Immu 12: Malabsorption

Question 1

List 3 causes of microcytic anaemia ?

Answer 1

Iron deficiency anaemia
Thalassaemia trait
Anaemia of chronic disease

Question 2

If you see Basophilic stippling which disease is more likely ?

Answer 2

Beta Thalassaemia trait

Question 3

The presence of anisopoikilocytosis with elliptocytes makes which disease more likely ?

Answer 3

Iron deficiency anaemia

Question 4

Give 4 causes of Basophilic stippling ?

Answer 4

Beta thalassaemia trait
Lead poisoning
Alcoholism
Sideroblastic anaemia

Question 5

Which anaemia has hyper segmented neutrophils (more than 4) ?

Answer 5

Megaloblastic anaemia

Question 6

Give 4 causes of Megaloblastic anaemia

Answer 6

• Vitamin b12 deficiency
• Folate deficiency
• Drug that impair DNA synthesis
• Alcoholism

Question 7

List 4 causes of Target cells ?

Answer 7

Hyposplenism
Iron deficiency anaemia
Thalassaemia
Liver disease

Question 8

What causes Howell jolly bodies ?

Answer 8

Hyposplenism

Question 9

What are Howel Jolly bodies ?

Answer 9

Nuclear remnants of erythrocytes

Question 10

Give 4 causes of a poorly functioning spleen ?

Answer 10

IBD
Sickle cell disease
Coeliac disease
SLE

Question 11

What are 2 causes of an absent spleen ?

Answer 11

Surgical management of Sickle cell disease
Trauma

Question 12

Blood tests show:
Calcium 2.00 (2.15-2.65 mol/l)
Alk phos 400 (30-130 U/l)
Vitamin D 18 (70-150nmol/l)
PTH 14 (1.1-6.8pmol/l)

What is the diagnosis ?

Answer 12

Vitamin D deficiency and secondary hyperparathyroidism

Question 13

Which part of the G.I tract is most commonly affected in Crohn’s disease ?

Answer 13

Terminal Ilium

Question 14

Where are bile salts and Vitamin B12 reabsorbed ?

Answer 14

Terminal Ilium

Question 15

What test can diagnose moderate-severe pancreatic insufficiency ?

Answer 15

Faecal elastase

Question 16

List 3 antibodies seen in Coeliac disease ?

Answer 16

Anti-Gliadin
Anti-Tissue Transglutaminase
Anti-endomysial

Question 17

Which Coeliac antibodies are not useful in patients with IgA ?

Answer 17

Anti-TTG
Anti-Endomysial

Hence why you do duodenal biopsy to confirm Dx

Question 18

What’s the gold standard diagnostic test for coeliac disease ?

Answer 18

Endoscopy with Duodenal Histology

Question 19

What are the 2 characteristic histological features of Coeliac disease ?

Answer 19

Villous atrophy with crypt hyperplasia
Intra-epithelial lymphocytes (gamma-delta T cells)

Question 20

Name 1 disease that can cause the same histological findings as in Coeliac disease ?

Answer 20

Giardiasis

Question 21

List 5 complications of Coeliac disease ?

Answer 21

Malabsorption
Osteoporosis/ osteomalacia
Epilepsy
Cerebral calcification
Lymphoma

Question 22

Which cancer are Coeliacs at risk of ?

Answer 22

Multi-focal T cell lymphoma

Question 23

Is there a genetic component to Coeliac disease ?

Answer 23

Yes

HLA-DQ2

Question 24

How can you check adherence with Gluten free diet ?

Answer 24

Level of Anti-TTG antibody

Question 25

Which rash is seen in Coeliac disease ?

Answer 25

Dermatitis herpetiformis - on the extensor surfaces

Question 26

List 4 diseases commonly associated with Coeliac disease ?

Answer 26

Type 1 diabetes mellitus
Auto-immune thyroid disease
Down’s syndrome
Dermatitis Herpetiformis

Question 27

What is the most specific antibody test for Coeliac disease ?

Answer 27

Anti-TTG antibody