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Gastrointestinal > Coeliac in adults > Flashcards

Coeliac in adults Flashcards

1
Q

What is coeliac disease?

A

Autoimmune condition caused by sensitivity to the protein gluten

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2
Q

What is the name of the protein in gluten?

A

Gliandin

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3
Q

What is coeliac disease associated with?

A

Family history
HLA-DQ2 allele
Other autoimmune diseases

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4
Q

What alleles is coeliac associated with?

A

HLA-DQ2
HLA-DQ8

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5
Q

What other autoimmune diseases is coeliac associated with?

A

Type 1Diabtes mellitus
Autoimmune thyroid disease
Dermatitis herpetiformis
Irritable bowel syndrome

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6
Q

What are the main presenting features of coelaic in adults?

A

Persistent or unexplained GI symptoms
Prolonged fatigue
Recurrent abdominal pain, cramping
Abdominal distension
Sudden or unexpected weight loss

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7
Q

What are the possible complications of coeliac disease?

A

anaemia
hyposplenism
osteoporosis, osteomalacia
lactose intolerance
enteropathy-associated T-cell lymphoma of small intestine
subfertility

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8
Q

What forms of anaemia can occur in someone with coeliac disease?

A

Iron deficiency
Folate deficiency
B12 deficiency

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9
Q

What are the main GI symptoms of coeliac disease?

A

Abdominal pain
Distension
Nausea and vomiting
Diarrhoea
Steatorrhoea

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10
Q

What bone problems can arise as a result of coeliac?

A

Osteomalacia
Osteoporosis

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11
Q

What form of cancer is stongly associated with coeliac disease?

A

Enteropathy-associated T-cell lymphoma of small intestine

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12
Q

How long does someone need to reintroduce gluten into their diet for before they get tested for coeliac?

A

Reintroduce gluten for at least 6 weeks prior to testing.

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13
Q

What is the first line serological test for coeliac disease?

A

Tissue transglutaminase (TTG) antibodies (IgA)

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14
Q

What other antibody can be tested for in someone with coeliac?

A

endomyseal antibody (IgA)

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15
Q

What is the main diagnostic test for coeliac?

A

Endoscopic intestinal biopsy

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16
Q

Where is the endoscopy done in the small intestine?

A

Usually in the duodenum but can be done in jejunum

17
Q

What findings on endoscopy would support coeliac disease?

A

villous atrophy
crypt hyperplasia
increase in intraepithelial lymphocytes
lamina propria infiltration with lymphocytes

18
Q

What is the main management of coeliac disease?

A

Diet excludign gluten

19
Q

What are gluten containing foods?

A

Wheat
Rye
Barley

20
Q

What are some foods that do NOT contain gluten?

A

rice
potatoes
corn (maize)

21
Q

What do patients wih coeliac disease have a degree of?

A

Functional hyposplenism

22
Q

What do patients with coeliac disease have to get due to the hyposplenism?

A

Pneumococcal vaccine

every 5 years

Gastrointestinal (65 decks)

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