Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Jason's GI Block > Coeliac Disease > Flashcards

Coeliac Disease Flashcards

0
Q

What is a hallmark of coeliac disease?

A

remission on a gluten free diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Where do you mainly find gluten?

A

wheat
barley
rye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Coeliac disease definition?

A

immunologically mediated disease in genetically susceptible people driven by gluten antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Prevalence of Coeliac disease?

A

1:100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Coeliac disease has strong association with which genes?

A

HLA-DQ2

HLA-DQ8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When does Coeliac disease manifest?

A

anytime from infancy to late adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what’s the treatment for Coeliac disease?

A

gluten-free diet only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what mainly gets absorbed in the ileum?

A

Vitamin B12 and bile acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are valves of Kerkring?

A

found in duodenum

circumferential rings to increase surface area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how many cells (kgs) do we lose every 2-3 days ?

A

1kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

crypts produce how many cell per day?

A

200-300 cells and climb the villus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how are chylomicrons absorbed?

A

via lymphatics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the ratio for mature to crypt cells?

A

4:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are Paneth cells for?

A

secrete natural defensins (antibiotics) to ward off pathogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is IELs?

A

intraepethelial lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how does the small bowel keep bacteria undercontrol overall?

A

by being in a constant state of controlled mild inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

normally how many CD3/CD8 cells per enterocytes?

A

<25/100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what do you see in advanced Coeliac disease histologically? 3 things

A

total villous atrophy
crypt hyperplasia
intraepithelial lymphocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the ratio of IELs per enterocytes in Coeliac disease?

A

2-3 per enterocyte! More plasma cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what do the microvilli in Coeliac disease look like?

A

distorted

stunted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do you find in Marsh Type I?

A

more than 30 IELs per 100 enterocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do you find in Marsh Type II?

A

elongation and branching of crypts

22
Q

What do you find in Marsh Type III?

A

villi shortened and blunted

villous to crypt ratio is less than 1:4

23
Q

In Marsh Type III what is there a marked increase in?

A

CD8 and T-cells

24
Q

other causes of villous atrophy?

A

tropical sprue
other immunodeficiency
autoimmune enteropathy
drugs: mycophenolate mofetil (used in transplants)

25
Q

Gastro clinical presentations of Coeliac disease?

A 
fatty diarrhea
bloating
cramps
flatulence
malabsorption of nutrients
26
Q

nutrients affected by Coeliac disease?

A

anaemia

vitamin deficiencies

27
Q

bones and general disposition of Coeliac disease?

A

osteoporosis risk
lethargic
migraines

28
Q

people with Coeliac disease have increased prevalence of what else?

A

autoimmune diseases
type I diabetes
thyroiditis

29
Q

Coeliac disease in babies consequences?

A

failure to thrive

30
Q

does Coeliac disease have to be symptomatic?

A

could be asymptomatic

31
Q

age of many new Coeliac disease diagnosis?

A

0-9

30-59

32
Q

4 elements in pathogenesis of Coeliac disease?

A

genetics
environment
T-cells
Gluten

33
Q

what % of people have this gene in Coeliac disease?

A

99.6% have the HLA-DQ2/DQ8

34
Q

how many people who have HLA-DQ2.DQ8 don’t have Coeliac disease?

A

20-30%

35
Q

what does HLA-DQ2/DQ8 do?

A

helps with antigen presentation to T-Cells

36
Q

infant environment for Coeliac disease is avoided how? 3 ways

A

breast feeding
timing of gluten introduction
prevention of infections

37
Q

Where are the CD4 cells that react to gluten?

A

in the small bowel mucosa

38
Q

how do CD4s cause damage in Coeliac disease?

A

IFN-y

39
Q

how is the innate immune response in Coeliac disease?

A

CD8+ and NK cells accumulate in epethelium

40
Q

What proteins from wheat are the culprits for Coeliac disease?

A

Gliadins (alcohol soluble)

Glutenins

41
Q

What does proline do to toxic gluten peptides?

A

proline resists digestion by proteases and increases toxicity

42
Q

so what? high glutamine and proline and resists digestion?

A

it allow to pass through intestinal epithelium intact

43
Q

what happens after intact peptides pass through intestinal epithelium?

A

convert glutamine to negatively charged glutamate

44
Q

what converts glutamine to negatively charged glutamate?

A

tTG

tissue transglutaminase

45
Q

so big deal, there’s negatively charged glutamate?

A

they can bind to HLA-DQ2 T-cell receptor on an APC. effectively making the glutamate an antigen

46
Q

what happens after peptides bound to receptor on APCs??

A

bound to MHCII and start making cytokines

47
Q

what antibodies are made by plasma cells in Coeliac disease?

A

anti-tTG

anti AGA

48
Q

how do the enterocytes apoptose?

A

gliadin activated perforins are released

49
Q

can Coeliac disease give you cancer?

A

T-cell malignancy is possible

get autoreactive IEL

50
Q

Serological dx of Coeliac disease?

A

tTG antibody

deaminated gliadin peptide ( DGP-IgG)

51
Q

what is gold standard for dx of Coeliac disease?

A

small bowel biopsy during gluten exposure

52
Q

how soon to get the diagnosis of Coeliac disease?

A

the earlier the better

long term risks are bad

53
Q

long term risks of undiagnosed Coeliac disease?

A

osteoporosis
autoimmune diseases
cancer

Jason's GI Block (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions