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Z Year3 Gastro Conditions > Coeliac Disease > Flashcards

Coeliac Disease Flashcards

1
Q

What is coeliac disease?

A

systemic autoimmune disease triggered by dietary gluten peptides found in wheat, rye, barley, and related grains - GLIADIN

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2
Q

How common is coeliac disease?

A

affecting up to 1% of the general population, and may present at any age

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3
Q

What are the risk factors for coeliac disease?

A
  1. family history of coeliac disease
  2. immunoglobulin A deficiency
  3. type 1 diabetes
  4. autoimmune thyroid disease
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4
Q

What are the gastro symptoms of coeliac disease?

A
  1. Diarrhoea
  2. Bloating
  3. Stinky stools
  4. Abdominal pain/discomfort
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5
Q

What are the general symptoms for coeliac disease?

A
  1. IgA deficiency
  2. Anaemia
  3. family history
  4. Osteopenia/osteoperosis
  5. Fatigue
  6. Weight loss
  7. Failure to thrive
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6
Q

What are the potential differential diagnosis for coeliac disease?

A
  1. Peptic duodenitis
  2. Crohn’s disease
  3. Giardiasis
  4. Small-intestinal bacterial overgrowth
  5. Post-gastroenteritis
  6. Eosinophilic enteritis
  7. Tropical sprue
  8. Common variable immune deficiency (CVID) and other immunodeficiency states
  9. Graft-versus-host disease (GVHD)
  10. Autoimmune enteropathy
  11. Drug-induced enteropathy
  12. Non-coeliac gluten sensitivity
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7
Q

What bloods would you do for suspected coeliac disease?

A
  1. FBC and blood smear:
  2. immunoglobulin A-tissue transglutaminase (IgA-tTG):
  3. endomysial antibody (EMA):
  4. skin biopsy:
  5. IgG DGP (deamidated gliadin peptide) or IgA/IgG DGP
  6. IgG-tTG
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8
Q

What would the FBC and blood smear say in coeliac disease?

A
  • low Hb

- microcytic hypochromic red cells

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9
Q

What would the IgA-tTG say in coeliac disease?

A

titre above normal range for laboratory

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10
Q

What would the EMA be like in coeliac disease?

A

elevated titre

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11
Q

What would the skin biopsy be like in coeliac disease?

A

granular deposits of IgA at the dermal papillae of lesional and perilesional skin by direct immunofluorescence

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12
Q

What would the IgG DGP and IgG-tTG show in coeliac disease?

A

elevated titre

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13
Q

What other tests would you run for suspected coeliac disease?

A
  1. Small bowel endoscopy

2. Small bowel histology

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14
Q

What would small bowel endoscopy show in coeliac disease?

A
  • atrophy and scalloping of mucosal folds

- nodularity and mosaic pattern of mucosa

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15
Q

What would small bowel histology show in coeliac disease?

A
  1. presence of intra-epithelial lymphocytes
  2. villous atrophy
  3. crypt hyperplasia
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16
Q

What criteria is used for the histology in coeliac disease?

A

Marsh criteria

17
Q

What is the 1st line treatment for coeliac disease?

A

gluten free diet

18
Q

What else would you suggest for coeliac disease treatment?

A

vitamin and mineral supplementation

19
Q

What is the 1st line treatment for coeliac disease that has failure to respond to therapy/refractory coeliac disease?

A

referral to dietician or gastroenterologist

20
Q

How does coeliac crisis present?

A
  1. hypovolaemia
  2. severe watery diarrhoea
  3. acidosis
  4. hypocalcaemia
  5. hypoalbuminaemia
21
Q

What is the first line treatment for a coeliac crisis and adjunct?

A
  • 1st line: rehydration + correction of electrolyte abnormalities
  • Adjunct: corticosteroid
22
Q

What are the possible complications of coeliac disease?

A
  1. osteoperosis/osteopenia
  2. dermatitis herpetiformis
  3. malignancy
  4. idiopathic recurrent acute pancreatitis/ chronic pancreatitis
  5. pneumococcal infection
  6. non-response to hep B virus vaccine
23
Q

What is the prognosis of coeliac disease like?

A

Good - Fewer than 1% of patients can be expected to develop refractory coeliac disease

24
Q

What does coeliac disease result in histologically?

A
  1. Villous atrophy
  2. Hypertrophy of intestinal crypts
  3. Increased lymphocytes in epithelium and lamina propria
25
Q

What is the epi of coeliac?

A
  1. F>M

2. Western countries

26
Q

What is a skin condition assoicated with coleiac?

A

Dermatitis Herpetiformis

27
Q

Where can you find Dermatitis Herpetiformis?

A
  • extensor surfaces, face, scalp and neck
  • elbows
  • Description: bilateral itchy vesicles and plaques

Z Year3 Gastro Conditions (48 decks)

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