Gastro Flashcards
WHAT IS THE DEFINITION OF TODDLER DIARRHOEA?
CHRONIC NON SPECIFIC DIAHRRHOEA
STOOLS OF VARYING CONSISTENCY
ITS THE MOST COMMON CAUSE OF CHRONIC DIARRHOEA IN PRESCHOOL CHILDREN
WHY DOES TODDLER DIARRHOEA OCCUR?
AN UNDERLYING DELAY IN MATURATION OF THE INTESTINE LEADING TO ‘INTESTINAL HURRY’
IS THERE MALABSORBTION OR FAILURE TO THRIVE IN TODDLERS DIAHRROEA
NO !
HOW WOULD YOU MANAGE TODDLERS DIARRHOEA?
REASURRANCE AND WATCH AND WAIT (FOR SIGNS OF MALNUTRITION)
A HIGH FAT DIET
A HIGH FIBER DIET
WHAT IS NOT RECCOMENDED IN LARGE AMOUNTS IN A DIET FOR TODDLERS DIARRHOEA AND WHY
FRUIT - CONTAINS LARGE AMOUNTS OF SORBITOL
WHY IS A HIGH FAT DIET RECCOMENDED IN TODDLERS DIAHORREA?
FAT SLOWS GUT TRANSIT
WHAT IS THE DEFINITION OF RECURRANT ABDO PAIN
PAIN SEVERE ENOUGH TO DISRUPT DAILY ACTIVITIES
LASTING OVER 3 MONTHS
HOW WOULD YO INVESTIGATE RECURRANT ABDO PAIN?
WHAT SIGN WOULD YOU BE CONCERED OF?
COMPREHENSIVE HISTORY AND EXAMINATION LOOKING FOR PERIANAL FISSURES (IBD)
START GROWTH CHARTS
URINE CULTURES
ULTRASOUND (LOOKING FIR GALLSTONES/OBSTRUCTION)
WHAT IS THE MANAGEMENT FOR RECURRANT ABDO PAIN
IF CAUSE FOUND TREAT THAT
OTHERWISE CHILDHOOD IBS
REASUURE AND EDUCATE
DEFINE IBS
ALTERED GASTRIC MOTILITY AND ABNORMAL SENSATON OF INTRA ABDOMINAL EVENTS
HAS PHYSICAL AND PSYCHOLOGICAL FACTORS
WHAT ARE THE SYMPTOMS OF IBS
ABDO PAIN RELIEVED BY DEFICATION
EXPLOSIVE LOOSE MUCUSY STOOLS
BLOATING
FEELING OF INCOMPLETE DEFICATION
ALTERNATING CONSTIPATION
HOW WOULD OU DIAGNOSE IBS
HISTORY
LACK OF PHYSICAL FINDINGS
WHAT ARE D.D OF IBS AND WHAT INVESTIGATIONS ARE USED TO CONFIRM THESE
US - GALLSTONES AND OBSTRUCTIONS
FLEXIBLE SIGMOSTCOPY / COLONOSCOPY - IBD
HOW WOULD YOU MANAGE IBS
SMALL FREQUENT FEEDS
LOW FAT HIGH FIBER DIET
PROBIOTICS
LAXATIVES IE FIBROGEL
CIMETROPIUM (AN ANTISPASMODIC)
CBT
SSRI
WHAT PATHOGENS CAN CAUSE GASTROENTERITIS
E COLI
SHIGELLA
CHOLERA
CAMYLOBACTER JEJUNI
ADENOVIRUS
ROTAVIRUS
NOROVIRUS
WHAT IS A CLASSIC SIGN THAT THE GASTROENTERITIS IS BACTERIAL
BLOODY STOOLS
WHAT IS A CLASSIC SIGN THAT THE GASTROENTERITIS IS CAMPYLOBACTER JEJUNI
SEVERE ABDO PAIN
WHAT IS A CLASSIC SIGN THAT THE GASTROENTERITIS IS SHIGELLA
HIGH FEVER
PUS (AND BLOOD) IN STOOLS
WHAT IS A CLASSIC SIGN THAT THE GASTROENTERITIS IS CHOLERA/E COLI
PROFUSE DIAHORREA
