patients live gluten-free

doi: 10.1097/01.NPR.0000405093.93462.3e
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INSTRUCTIONS Celiac disease: Helping patients live gluten-free


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Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.1 contact hours for this continuing nursing education activity.

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Celiac disease: Helping patients live gluten-free

General Purpose: To prepare the NP to identify the signs and symptoms of celiac disease and to educate and manage patients effectively. Learning Objectives: After reading the preceding article and taking this test, you should be able to: 1. Explain the pathophysiology and risk factors for celiac disease. 2. Discuss screening and management of the patient with celiac disease.

1. Gluten is a protein found in all of the following except

a. rice.

b. barley.

c. wheat.

d. rye.

2. Untreated celiac disease can result in

a. lupus erythematosus.

b. colorectal cancer.

c. liver failure.

d. early mortality.

3. An immune-mediated response to gluten causes damage to the

a. sigmoid colon.

b. stomach.

c. jejunum.

d. transverse colon.

4. Antibodies produced in response to consuming gluten attack

a. mucosal cilia.

b. intestinal villi.

c. mucosa of the large intestine.

d. digestive enzymes.

5. The damage caused by gluten consumption results in illnesses associated with

a. constipation.

b. polyps.

c. malabsorption.

d. anorexia.

6. Individuals who do not carry the common alleles HLA-DQ2 or HLA-DQ8 are

a. likely to develop celiac disease later in life.

b. likely to develop celiac disease early in life.

c. likely to experience early mortality.

d. unlikely to develop celiac disease.

7. There are numerous nonintestinal symptoms of celiac disease including growth delay in children, anemia, and

a. thrombosis.

b. osteopenia.

c. hypercalcemia.

d. vascular insufficiency.

8. Continued exposure to gluten results in

a. a greater risk of developing autoimmune disorders.

b. an increased tolerance to intestinal symptoms.

c. an improved ability to digest gluten.

d. more difficulty diagnosing the disease.

9. Although symptoms of celiac disease vary among patients, the most well-known symptoms include which of the following?

a. chronic constipation.

b. acid-reflux.

c. weight gain.

d. foul-smelling voluminous stools.

10. Which population has the highest prevalence of celiac disease?

a. first-degree relatives of a celiac patient

b. second-degree relatives of a celiac patient

c. individuals with IDA and intestinal symptoms

d. individuals with IDA regardless of intestinal symptoms

11. Patients with which of the following conditions have the highest prevalence of celiac disease?

a. type I diabetes mellitus

b. unexplained elevated transaminase levels

c. osteoporosis and osteomalacia

d. biliary cirrhosis

12. Women with celiac disease may experience which reproductive disorder?

a. early menarche

b. delayed menopause

c. delayed fertility

d. postterm deliveries

13. The recommended serologic screening for celiac disease in adults includes total IgA antibodies, IgA endomysial antibodies and

a. IgG antigliadin antibodies

b. IgA tissue transglutaminase (tTG).

c. IgA antigliadin antibodies

d. IgG tTG.

14. The gold standard diagnostic approach to diagnosing celiac disease is

a. intestinal biopsy demonstrating damage, followed by improvement after a gluten-free diet.

b. intestinal biopsy with quarterly follow-up biopsies until improvement is demonstrated.

c. intestinal ultrasound demonstrating damage due to the disease.

d. computed axial tomography clearly demonstrating damage from celiac disease.

15. Patients should be advised that gluten may be found in

a. bottled water.

b. cornmeal.

c. rice paper.

d. adhesives on envelopes and stamps.

16. Which dietary nutrient is least likely to be deficient in patients with celiac disease?

a. calcium

b. fat soluble vitamins

c. vitamin B6

d. folic acid

17. When educating patients about the harm that gluten can cause, the NP should

a. offer a comprehensive list of foods and other items to exclude.

b. identify the amount of gluten contained in common food sources.

c. focus on what can be eaten.

d. not be concerned about insurance coverage for resource services.



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