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GI Year 2 > Coeliac and nutrition > Flashcards

Coeliac and nutrition Flashcards

1
Q

What’s a S+S of coeliac disease?

A

Dermatitis herpetiformis

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2
Q

How does dermatitis herpetiformis present?

A 
Cutaneously 
Blistering
Intensely itchy 
Scalp, shoulders, elbows, knees
IgA deposit in skin
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3
Q

Which antibody test is most reliable and why?

A

IgG as some people just don’t make IgA so an IgA serology wouldn’t work for them

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4
Q

What’s the gold standard Ix for coeliac?

A 
Distal duodenal biopsy
Looks for villus atrophy 
-partial 
-subtotal
-total
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5
Q

Tx for coeliac?

A

Withdraw gluten

Must refer to dietician

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6
Q

Where is gliadin found?

A

Absent from rice and maize

Not found in oats but most oats in contaminated with wheat

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7
Q

Conditions associated with coeliac

A 
Dermatitis herpetiformis 
IDDM
-insulin dependent diabetes mellitus
Autoimmune thyroid disease
Autoimmune hepatitis 
Primary biliary cholangitis
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8
Q

Complications arising from coeliac disease

A 
Refractory coeliac disease 
-symptoms despite gluten free diet
Small bowel lymphoma 
Oesophageal carcinoma
Colon carcinoma
Small bowel adenocarcinoma
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9
Q

Other small bowel disease which may cause malabsorption

A

Can be due to inflammation or infection

Inflammation:

  • coeliac
  • crohns

Infection:

  • tropical spruce
  • -folate deficiency
  • HIV
  • giardia lamblia
  • whipple’s disease
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10
Q

What’s giardia lamblia, where is it found, and what’s the Tx?

A

Unicellular parasite
Contaminated water is where its found
Metronidazole

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11
Q

RF for whipple’s disease

A

Middle aged men

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12
Q

S+S for whipple’s disease

A

Skin, brain, joint and cardiac effects
Weight loss
Malabsorption
Abdominal pain

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13
Q

What is the causative organism in whipple’s disease?

A

Tropheryma whippelli

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14
Q

Tx for small bowel bacterial overgrowth

A

each for 2 weeks
Metronizadole
Tetracycline
Amoxicillin

Vitamin and nutrition supplements

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15
Q

Ix for small bowel bacterial overgrowth

A

H2 breath test

Can be unreliable

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16
Q

Consequences of antibiotic treatment?

A

Decreased diversity
Opportunity for pathogen colonisation
Results in a pathogen dominated colonisation
Recurring C. difficile infections

17
Q

What’re probiotics?

A

Live microorganisms which can have health benefits

18
Q

In what ways do probiotics improve gut function?

A

Stool bulking, faster transit
Management of IBD
Reduces the risk of colon cancer

19
Q

Why do probiotics reduce the risk of colon cancer?

A

Reduce DNA damage and cell proliferation

Calcium absorption and bone health

20
Q

Mechanisms of probiotic actions

A 
Competition
Bioconversions
Production of vitamins 
Direct antagonisms
Barrier function 
Reduce inflammation 
Immune stimulation
21
Q

In which % of cases and in which type of infection is FMT effective?

A

90

C. Difficile

22
Q

How is the basal metabolic rate measured?

A

Direct calorimetery

23
Q

What does the basal metabolic rate depend on?

A

Lean body mass
Activity
Illness

24
Q

What is the term for undernourishment which causes a child’s weight to be much lower than it should be for its age?

A

Marasmus

25
Q

What’s stage one of MUST and its method of scoring?

A

BMI
Score <20=1
Score <18=2

26
Q

What’s step 2 of MUST?

A

Unintentional weight loss in the last 30% months
Yes-10%=2
Yes-5%=1

27
Q

Step 3 of MUST

A

Has the patient eaten in the last 5 days?

Yes=2

28
Q

What score on MUST must you achieve to be at a suggested risk of undernutrition?

A

2

29
Q

What is the Tx for a MUST score of 1?

A

Supplements and watch

30
Q

What odes a MUST score of 0 mean?

A

Subject patient to monitoring

31
Q

What is malnutrition associated with?

A

Illness
Social isolation
Age
Socially vulnerable groups

32
Q

Clinical consequences of malnutrition?

A 
Impaired immune response 
Reduced muscle strength 
Impaired wound healing 
Impaired psycho-social function 
Impaired recovery from illness and surgery 
Poorer outcomes
33
Q

What’re the 3 classifications of aetiologies for malnutrition?

A

Appetite failure
Access failure
Intestinal failure

34
Q

2 examples of appetite failure?

A

Anorexia nervosa

Disease related

35
Q

4 examples of access failure

A

Teeth
Stroke
Cancer of the head and neck
Head injury

36
Q

What causes intestinal failure malnutrition?

A

Reduction in functioning gut mass below minimal amount necessary for adequate absorption of nutrients

GI Year 2 (22 decks)

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