WHAT ARE GENERIC SYMPTOMS OF GASTROENTERITIS
WATERY LOOSE STOOLS
VOMITING
DEHYDRATION
+/- SHOCK
HOW WOULD YOU DIAGNOSE AND ASSES GASTROENTERITIS
ASSESS DEHYDRATION
BLOODS: FBC, SODIUM (U+E)
STOOL AND BLOOD CULTURES
HOW WOULD YOU MANAGE GASTROENTERITIS
ENCOURAGE FLUID INTAKE + ORS
IF NEEDED IV FLUIDS (MAINTENENCE)
+/- NG TUBE
ZINC IF MALNURISHED
ANTI DIARRHOEAL (LOPERAMIDE)
ABX IF NEEDED
FULL FAT MILK AND SOLIDS AFTER REHYDRATION
HOW WOULD YOU AVOID CEREBRAL OEDEMA
FLUIDS OVER 48 HRS
SODIUM REPLACEMENT (HYPONATREMIC)
WHAT IS A CONTRAINDICATION OF ANTI DIAHORREAL
POSITIVE CULTURES ONLY GIVE AFTER OR IF CULTURES ARE CLEAN
WHAT ARE INDICATIONS OF AN ANTIBIOTIC
CHOLERA
SHIGELLA
C. DIFF
IMMUNOCOMPRIMISED (OR MALNURISHED)
WHAT CAN BE CONSEQUENCES OF GASTROENTERITIS ONCE IT HAS PASSED
TEMPORARY LACTOSE INTOLERANCE
WHAT IS INTRASUCCEPTION
AN INVAGINATION OF THE PROXIMAL BOWEL INTO DISTAL SEGMENT
WHERE DOES INTRACUEPPTION NORMALLY OCCUR
THROUGH ILEOCOECAL VALVE
ILLEUM -> CAECUM
WHAT IS THE PRESENTATION OF INTRACUSSEPTION
VOMITING (+BILE IF SEVERE)
RED CURRENT JELLY STOOLS
PAROXYSMAL SEVERE COLICKY PAIN
PERIOD OF RECOVERY WITH THEN A PERIOD OF LETHARGY
PALLOR AROUND MOUTH
AT WHAT AGE DIES INTRACUSSEPTION USUALLY OCCUR
3M -> 2Y
HOW WOULD YOU DIAGNOSE INTRUCUSSEPTION
X RAY - ABDOMINAL
US - ABDOMINAL
HOW WOULD YOU TREAT INTRUCUSSEPTION
FLUID RESUS
RECTAL AIR INFLATION
SURGERY
WHAT SIGNIFICANT ADVERSE EVENTS CAN OCCUR DUE TO INTRACUSSEPTION
VENOUS OBSTRUCTION CAUSING BLEEDING AND STRETCHING OF GASTRIC MUCOSA CAUSING FLUID LOSS AND PERFORATION
WHAT IS THE DEFINITION OF BOWEL ATRESIA
ANY CONGENITAL MALFORMATION OF THE INTESTINE CAUSING BOWEL OBSTRUCTION
DESCRIBE THE LOCATION CLASSIFICATIONS OF BOWEL ATRESIA
DUODENAL
JEJUNAL
ILLEAL
COLON
WHAT ARE THE MALFORMATION CLASSIFICATIONS OF BOWEL ATRESIA
WEB
- COMPLETE
- INCOMPLETE
BLIND END COMPLETE
MESENTERIC GAP
APPLE PEEL SYNDROME
MULTIPLE BLOCKAGES
WHAT CAUSES BOWEL ATRESIA
VASULAR EVENT EN UTERO CAUSING DECREASED PERFUSION AND TISSUE DEATH
WHAT IS THE PRESENTATION OF BOWEL ATRESIA
VOMITING (+BILE)
SWOLLEN, SOFT ABDOMEN
NO MECONIUM
HOW WOULD YOU DIAGNOSE BOWEL ATRESIA
CAN BE DIAGNOSED EN UTERO VIA US
(INDICATED IN POLYHYDRAMNIOUS)
X RAY (+- CONTRAST +- ENEMA)
LAPROSCOPY
HOW WOULD YOU TREAT BOWEL ATRESIA
