Celiac Disease

Question 1

inflammation of the small bowel 2/2 ingesting gluten-containing foods

Answer 1

celiac dz

Question 2

common gluten containing foods

Answer 2

wheat

barley

rye

some oats

malt

durum (semolina)

Question 3

what causes the immune rxn in cd

Answer 3

gliaden

Question 4

what predisposes pt’s to cd

Answer 4

genetics

Question 5

mc celiac pt population

Answer 5

caucasian

Northern European ancestry

Question 6

t/f cd is more prevalent than is recognized

Answer 6

t!

Question 7

cd usually presents btw __ to

__ yo

Answer 7

10-40

Question 8

gi sx of cd

Answer 8

diarrhea w. bulky, foul smelling stools

steatorrhea w. floating stool

flatulence

abd distension

Question 9

generalized sx of cd

Answer 9

wt loss

weakness

ftt in peds

Question 10

hematologic sx of cd

Answer 10

iron deficiency anemia

Question 11

osteo sx of cd

Answer 11

osteopenia

osteoporosis

Question 12

often the presenting sx of cd

Answer 12

dermatitis herpetiformis

Question 13

describe dermatitis herpetiformis

Answer 13

grouped pruritic papule and vesicles

Question 14

where is dermatitis herpetiformis mc found

Answer 14

elbows

distal forearms

knees

scalp

back

buttocks

Question 15

other conditions (besides dermatitis herpetiformis) associated w. cd

Answer 15

T1DM

Down’s syndrome

liver dz

menstrual/reproductive issues

Question 16

reproductive issues associated w. cd

Answer 16

recurrent miscarriage

infertility

later menarche

earlier menopause

preterm delivery

low birth weight

Question 17

low probability of cd criteria (3)

Answer 17

no significant sx of malabsorption

no fh cd

Chinese, Japanese, or sub-saharan African descent

Question 18

what testing should low probability pt’s receive

Answer 18

serologic

Question 19

high probability of cd criteria (2)

Answer 19

classic presentation

rf present

Question 20

rf for cd

Answer 20

1st or 2nd degree relative w. confirmed cd

T1DM

AI thyroiditis

down’s syndrome

Turner syndrome

Question 21

testing for high probability of cd pt

Answer 21

serologic testing

PLUS

small bowel bx

Question 22

definitive dx for cd

Answer 22

small bowel bx x 4

Question 23

preferred serologic test for cd

and 2nd line test

Answer 23

1. tTg-IgA → 90-98% sensitivity
2. anti-endomysial (EMA-IgA)

Question 24

if serology is (+) what test should be done

Answer 24

small bowel bx

Question 25

does negative serology r.o cd

Answer 25

no!

Question 26

reasons for negative serology in cd

Answer 26

IgA deficiency

low gluten/gluten free diet

mild dz

Question 27

scalloping

atrophic appearing mucosa w. lots of folds

visible fissures

modularity

prominent submucosal vascular

Answer 27

endoscopic findings of cd

Question 28

cd bx is graded using __

and at least __ bx’s are recommended for dx

Answer 28

marsh-oberhuber classification

4

Question 29

increased intraepithelial lymphocytes

atrophic mucosa w. villi loss

epithelial apoptosis

crypt hyperplasia

Answer 29

bx findings of cd

Question 30

tx for cd

Answer 30

gluten-free diet

RD referral

replete deficiencies

DXA

pneumococcal vaccination

consider screening family

Question 31

what should pt’s know about dermatitis herpetiformis

Answer 31

healing is more delayed than intestinal manifestations

Question 32

cd pt’s have increased risk in overall mortality dt

Answer 32

CVD

malignancy

Question 33

cd also increases risk for what 2 cancers

Answer 33

lymphoma

GI cancers