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COELIAC DISEASE Flashcards

1
Q

3 MAIN SOURCES OF GLUTEN?

A

BARLEY, RYE AND WHEAT

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2
Q

TYPICAL SYMPTOMS OF COELIAC DISEASE?

A

DIARRHOEA, STOMACH PAIN, BLOATING, FARTING, INDIGESTION, CONSTIPATION
+ FATIGUE, UNINTENTIONAL WEIGHT LOSS, ITCHY RASH, INFERTILITY, PERIPHERAL NEUROPATHY, ATAXIA…

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3
Q

WHAT IS THE NAME OF THE ITCHY RASH THAT SOMETIMES ACCOMPANIES COELIAC DISEASE?

A

DERMATITIS HERPETIFORMIS

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4
Q

SHOULD ASYMPTOMATIC COELIAC DISEASE BE TREATED? WHY?

A

YES, BECAUSE EVEN IF THERE ARE NO SYMPTOMS THE COMPLICATIONS ARISING FROM DAMAGE TO INTESTINAL VILLI CAN STILL OCCUR (E.G. MALABSOPRTION)

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5
Q

WHAT IS THE MOST COMMON SYMPTOM OF COELIAC DISEASE?

A

DIARRHEA

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6
Q

STEATORRHEA?

A

STOOL CONTAINING ABNORMALLY HIGH AMOUNTS OF FAT; FOUL SMELLING, GREASY, DIFFICULT TO FLUSH

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7
Q

1 IN HOW MANY COELIAC PATIENTS HAVE DERMATITIS HERPETIFORMIS?

A

1/5

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8
Q

HOW IS COELIAC DISEASE DIFFERENT THAN OTHER AUTOIMMUNE DISEASES?

A

THE BODY ATTACKS ITSELF BUT IN RESPONSE TO GLIADIN INSIDE GLUTEN, WHILE MOST OTHER AUTOIMMUNE DISEASES LEAD TO BODY ATTACKING ITS OWN TISSUE WITHOUT OUT AN EXTERNAL STIMULANT

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9
Q

APART FROM BARLEY, RYE AND WHEAT WHAT ELSE CAN BE HARMFUL FOR PEOPLE WITH COELIAC DISEASE IN MORE SEVERE CASES AND WHY?

A

OATS, BECAUSE THEY CONTAIN A PROTEIN AVENIN WHICH IS SIMILAR TO GLUTEN

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10
Q

RISK OF COELIAC DISEASE IF YOU HAVE FAMILY HISTORY OF IT?

A

10%

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11
Q

IF YOU HAVE AN IDENTICAL TWIN WITH COELIAC, CHANCES YOU WILL DEVELOP IT ARE:

A

75%

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12
Q

MUTATIONS IN WHICH GENE ARE ASSOCIATED WITH COELIAC DISEASE?

A

HLA-DQ

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13
Q

HOW MANY PEOPLE IN THE GEN POP HAVE HLA-DQ GENE MUTATIONS?

A

1/3

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14
Q

ENVIRONMENTAL FACTORS IN EARLY CHILDHOOD THAT CAN INCREASE THE LIKELIHOOD OF DEVELOPING COELIAC:

A
  • HAVING DIGESTIVE SYSTEM INFECTION (E.G. ROTAVIRUS)
  • HAVING GLUTEN INTRODUCED TO DIET BEFORE TURNING 3 M.O.
  • NOT BEING BREASTFED WHEN GLUTEN IS INTRODUCED IN DIET
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15
Q

HEALTH CONDITION THAT CAN INCREASE RISK OF DEVELOPING COELIAC (COMMON COMORBIDITIES):

A

T1D, THYROID CONDITIONS, ULCERATIVE COLITIS, NEUROLOGICAL DISORDERS LIKE EPILEPSY, DOWN’S, TURNER’S

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16
Q

AFTER PATIENTS WITH COELIAC SWITCH TO NO-GLUTEN DIET, IT CAN TAKE UP TO HOW LONG FOR THEIR GI TRACT TO HEAL?

A

2 YRS

17
Q

IS GLUTEN ESSENTIAL IN DIET?

A

NO

18
Q

IF A PERSON KEEPS EATING GLUTEN AFTER BEING DIAGNOSED WITH COELIAC, WHAT ARE SOME OF THE LONG TERM RISKS?

A

VERY UNPLEASANT INTESTINAL SYMPTOMS, CANCER, OSTEOPOROSIS, IRON DEFICIENCY ANEMIA, B12 ANEMIA…

19
Q

MAX AMOUNT OF GLUTEN THAT FOOD LABELLED AS ‘GLUTEN FREE’ CAN CONTAIN:

A

20 PARTS PER MILLION (PPM)

20
Q

GLUTEN SHOULDN’T BE GIVEN TO BABIES BEFORE THEY TURN:

A

6 MONTHS

21
Q

GLUTEN CONTENT OF BREAST AND INFANT FORMULA MILK?

A

ALL ARE GLUTEN FREE

22
Q

WHAT IS REFRACTORY COELIAC DISEASE?