LAPROSTOMY WITH A TEMPORARY STOMA BAG TO ALLOW FOR HEALING
WHAT IS APPENDICITIS
ACUTE APPENDICITIS IS A COMMON CAUSE OF ABDOMINAL PAIN IN CHILDREN
AT WHAT AGE DIES APPENDICITIS USUALLY OCCUR
3Y <
WHAT IS THE PRESENTATION OF APPENDICITIS IN OLDER CHILDREN
ABDO PAIN
- CENTRAL -> R ILLIAC FOSSA
- TENDERNESS AT MCBURNEYS POINT
- WORSE ON COUGHING AND MOVEMENT
ANOREXIA
VOMITING
FLUSHED FACE
ORAL FETOR
WHAT IS THE PRESENTATION OF APPENDICITIS IN YOUNGER CHILDREN
IRRITABLE
GENERALISED PRESENTATION
WHAT SIGN CAN BE FORUND ON X RAY OF APPENDICITIS IN YOUNGER CHILDREN
FAECOLITHS
WHAT IS A SERIOUS COMLICATION OF APPENDICITIS IN YOUNGER CHILDREN AND WHY DOES IT OCCUR
PERFORATION
OMENTUM IS LESS WELL DEVELOPED
HOW WOULD YOU DIAGNOSE APPENDICITIS
US
- INCREASED THICKNESS OF APPENDIX
- ABCESSES AND MASSES
X RAY
- FAECOLITHS
BLOODS
- NEURTOPHILLIA
URINE DIPSTICK
- WBC AND NITRATES
LAPSROSCOPY
WHAT IS THE CLASSIC SIGN OF A RETROCELE APPENDIX
ABSENT GUARDING
WHAT IS THE DIFFEENCE IN PRESENTATION OF A PELVIC APPENDIX
FEW ABDO SIGNS
PAIN IN PELVIC AREA
HOW DO YOU MANAGE APPENDICITIS
WHEN WOULD YOUR MANAGEMENT BE DIFFERENT AND HOW WOULD YOU MANAGE THAT APPENDICITIS
ABX AND LAPEROTOMY
UNLESS THERES A PALPABLE MASS WITH NO GENERALISED PERITONITIS THEN ONLY GIVE IV ABX
WHAT IS HIRSPRIGS
BIRTH DEFECT RESULTING IN A LACK OF INNERVATION OF THE INTESTINES
WHAT GENETIC DIFECT IS HIRSPRUNGS ASSOCIATED WITH
DOWNS
WHAT HAPPENS EN UTERO FOR HISPRUNGS TO DEVELOP
NEURAL CREST CELLS DONT MIGRATE TO INNERVATE INTESTINE MEANING THERE IS A LACK OF NERVE PLEXUSES
WHAT PART OF THE INTESTINE IS MOST COMMONLY AFFECTED IN HIRSPRUNGS
RECTOSIGMOID COLON
WHICH NERVE PLEXUS IS AFFECTED
MESENTERIC NERVE PLEXUS
HOW DO YOU DIAGNOSE HIRSPRUNGS
BARIUM ENEMA
SUCTION BIOPSY
HYSOLOGICAL SAMPLE
WHAT IS THE PRESENTATION OF HIRSPRUNGS
VOMITING
CONSTIPATION
ABDO PAIN
NO FLATULENCE
NO MECONIUM IN FIRST 24HRS AND GROSS ABDO DISTENSION
HOW DO YOU MANAGE HIRSPUNGS
SURGERY
- REMOVAL OF ABNORMAL BOWEL AND INSERTION OF COLONOSTOMY BAG
WHEN CHILD IS OLDER A NEW FUNCTIONAL COLON IS CREATED
WHAT IS COLIC
A SYMTOM COMPLEX WHICH OCCURS IN FIRST FEW MONTHS OF LIFE
WHAT IS THE PRESENTATION OF CHOLIC
PAROXYSMAL INCONSOLABLE CRYING
DRAWING OF KNEES
PASSAGE OF XS FLATULANCE
WORSE IN EVENINGS
WHAT ARE RISKS OF CHOLIC
