Coeliac Disease and Pernicious Anaemia Flashcards

1
Q

what diseases affect the small bowel?

A

coeliac disease, pernicious anaemia, Crohn’s disease, infections, tumours

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2
Q

what is coeliac disease?

A

sensitivity to alpha gliaden component of gluten

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3
Q

what is the main cereal for coeliacs to avoid?

A

wheat

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4
Q

what are the symptoms of coeliac disease

A

depression/anxiety, fatigue/tiredness, bloating, lack of motivation, brain fog, headaches, difficulty losing weight, digesting issues, skin issues, irritability

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5
Q

what is the aetiology of coeliac disease?

A

genetic susceptibility, environmental trigger, consumption of gluten, T lymphocytes damage mucosal tissue, villous atrophy

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6
Q

why does coeliac disease occur?

A

due to gluten alpha gliaden component passing through the bowel which causes an immune reaction.

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7
Q

what happens as the projections of the villi are lost?

A

surface area for absorption is also lost

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8
Q

what are the effect of jejunal atrophy?

A

growth failure, oral ulceration

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9
Q

what are the classic symptoms of coeliac disease?

A

weight loss, lassitude, weakness, abdominal pain/swelling, diarrhoea, oral aphthae, tongue papillary loss, steatorrhoea, dysphagia

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10
Q

what are the malabsoprtion issues for coeliac disease?

A

iron, folate, vitamin B12, fat

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11
Q

what investigations are used for coeliac disease?

A

autoantibody test, jejunal biopsy, faecal fat, haematinics

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12
Q

what is the autoantibody test used for coeliac disease?

A

serum transglutaminase (TTG)

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13
Q

what happens to faecal fat with coeliac disease?

A

it is increased with malabsorption

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14
Q

if a coeliac has a gluten free diet what is the outcome?

A

reversal of jejunal atrophy, improved well-being, reduced risk of lymphoma

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15
Q

what skin disease is associated with coeliac disease?

A

dermatitis herpetiformis

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16
Q

what skin conditions are seen with coeliac disease?

A

oral ulceration and blisters, granular IgA deposit in skin and mucosa - itchy and blisters

17
Q

what is pernicious anaemia caused by?

A

vitamin B12 deficiency, disease of gastric parietal cells, inflammatory bowel disease of terminal ileum, bowel cancer at ileo-coecal junction

18
Q

what does vitamin B12 need to be absorbed?

A

intrinsic factor from gastric parietal cells, functioning of a discrete area of the terminal ileum

19
Q

what is the best test for pernicious anaemia?

A

the antibody test

20
Q

what is the patients responsibility for vitamin B12 deficiency treatment?

A

a diet with an adequate quantity of vitamin B12, taking vitamin B12 supplements if prescribed

21
Q

what is the medical responsibility for vitamin B12 deficiency treatment?

A

arrange IM injections of vitamin B12 if GI absorption is not possible