NBME Step 2 CK Form 7 Digestive enzyme deficiency (NBME Answers)

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submitted by ∗yotsubato(1208)

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Lactose Intolerant I guess? Not Celiac. Kind of a bullshit question.

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study_dude_guy Had the same reaction as you and then I learned that AA is a buzz word for lactose intolerance "African American and Asian ethnicities see a 75% - 95% lactose intolerance rate, while northern Europeans have a lower rate at 18% - 26% lactose intolerance" +1

seagull I also choose Celiac's. "BuT RaCe AnD mEdICiNe DoN't Go ToGeThEr". +3

hayayah I think a key part to differentiate between celiac's and lactose intolerance in this question isn't race, it's because of the part that says "he occasionally had diarrhea after meals since 12 years old and then it got worse since starting college". If he had celiac's he'd have GI symptoms (i.e. diarrhea) any time he ate something containing gluten (which would be every single time he had a meal) since he was 12. You'd also see signs of fat or vitamin malabsorption in celiac's patients and other autoimmune symptoms. Whereas in lactose intolerance, it's much more likely he'd once in a while eat a lot of dairy and have his symptoms triggered, and then he starts college and has even less of a well rounded diet and so his symptoms get worse. +4

sahusema I agree with above, but it could just as easily of been CD and people here would have been like "JuSt cAUse He aFricaN AmErICaN DoNT MaEN he CanT haVe CEliaC." +

imtheman I dont understand how the whole college part adds into this? I thought IBD to be honest. Complete BS question. Are we to assume he eats more milk products in college? +

machetebetty My best guess re: college is the primary currency of (pre-Covid) college gatherings: FREE PIZZA. +1

jj375 Also lactose intolerant commonly begins around puberty, so that may be a buzzword. Most people can digest lactose when theyre young and then grow out of that ability and stop making enough lactase! +