INCREASE RISK OF NON ACCIDENTAL INJURY AND POSTNATAL DEPRESSION
HOW DO YOU TREAT CHOLIC
REASSURE
SUPPORT
WHEN DOES CHOLIC USUALLY RESOLVE
4M
IF CHOLIC PERSISTS WHAT COULD THAT MEAN
GORD
COWS MILK PROETIN ALLERGY
WHAT IS THE INVESTIGATION OF COWS MILK PROETIN ALLERGY
2 WEEKS TRIAL OF WHEN HYDROLYSATE FORMULA
FOLLOWED BY TRIAL OF ANTI REFLEX MEDS
WHAT IS MECKELS DIVERTICULUM
A REMENENT OF THE VITELLOUS INTESTINAL DUCT
CONTAINING ECTOPIC GASTRIC MUCOSA OR PANCREATIC TISSUE
WHAT IS THE PRESENTATION OF MECKELS DIVERTICULUM
USUALLY ASYMPTOMIAC
BUT:
- RECTAL BLEEDING WHICH CAN BE SEVERE AND LIFE THREATNING
- INTRUCUSSEPTION
- SYMPTOMS OF APPENDICITIS (CENTRAL TO RIGHT ILLIAC FOSSA PAIN W N+V)
HOW WOULD YOU DIAGNOSE MECKELS DIVERTICULUM
A TECHNETIUM SCAN
HOW WOULD YOU TREAT MECKELS DIVERTICULUM
SURGICAL RESECTION
WHAT IS GORD
INE INVOLUNTARY PASSAGE OF GASTRIC CONTENTS INTO THE OESOPHAGUS
WHAT IS THE PATHOLOGY OF GORD
INAPROPRIATE RELAXATION OF THE LOWER OESOPHAGEAL SPHINCTER DUE TO FUNCTIONAL IMMATURITY
WHAT ARE SOME RISK FACTORS OF GORD
A FLUID DIET
A HORIZONAL POSTURE
A SHORT INTRAABDOMINAL OESOPHAGUS
WHAT IS THE MANAGEMENT OF GORD
REASSURANCE
USUALLY SPONTANEOUSLY RESOLVES AT 12M AS CHILD GROWTH
WHAT ARE CAUSES OF SEVERE GORD
NEUROLOGICAL DISORDERS (CEREBRAL PAULSEY)
PREM BABY
POST OPERATIVE (ESPECIALLY PREM BABY) FOR DIAPHRAGMATIC HERNIA OR BRONCHOPULMONARY DISPLASIA
(GORD) WHEN WOULD YOU WANT TO PERFORM A ENDOSCOPY AND BIOSPY OF THE OESOPHAGUS
IS THERE ARE COMPLICATIONS PRESENT SUCH AS
- FAILURE TO THRIVE
- OESOPHAGITIS
- HAEMATEMESIS
- ANAEMIA
- ASPIRATION
- PNEUMONIA
HOW WOULD YOU MANAGE SEVERE GORD
THICKENING AGENTS TO FEED
RANITADINE (H2 RECEPTOR AGONIS)
OMEPRAZOLE (PPI)
SURGERY IF THERES AN OESOPHAGEAL STRICURE
WHAT IS PYLORIC STENOSIS
HYPERTROPHY OF PYLORIC MUSCLE CAUSING GASTRIC OBSTRUCTION
WHAT ARE THE RISK FACTORS FOR PYLORIC STENOSIS
FIRST BORN CHILD
MALE
MATERNAL FAMILY HX
WHAT IS THE PRESENTATION OF PYLORIC STENOSIS
VOMITING
- MORE FREQUENT AND FORCEFUL OVER TIME
DEHYDRATION
- LOSS OF INTEREST IN FEEDS, LETHARGY
WEIGHT LOSS
AT WHAT AGE DOES PYLORIC STENOSIS TEND TO PRESENT
2 - 7 Y
WHAT IS A COMPLICATION OF PYLORIC STENOSIS
HYPOCHLORAEMIC METABOLIC ACIDOSIS
LOW SODIU M AND LOW POTASSIUM
WHAT IS THE INVESTIGATION OF PYLORIC STENOSIS
