Brainscape's Knowledge GenomeTM

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


See full index

Year 3 - Clinical Science and Professionalism > Coeliac Disease > Flashcards

Coeliac Disease Flashcards

You may prefer our related Brainscape-certified flashcards:
Biology 101 flashcards
1
Q

What is coeliac disease

A

An inflammatory disorder, primarily affecting the small intestine, caused by exposure to gluten

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

What is another name for coeliac disease

A
  • Gluten-sensitive enteropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the clinical features of coeliac disease

A
  • steatorrhoea
  • bloating
  • malabsorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the histological features of coeliac disease

A
  • chronic inflammatory cell infiltrate in lamina propria
  • increased intra-epithelial lymphocytes
  • subtotal villous atrophy
  • deepening of crypts
  • can cause small intestinal ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the autoantibodies involved in coeliac disease

A
  • Anti transglutaminase antibodies
  • Anti- endomysial antibodies
  • anti-reticulin antibodies
  • anti-gliadin antibodies.

these are all IgA

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

What is gluten

A
  • Gluten is the name of a group of storage proteins that are found in various cereal grains
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is glutens made out of

A
  • prolamins

- glutelins

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

What do prolamins include

A
  • gliadins in wheat
  • hordeins in barley
  • secalins in rye
  • avenins in oats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is true gluten limited to

A 
Proteins from these four grains 
- gliadins
- hordeins 
- secalins 
- avenins 
these are collectively called gluten
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What gluten protein is resistant to digestion in the lumen of the bowel

A
  • alpha gliadin - rich in proline and glutamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is tissue transglutaminase

A
  • This is an enzyme that is active both intracellularly and extracellularly
  • it is produced by a variety of cells including those in the bowel wall
  • it mediates deamidation and transamidation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is deamidation

A

Deamidation is the removal of the side chain amino group from glutamines, converting them to glutamate.

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

What is transamidation

A

Transamidation is the cross-linking of a glutamine from the gliadin peptide to a lysine on the transglutaminase itself.

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

what is endomysium

A

Endomysium is the fine connective tissue just outside a muscle cell.

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

tissue transglutaminase is ….

A

Tissue transglutaminase is associated with the endomysium. - it gets stuck on to the endomysium

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

What is the structure of reticulin

A
  • Reticulin is a fine meshwork of fibres within the lamina propria.
  • Collagen type III is the structural protein
17
Q

What happens in coeliac disease

A
  • peptides from gliadins are difficult to digest in the lumen of the bowel
  • if they leak into the lamina propria they engage the tTG
  • therefore they become deamidated
  • the deamidated version binds strongly into the groove of certain class II HLA molecules (DQ2 and DQ8).
  • this presentation activates T lymphocytes which secrete cytokines and initiate the changes
  • villous atrophy and crypt enlargement may be a response to infection medicated by cytokines
18
Q

who is coeliac present in

A
  • white people of european origin

- twice as common in females as males

19
Q

when does coeliac disease tend to present

A
  • presents in infancy following introduction of gluten
20
Q

What two HLA classes are associated with coeliac disease

A

DQ2 and DQ8

21
Q

What can be used a diagnostic test for coeliacs disease

A
  • antibodies in the blood

- Anti tTG is detected by ELISA = this is the standard test

22
Q

what are the features of coeliac disease

A
  • Growth failure in children
  • Weight loss
  • Anaemia (iron deficiency and folate deficiency)
  • Other vitamin deficiencies, giving osteopenia (vit D) and neurological symptoms (vitamin B)
  • Hyposplenism
  • IgA deficiency
23
Q

What are the neurological symptoms in coeliac disease

A
  • Headache
  • peripheral neuropathy
  • ataxia
  • depression
  • dysthymia
  • anxiety
  • epilepsy
  • abnormalities on MRI scan

can be due to vitamin deficiency

24
Q

Why do you get sore mouth and mouth ulcers in coeliac disease

A
  • gluten on the mucus membrane
25
Q

What is the gold standard for diagnosis of coeliac disease

A

endoscopy and looking at the histology

26
Q

why are type 1 diabetes and autoimmune thyroid disease associated with coeliac disease

A
  • they are also associated DQ2 and DQ8
27
Q

what is dermatitis herpetiformis

A
  • this may occur as part of typical coeliac disease or it may be prominent with less obvious bowel symptoms
  • get multiple intensely pruritic papules and vesicles that occur in grouped arrangements
  • IgA immune complexes are found at dermo-epidermal junction probably bound to gliadin
28
Q

where is dermatitis herpetiformis found

A
  • elbows
  • dorsal forearms
  • knees
  • scalp
  • back
  • buttocks
29
Q

What malignancy is coeliac disease released to

A
  • T cell non-hodgkin lymphoma and carcinomas
30
Q

What are the other possible reasons for wheat intolerance

A
  • Wheat amylase-tryptase inhibitors may excite TLRs these may be a cause of low level inflammation and malaise
  • non coeliac gluten sensitivity - possible by activation of TLRs
  • true wheat allergy caused by IgE
  • FODMAPS - these are short chain carbohydrates, poorly absorbed which may be fermented in the bowel and cause discomfort in bloating
31
Q

What does FODMAPs stand for

A
  • fermentable oligosaccharides, disaccharides, monosaccharides and polyols
32
Q

How do you diagnose coeliac disease

A
  • History.
  • Antibodies (especially anti-transglutaminase IgA antibodies).
  • Biopsy of bowel wall via endoscopy.

These tests should be done when the patient is consuming gluten etc, because autoantibodies and histological changes may disappear while on gluten-free diet.

33
Q

What is the treatment for coeliac disease

A
  • Gluten-free diet. This is difficult because wheat flour is used in many foods.
  • Non-compliance is the most likely reason for failure of treatment
34
Q

Do autoantibodies contribute to the damage that happens in coeliac disease

A

They are IgA, so do not activate complement or opsonise for phagocytosis, but may contribute by trapping antigen, or blocking actions of transglutaminase.

Year 3 - Clinical Science and Professionalism (32 decks)

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