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FIRST PUBLISH OCTOBER 2024
GI block i-Human cases Exam Study Guide Solutions
Clues about the patient's stool for Ms. Schilling - Ans:✔✔-If floating high fat content, if watery the colon
is not able to absorb water, urgency also indicates more water in stool
Role of the gallbladder for Ms. Schilling - Ans:✔✔-Patient had gallstones, gallbladder is responsible for
making bile so could be recurrence of gallstones. Gallstones can be stuck in gallbladder and often in the
sphincter of Oddi area. This could be the reason for her pain.
Differential diagnoses for Ms. Schilling - Ans:✔✔-Gluten sensitivity, gallstones, irritable bowel syndrome,
pancreatitis maybe (but usually related to alcohol use), substance abuse--possibly laxative abuse in this
case, ulcerative colitis, anxiety/stress, cancer, giardiasis (from contaminated water)
Significant findings for Ms. Schilling - Ans:✔✔-Low albumin (protein) levels (malabsorption), gall stones
were present but no signs of inflammation, macrocytic anemia due to low vitamin B12 (malabsorption),
positive for glandin IgA and glandin IgG antibodies (Celiac), positive endomysial Ab screen (Celiac)
Findings which support Ms. Schilling's diagnosis - Ans:✔✔-Diarrhea (with fecal fat) associated with
abdominal pain worsened with wheat products, weight loss due to malabsorption, positive antibodies
for gliadin and endomysium, to confirm diagnosis obtain biopsy of small intestine via endoscopy (will
show flat mucosal villi surface with plasmacytic infiltration of subepithelial region), coagulopathy
(deficiencies)
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FIRST PUBLISH OCTOBER 2024
GI block i-Human cases Exam Study Guide Solutions
Clues about the patient's stool for Ms. Schilling - Ans:✔✔-If floating high fat content, if watery the colon
is not able to absorb water, urgency also indicates more water in stool
Role of the gallbladder for Ms. Schilling - Ans:✔✔-Patient had gallstones, gallbladder is responsible for
making bile so could be recurrence of gallstones. Gallstones can be stuck in gallbladder and often in the
sphincter of Oddi area. This could be the reason for her pain.
Differential diagnoses for Ms. Schilling - Ans:✔✔-Gluten sensitivity, gallstones, irritable bowel syndrome,
pancreatitis maybe (but usually related to alcohol use), substance abuse--possibly laxative abuse in this
case, ulcerative colitis, anxiety/stress, cancer, giardiasis (from contaminated water)
Significant findings for Ms. Schilling - Ans:✔✔-Low albumin (protein) levels (malabsorption), gall stones
were present but no signs of inflammation, macrocytic anemia due to low vitamin B12 (malabsorption),
positive for glandin IgA and glandin IgG antibodies (Celiac), positive endomysial Ab screen (Celiac)
Findings which support Ms. Schilling's diagnosis - Ans:✔✔-Diarrhea (with fecal fat) associated with
abdominal pain worsened with wheat products, weight loss due to malabsorption, positive antibodies
for gliadin and endomysium, to confirm diagnosis obtain biopsy of small intestine via endoscopy (will
show flat mucosal villi surface with plasmacytic infiltration of subepithelial region), coagulopathy
(deficiencies)
Page 1/3