OBSERVE A TEST FEED
ABDO EXAM
US - ABDOMEN
WHAT MAY YOU OBSERVE WHILST THE BABY IS FEEDING
PYLORIC STENOSIS CANBE SEEN AS A WAVE MOVING FROM LEFT TO RIGHT
WHAT IS A KEY FINDING ON AN ABDOMINAL EXAMINATION OF PYSLORIC STENOSIS
MASS IN UPPER RIGHT ABDOMINAL QUADRANT
HOW WOULD YOU MANAGE PYLORIC STENOSIS
IV FLUIDS + POTASSIUM
PULOROMYOTOMY (SURGERY)
WHAT ARE KEY DIFERENCES BETWEEN CHRONS AND ULCERATIVE COLITIS
CHRONS
- MOUTH TO UNUS
- SKIP LESIONS
- TRANSMURAL
UC
COLON
CONINOUS PATTERS
SUBMUCOSAL AND MUCOSAL LAYERS
WHAT IS THE PRESENTATON OF CHRONS
FAILURE TO THRIVE
FEVER, LETHARGY, WEIGHT LOSS
ABDO PAIN
DIARRHOEA
ORAL LESIONS AND PERIANAL SKIN TAGES
ANT. UVEITIS
ARTHRALGIA
ERYTHEMA NODOSUM
WHAT IS THE PRESENTATION OF ULCERATIVE COLITIS
DIARRHOEA
RECTAL BLEEDING
COLIC LIKE PAIN
WEIGH LOSS, FAILURE TO THRIVE (ALTHOUGH LESS DIGNIFICANT THAN CHRONS)
WHAT ARE THE INVESTIGATIONS REQUIRED FOR IBD
BLOODS
- FBC, IRON STUDIES, ESR ERP, PLATELETS, SERUM ALBIMUN
ENDOSCOPY +/- ILEO COLONOSCOPY
SMALL BOWEL IMAGING (FOR CHRONS)
WHERE IS MOST COMMONLY AFFECTED IN CHRONS
DISTAL ILEUM
WHERE IS MOST COMMONLY AFFECTED IN ULCERATIVE COLITIS
IN ADULTS
IN CHILDREN
ADULTS = DISTAL COLON
CHILDREN = PANCOLITIS
WHEN WOULD YOU FIND NON CAESATING EPITHELIAL GRANULOMAS
IN CHRONS
HISTOLOGICAL BIOPSY
WHEN YOULD YOU SEE FISTULAS AND STRICUTRES
IN CHRONS
(ON ILEOCOLONOSCOPY AND SMALL COWEL IMAGING)
WHEN WOULD YOU SEE CRYPT DAMAGE
ULCERATIC COLITIS
ILEOCOLONOSCOPY BIOPSY
WHAT IS THE MANAGEMENT FOR IBD
BOWEL REST
- POLYMERIC DIET FOR 6-8 WEEKS
AMINOSALICATES (BALSALAZIDE)
SYSTEMIC STEROIDS (PREDNISOLONE)
IMMUNO SUPPRESSION (METHOTREXATE AND AZOTHIOPRINE)
ANTI TNF (INFLIXIMAB)
SURGERY
HOW DO AMINO SALICATES WORK
RELEASE 5 ASA TO CONTROL INFLAMMATION
WHAT IS FULMINATING ULCERATIVE COLITIS
A RAPID AND SERIOUS IMMUNE RESPONSE AFFECTING THE ENTIRE COLON
WHAT IS THE PRESENTATION OF FULMINATING UC
SEVEERE PAIN AND DIARRHOEA
DEHYDRATION
SHOCK
RAPID ONSET
HOW DO YOU MANAGE FULMINATING UC
IV FLUIDS
IV STERIODS
CICLOSPORIN (IMMUNOSUPPRESSANT)
WHY IS REGULAR COLONOSCOPIC SCREENING REQUIRED IN IBD
HOW OFTEN IS SCREENING
INCREASED RISK OF ADENOCARCINOMA
EVERY 10Y
WHAT IS THE ASSESMENT FOR DEHYDRATION
capillary refill
conciousness level
hr
bp
mucus membranes
eyes sunken?
fontanelles sunken?
