coeliac Flashcards
what alcoholic beverage contains gluten?
beer
does bread have gluten?
yes
does pasta have gluten?
yes
does rice have gluten?
no
does potatoes have gluten?
no
does oats have gluten?
yes
what molecule in gluten is most pathogenic?
gliadin
gliadin is deamidated by what enzyme?
which antibody is made against this enzyme?
tissue transglutaminase
IgA
which genes are almost always implicated in coelaic?
-2
HLA-DQ2 or HLA-DQ8
what is the hallmark of coeliac?
malabsorption
which type of WBC is mainly implicated in coeliac?
lymphocytes
what happens to crypts?
hyperplasia
HLA-DQ2 presents peptides to what immune cell?
T-helper cell
which syndromes are associated with coeliac?
-2
Down’s syndrome
Turner’s syndrome
which autoimmune diseases are associated with coeliac?
-2
T1DM
autoimmune thyroid disease
histology of duodenum in coeliac?
-2
villous atrophy
crypt hyperplasia
why is there pale, floating stool?
fat malabsorption
whys is there watery diarrhoea?
not absorbing water
what skin condition can occur?
why?
dermatitis herpetiformis
IgA deposits in skin
is here high or low levels of circulating IgA in coeliac?
high IgA
hallmark feature of coeliac specifically in children?
asides from malabsorption
child does not grow
what happens to weight?
weight loss
there is no constipation in coeliac.
true or false
false
can you get diarrhoea?
yes
why do coeliac patients need vaccination?
explain why the phenomena in the first answer happens?
hyposplenism
↓Folate, lymphocytes lost through GI we think
coeliac has a lot of complications.
which are caused by vit D loss?
-3
Osteoporosis
Osteomalacia
Hyperparathyroidism
low vitamin B1 can cause what complication in coeliac?
not heart or brain
peripheral neuropathy
list all complications of coeliac?
-13
Dermatitis herpetiformis Malignancy Hyperparathyroidism Vit D loss Osteoporosis Osteomalacia Microcytic anaemia Macrocytic anaemia Peripheral neuropathy Hyposplenism Lactose intolerance infection sub-fertility
why can
Microcytic anaemia
Macrocytic anaemia
happen in coeliac.
↓Fe
↓B12, ↓Folate
character of diarrhoea in coeliac?
foul smelly oily, floating
symptoms of coeliac?
-5
Diarrhoea N&V Abdo pain Fatigue Weight loss
1st line Ix?
positive result in this test?
Coeliac serology
↑↑IgA antibody against TTG*
after initial 1st line Ix what Ix must be done to confirm diagnosis?
positive result on this Ix?
-3
Duodenal biopsy
villi destroyed + crypt hyperplasia + ↑lymphocytes
what must pt be doing leading up to Coeliac serology?
eating gluten
what Ix must be done alongside coeliac serology to stop false negative and why?
total IgA must be measured
a small proportion of pts are IgA deficient
what is the definitive diagnostic pathway?
- two steps
Serology –> biopsy
pt has suspected coeliac and a red vesciular rash.
what is definitive Ix to investigate the rash?
skin biopsy
IgA is deficient.
what blood Ix is done now instead.
IgG antibody against Tissue Transglutaminase or Gliadin
What is nutshell Mx for coeliac?
- 3 things
Gluten free diet
pneumococcal vaccine
diet supplements if needed
treatment for dermatitis herpetiformis?
this drug belongs to which groups of meds?
-2
dapsone
antibiotic
anti-inflammatory
