Malnutrition

Question 1

What is coeliac disease

Answer 1

Intolerance to gluten

Question 2

What is the pathology behind coeliac disease

Answer 2

Antibodies are made in response to gluten that attack the epithelial cells of the intestine

Question 3

What antibodies are involved in coeliac disease

Answer 3

Anti-tissue transglutamate (anti-TTG) and anti-endomysial (anti-EMA

Question 4

Where is most of the inflammation found in coeliac disease

Answer 4

Small bowel, jejunum

Question 5

What is dermatitis herpetiformis

Answer 5

Rash on belly, coeliac related

Question 6

Failure to thrive in young children, diarrhoea, fatigue, mouth ulcers and weight loss indicate what disease

Answer 6

Coeliac

Question 7

What is shown on an endoscopy of a patient with coeliac disease

Answer 7

Villous atrophy, crypt hypertrophy

Question 8

Villous atrophy causes what

Answer 8

Malabsorption

Question 9

Tx for coeliac disease

Answer 9

Life long Gluten free diet

Question 10

Gastrointestinal symptoms for coeliac

Answer 10

Bloating, flatulance, steatorrhea, vomiting and constipation

Question 11

General features of coeliac disease (4)

Answer 11

Delayed period, clubbing, short stature, oedema

Question 12

Extra intestinal symptoms for coeliac (7)

Answer 12

Peripheral neuropathy, night blindness (vit A def.), hypertransaminasemia, thrombocytosis, osteomalacia/osteoporosis, infertility, poor education

Question 13

Definite associations for coeliac (7)

Answer 13

Hyposplenism, dermatitis herpetiformis (extensor surfaces), IgA deficiency, autoimmune thyroid disease, sjorgrens syndrome, type 1 diabetes, microscopic colitis

Question 14

IgA deficiency causes increased risk of?

Answer 14

Chest infections

Question 15

what chromosomal abnormality is related to coeliac disease

Answer 15

Downs

Question 16

Refractory sprue?

Answer 16

5-10% people dont get better with gluten free diet

Question 17

What cancer is related to non-compliant coeliac disease

Answer 17

Enteropathy-associated T cell lymphoma

Question 18

Which genes are related to coeliac

Answer 18

HLA-DQ8 and HLA-DQ2

Question 19

What does an endoscopy for coeliac disease look like?

Answer 19

Flattened villi, smooth to look and drier

Question 20

What scans do you give someone with coeliac

Answer 20

DEXA

Question 21

How to treat resistant coeliac

Answer 21

Steroids, other immunosuppressants (azathioprine)

Question 22

Prognosis for coeliac

Answer 22

70% improve within 2 weeks

Question 23

Differential diagnoses for coeliac

Answer 23

Lactose intolerance, IBS, IBD

Question 24

Risk for coeliac disease in first degree relative?

Answer 24

10-15%

Question 25

What 3 flags should you check for coeliac

Answer 25

IBS, iron deficiency anaemia, chronic diarrhoea