urine output
weigh loss
stool cultures
blood cultures
WHAT ARE SIGNS OF MILD DEHYDRATION
ALERT CHILD
CAP REFILL <2S
NORMAL HR BP
MUCOUS MEMBRANES MAY BE DRY
NON SUNKEN EYES AND FONTANELLE
NORMAL URINE OUTPUT
WHAT ARE SIGNS OF MODERATE DEHYDRATION
IRRATABLE CHILD
SLOWED CAP REFILL
TACHYCARDIA
HYPOTENSION
DRY MUCOUS MEMBRANES
NON SUNKEN EYES
SUNKEN FONTANELLES
URINE OUTPUT
WHAT ARE SIGNS OF SEVERE DEHYDRATION
LETHARGY
V SLOW CAP REFILL
FAST TACHYCARDIA
SEVERE HYPOTENSION
PARCHED MUCOUS MUMBRANES
SUNKEN EYES
V SUNKEN FONTANELLE
LITTLE TO NO URINE OUTPUT
WHAT % DEHDRATION IS NEEDED TO BE CLASSED AS MILD
5%
WHAT % DEHDRATION IS NEEDED TO BE CLASSED AS MODERATE
10%
WHAT % DEHDRATION IS NEEDED TO BE CLASSED AS SEVERE IE SHOCK
15%
WHAT IS THE MANAGEMENT OF MILD DEHYDRATION
ENCOURAGE FLUID INTAKE AND ORS
WHAT IS THE MANAGEMENT OF MODERATE DEHYDRATION
IV FLUIDS FOR 4 HOURS
MAINTENENCE FLUIDS
ORS
NASOGASTRIC TUBE
WHAT IS THE MANAGEMENT OF SEVERE DEHYDRATION
IV FLUIDS 0.9% SODIUM CHLORIDE
IV MAINTENENCE FLUIDS 0.9% NACL + DEXTROSE
+ZINC IF MALNURISHED
POST REHYDRATION FULL FAT MILK AND SOLIDS
WHAT IS HYPONATREMIC DEHYDRATION
DECREASED PLASMA DOSIUM BECAUSE OF SODIUM LOSS
WHAT IS THE MANAGEMENT OF HYPONATREMIC DEHYDRATION
FLUID REPLACEMENT OVER 48H NOT 24 TO AVOID CEREBRAL OEDEMA
WHAT IS KWASHIORKOR
PROTEIN MALNUTRITION CAUSING SEVERE OEDEMA
THE WEIGHT HEIGHT RATIO OF A MALNURISHED CHILD IS NORMAL WHAT TYPE OF MALNURESHMENT IS THIS
KWASHIOKUR
(DUE TO INCREASED FLUID)
WHAT IS MARASMUS
SEVERE PROTEIN AND ENERGY MALNUTRITION
WHAT IS THE PRESENTATION OF MARASMUS
WAISTED ELDERLY APPEARENCE
NO OEDEMA
MIDARM CIRCUMFERENCE IS LOW
REDUCED SKIN FOLD THICKNESS
WITHDRWARN AND APATHETIC CHILD
WHAT ARE THE SYMPTOMS OF KWASHIOKUR
OEDEMA AND DISTENDED ABDOMEN
SEVERE WAISTING
DESQUAMATING SKIN AND HYPERKERATOSIS
ENLARGED LIVER
ANGULAR STOMATOSIS
DIAHORREA
HYPOTENSION AND BRADYCARDIA
HYPOTHERMIA
HOW DO YOU MANAGE MALNUTRITION
GLUCOSE AND DEXTROSE
FLUIDS
ELECTROLYTES NA, K, CL,
MICRONUTRIENTS A D E K
SMALL AND OFTEN FEEDS
WHAT ARE CAUSES OF MALNUTRITION
IBD
COELIAC
CHOLESTATIC LIVER DISEASW
SHORT BOWEL SYNDROME
EXOCRINE PANCREATIC DYSFUNCTION
HOW DOES CHOLESTATIC LIVER DISEASE AFFECT ABSORBTION
BILE SALTS NO LONGER REACHING DUODENUM
DECREASED FAT AND VITAMIN ABSORBTION
WHAT ENZYMES ARE AFFECTED IN PANCREATIC DISFUNCTION
LIPASE
PROTEASE
AMYLASE
WHAT IS COELIAC DISEASE
AN ENTEROPATHY
GLIADIN CAUSES IMMUNE RESPNSE DAMAGING PROXIMAL SMALL INTESTINE
CAUSING VILLOUS ATROPHY
WHAT IS THE PRESENTATION OF COELIAC DISEASE
FAILURE TO THRIVE
BUTTOCK WAISTING
DIARRHOEA
ABDOMINAL DISTENSION
ANAEMIA
HOW WOULD YOU DIAGNOSE COELIAC
LOOK AT IgA
- TISSUE TRANSGLUTAMINASE ANTIBODIES
ENDOMIPIAL ANTIBODIES
ENDOSCOPY LOOKING AT MUCOSAL CHANGES
GLUTEN CHALLENGE
WHAT MUCOSAL CHANGES ARE PRESENT IN COELIAC
INTRAEPITHELIAL LYMPHOCYTES
VILLOUS ATROPHY
CYST HYPERTROPHY
WHAT ARE RISK FACTORS FOR COELIAC
AUTOIMMUNE PEOPLE
- T1 DM
- THYROID IE HASHIMOTOS
ALSO
DOWNS
1ST DEGREE RELATIVES
HOW WOULD YOU MANAGE COELIAC
DIETICIAN
EXPLAIN RISK OF SMALL BOWL MALIGNANCY FOR NON ADHERENCE
