Malabsorption and chronic diarrhoea long

Question 1

Diagnostic criteira for coeliac disease

Answer 1

1. Positive serology by tissue transglutaminase (tTG) or anti-endomysial antibody
2. Abnormal duodenal biopsy consistent w coeliacs disease
3. Clinical, biochemical and histological improvement on a gluten-free diet

Question 2

Lack of response to a gluten free diet

Answer 2

1. Incorrect diagnosis
2. Patient not adhering to the diet
3. Collagenous sprue
4. Intestinal lymphoma
5. Diffuse ulceration
6. Other intercurrent disease

Question 3

Complications of coeliac disease

Answer 3

1. T cell lymphoma
2. Ulceration of the small bowel
3. Carcinoma of the GIT system is slightly increased

Question 4

What to ask in the history for malabsorption

Answer 4

steatorrhea
weakness (potassium deficiency)
anaemia
bone pain - osteomalacia
glossitis/angular stomatitis 
bruising
oedema
peripheral neuropathy
skin rash
amenorrhea (protein depletion)

Question 5

Exam for malabsorption

Answer 5

Weight, BMI
abdominal scars
skin lesions
pigmentatoin
stomatitis
perianal lesions
signs of anaemia
signs of chronic liver disease
signs of peripheral neuropathy
lymphadenopathy

Question 6

What are signs of malnutrition on investigations

Answer 6

1. iron, INR, calcium, cholesterol, carotene, position sudan’s test (steatorrhoea)
   2.