Coealic Disease

Question 1

What is coeliac disease?

Answer 1

A chronic immune-mediated systemic disorder in genetically predisposed people, triggered by exposure to dietary gluten leading to small bowel damage and malabsorption

Question 2

Coeliac hypersensitivity type

Answer 2

Type IV

Question 3

Coeliac Sereology

Answer 3

Anti-TTG IgA (min. 6/52 of gluten diet before test)

Question 4

Gold standard diagnostic for Coealiac

Answer 4

OGD and duodenal/jejunal Bx

Question 5

Coeliac GI Sx

Answer 5

Abdominal pain
Distension
Nausea and vomiting
Diarrhoea
Steatorrhoea

Question 6

Coeliac clinical features

Answer 6

1. Pallor (secondary to anaemia)
2. Vitamin def. from malabsorption (bruising from vit K def.)
3. Abdo distention (bloating)

Question 7

Coeliac derm manifestation

Answer 7

Dermatitis herpetiformis (pruritic papulovesicular lesions over the buttocks and extensor surfaces of the arms, legs, and trunk)

Question 8

Coealic exclusion lab tests

Answer 8

1. Stool MC&S: to exclude infectious cause
2. Faecal calprotectin: to exclude IBD

Question 9

Coeliac histological findings

Answer 9

1. sub-total villous atrophy
2. crypt hyperplasia
3. intra-epithelial lymphocytes

Question 10

Coeliac Mx

Answer 10

1. lifelong adherance to a gluten-free diet
2. Annual monitoring for gluten adhearance
3. Annual flu vaccine
4. Pneumococcal vaccine

Question 11

Dermatitis Herpetiformis Tx

Answer 11

Dapsone