A

RARE TYPE OF COELIAC WHERE THE SYMPTOMS PERSIST EVEN IF ONE’S DIET IS COMPLETELY GLUTEN FREE, REASONS ARE UNKNOWN

23
Q

HOW MANY PEOPLE WITH COELIAC HAVE THE REFRACTORY TYPE OF THE DISEASE?

A

1/140

24
Q

HOW MANY PEOPLE IN THE UK ARE AFFECTED BY COELIAC?

A

1%

25
Q

WHICH SEX IS AFFECTED BY COELIAC MORE AND HOW MUCH MORE?

A

WOMEN, 3 TIMES MORE THAN MEN

26
Q

MOST COMMON AGES OF DIGANOSIS OF COELIAC DISEASE:

A 
EARLY CHILDHOOD (BEFORE 1 Y.O.)
OR LATE ADULTHOOD (40-60!!!)
27
Q

WHAT PERCENTAGE OF PEOPLE WITH COELIAC ARE SENSITIVE TO OATS AS WELL?

A

5%

28
Q

TESTING FOR WHICH ANTIBODIES IS A VERY SENSITIVE AND SPECIFIC TESTS FOR DIAGNOSIS OF COELIAC?

A

ANTI-tTG (TISSUE TRANSGLUTAMINASE)

29
Q

WHAT STIMULATES IMMUNE RESPONSE BY T LYMPHOCYTES IN COELIAC DISEASE?

A

TISSUE TRANSGLUTAMINASE (tTG) INSIDE OF ENTERIC CELLS DEAMIDATES GLUTAMINE IN GLIADIN, CONVERTING IT FRO A NEUTRAL TO A NEGATIVELY CHARGED MOLECULE, WHICH WILL STIMULATE THE T CELLS.

29
Q

WHAT STIMULATES IMMUNE RESPONSE BY T LYMPHOCYTES IN COELIAC DISEASE?

A

TISSUE TRANSGLUTAMINASE (tTG) INSIDE OF ENTERIC CELLS DEAMIDATES GLUTAMINE IN GLIADIN, CONVERTING IT FRO A NEUTRAL TO A NEGATIVELY CHARGED MOLECULE, WHICH WILL STIMULATE THE T CELLS.

30
Q

WHICH ANTIBODIES WILL USUALLY BE PRESENT IN PEOPLE WITH COELIAC WHEN THEY CONSUME GLUTEN?

A

ANTIGLIADIN ANTIBODIES, ANTI-tTG ANTIBODIES AND IgA ANTIBODIES TO SMOOTH MUSCLE ENDOMYSIUM

31
Q

WHAT ARE SOME OF THE COMMON SUPPLEMENTATIONS THAT MIGHT BE REQUIRED FOR PATIENTS WITH COELIAC AFTER SWITCHING TO GF DIET?

A

B12, FOLATE, VIT D, IRON, ZINC, CALCIUM, Mg

32
Q

HOW DOES THE NEED FOR CALCIUM IN PEOPLE WITH COELIAC COMPARE TO THAT OF PEOPLE WITHOUT COELIAC?

A

PEOPLE WITH COELIAC HAVE HIGHER REQUIREMENTS FOR CALCIUM (1000 mg per day compared to 700 in gen pop)

33
Q

WHAT IS ONE OF THE FIRST CHANGES IN THE INTESTINE IN PEOPLE WITH COELIAC?

A

INCREASED NUMBER OF INTRAEPITHELIAL LYMPHOCYTES

34
Q

WHAT PERCENTAGE OF PEOPLE WHO MEET DIAGNOSTIC CRITERIA FOR IBS DON’T HAVE A FORMAL DIAGNOSIS?

A

CCA 40%

35
Q

WHAT IS THE PERCENTAGE OF PEOPLE WITH IBS (PREVALENCE INTERNATIONALLY)?

A

10-15%

36
Q

DOMINANT POPULATION WITH IBS IN TERMS OF SEX AND AGE?

A

WOMEN

YOUNGER THAN 50 Y.O.

37
Q

HOW IS IBS DEFINED ACCORDING TO THE ROME IV CRITERIA?

A

RECURRENT ABDOMINAL PAIN AT LEAST ONE DAY A WEEK IN THE LAST 3 MONTHS ASSOCIATED WITH AT LEAST TWO OF THE FOLLOWING:

  • RELATED TO DEFECATION
  • ASSOCIATED WITH CHANGE IN STOOL FREQUENCY
  • ASSOCIATED WITH CHANGE IN STOOL FORM/APPEREANCE
38
Q

MANAGEMENT STRATEGIES FOR IBS:

A
  • EXCLUSION OF GAS PRODUCING FOODS
  • LOW FODMAP DIET
  • GLUTEN AND LACTOSE AVOIDANCE IN SOME CASES
  • AVOIDANCE OF LARGE MEALS
  • REGULAR MEAL PATTERN
  • REDUCED INTAKE OF FAT, INSOLUBLE FIBRES, CAFFEINE

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