Gastrointestinal

Question 1

Coeliac disease pathophysiology

Answer 1

Auto immune disease in reaction to gluten that causes inflammation in the small bowel. Usually presents in early childhood but can present at any age.

Question 2

Coeliac disease presentation

Answer 2

Failure to thrive 
Diarrhoea 
Fatigue 
Weight loss 
Mouth ulcers 
Anaemia 
Abdominal rash - dermatitis herpetiformis

Question 3

Coeliac disease Investigations

Answer 3

Bloods to look for manifestations of Coeliac disease e.g. anaemia
Diagnosis through endoscopy and biopsy

Question 4

Coeliac disease treatment

Answer 4

Gluten free diet for life

Question 5

Hirschsprung’s disease what it is and RF’s

Answer 5

Congenital condition where the nerve cells of the myenteric plexus are absent in the distal bowel and rectum. The area which is not innervated can vary.

Risk factors
Family history
Usually occurs in isolation

Question 6

Hirschsprung’s disease presentation

Answer 6

Severity and age can vary significantly
Acute intestinal obstruction, shortly after birth
Delay in passing meconium >24hrs
Chronic constipation since birth
Abdo pain and distension
Vomiting, poor weight and failure to thrive

Question 7

Hirschsprung’s disease management

Answer 7

X-ray abdo, looking for signs of obstruction
Rectal biopsy to confirm diagnosis - histology will show absence of ganglion if cells.

Fluid resus
Management of intestinal obstruction
IV antibiotics
Surgical removal of Aganglionic section of bowel