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Upper GI Tract > Coeliac Disease > Flashcards

Coeliac Disease Flashcards

1
Q

Coeliac occurs at what age?

A

Any age, but mainly infancy and old age

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2
Q

What are the genes involved in coeliac?

A

HLA-DQ2 (95%)

DQ8

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3
Q

What is the pathophysiology of coeliac?

A

CD8+ mediated response to gliadin in gluten

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4
Q

What is the pneumonic for the presentation of Coeliac?

A

GLIAD

GI malabsorption
Lymphoma and Carcinoma
Immune associations (IgA deficiency)
Anaemia
Dermatological (dermatitis herpetiformis + aphthous ulcers)
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5
Q

With what symptoms should you always suspect Coeliac? (3)

A

diarrhoea, weight loss, anaemia

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6
Q

What can malabsorption of carbs cause? (4)

A

Nausea, diarrhoea, vomiting
Abdo distension + colic
Flatus
Weight loss

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7
Q

What can malabsorption of fats cause? (2)

A

Steatorrhoea

Hyperoxaluria -> renal stones

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8
Q

What can malabsorption of protein cause?

A

Protein-losing enteropathy if severe

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9
Q

What can malabsorption of folate and iron cause?

A

iron-deficiency anaemia

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10
Q

What can malabsorption of Vit D and Ca cause?

A

Bone pain

Osteoporosis

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11
Q

What can malabsorption of Vit K cause?

A

petechiae

increased INR

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12
Q

What can malabsorption of Vitamin B2 (riboflavin) cause?

A

angular stomatitis

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13
Q

What can malabsorption of Vitamin B1 and B6 cause?

A

polyneuropathy

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14
Q

What are dermatitis herpetiformis?

A

Occur in 20% of coeliacs
Symmetrical, itchy vesicles on extensor surfaces, esp elbows
Biopsy = granular deposition of IgA

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15
Q

What would you expect to see on LFT’s in coeliac disease?

A

decreased albumin

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16
Q

What blood tests would you perform for coeliac? (6)

A

FBC, LFT, INR, Vit D and bone, red cell folate, serum B12

17
Q

What immunological tests would you run for a suspected coeliac?
(ie what autoantibodies would you test for?) (4)

A

Anti-endomysial (95% specificity)
Anti-tissue transglutaminase
Anti-reticulin
Anti-gliadin

18
Q

What procedure would you perform to diagnose coeliac?

A

OGD + duodenal biopsy

19
Q

What will a biopsy show in coeliac?

A

subtotal villous atrophy
crypt hyperplasia
intra-epithelial lymphocytes

20
Q 
Which of these foods should be avoided in coeliac?
Barley
Rye
Rice
Oats
Wheat
Maize
Soya
A

Barley
Rye
Oats
Wheat

Rice, Maize and Soya are fine

21
Q

Rx for coeliac?

A

Gluten free diet

Dapsone for dermatitis herpetiformis

Upper GI Tract (17 decks)

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