The protein to which patients are intolerant when they have Celiac Disease is?

Appeared in: NIA - 29 January 2023

Explanation

Celiac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine.
Gluten is a storage protein found in wheat, barley, and rye.
The immune reaction to gluten causes inflammation and flattening of the intestinal villi (villous atrophy), which impairs nutrient absorption and leads to malabsorption.
The only treatment for celiac disease is a strict, lifelong gluten-free diet.

Option B: Casein is the primary protein found in milk. An adverse reaction to it is associated with milk allergy or intolerance, not celiac disease.
Option C: Phenylalanine is an essential amino acid. A metabolic disorder associated with it is Phenylketonuria (PKU), where individuals must follow a low-phenylalanine diet.
Option D: Methionine is an essential amino acid necessary for various metabolic functions in the body but has no direct link to the intolerance seen in celiac disease.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology and dietary triggers of Celiac Disease helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a vital role in educating patients with celiac disease about adhering to a strict, lifelong gluten-free diet, which is the cornerstone of treatment.
Patient education must include skills for reading food labels to identify hidden gluten and strategies to prevent cross-contamination during food preparation.
Nurses should monitor patients for signs of nutritional deficiencies (e.g., iron, vitamin B12, folate, vitamin D) and assess for improvement in symptoms and weight after starting a gluten-free diet.

How to Approach the Question

First, identify the core of the question. It asks to identify the specific protein that triggers the intolerance in Celiac Disease.
This is a factual recall question that relies on your knowledge of common gastrointestinal disorders.
Recall the definition and pathophysiology of Celiac Disease. It is an autoimmune disorder triggered by a specific protein in certain grains.
Evaluate each option based on this knowledge:
Gluten: Known to be the protein in wheat, barley, and rye that triggers celiac disease.
Casein: Associated with milk products.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 2 p. 449-451

E6 Nutrition Kumud Khanna 2e p. 258-260

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 109-111

Practise the full NIA - 29 January 2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.