coeliac

Question 1

what alcoholic beverage contains gluten?

Answer 1

beer

Question 2

does bread have gluten?

Answer 2

yes

Question 3

does pasta have gluten?

Answer 3

yes

Question 4

does rice have gluten?

Answer 4

no

Question 5

does potatoes have gluten?

Answer 5

no

Question 6

does oats have gluten?

Answer 6

yes

Question 7

what molecule in gluten is most pathogenic?

Answer 7

gliadin

Question 8

gliadin is deamidated by what enzyme?

which antibody is made against this enzyme?

Answer 8

tissue transglutaminase

IgA

Question 9

which genes are almost always implicated in coelaic?

-2

Answer 9

HLA-DQ2 or HLA-DQ8

Question 10

what is the hallmark of coeliac?

Answer 10

malabsorption

Question 11

which type of WBC is mainly implicated in coeliac?

Answer 11

lymphocytes

Question 12

what happens to crypts?

Answer 12

hyperplasia

Question 13

HLA-DQ2 presents peptides to what immune cell?

Answer 13

T-helper cell

Question 14

which syndromes are associated with coeliac?

-2

Answer 14

Down’s syndrome

Turner’s syndrome

Question 15

which autoimmune diseases are associated with coeliac?

-2

Answer 15

T1DM

autoimmune thyroid disease

Question 16

histology of duodenum in coeliac?

-2

Answer 16

villous atrophy

crypt hyperplasia

Question 17

why is there pale, floating stool?

Answer 17

fat malabsorption

Question 18

whys is there watery diarrhoea?

Answer 18

not absorbing water

Question 19

what skin condition can occur?

why?

Answer 19

dermatitis herpetiformis

IgA deposits in skin

Question 20

is here high or low levels of circulating IgA in coeliac?

Answer 20

high IgA

Question 21

hallmark feature of coeliac specifically in children?

asides from malabsorption

Answer 21

child does not grow

Question 22

what happens to weight?

Answer 22

weight loss

Question 23

there is no constipation in coeliac.

true or false

Answer 23

false

Question 24

can you get diarrhoea?

Answer 24

yes

Question 25

why do coeliac patients need vaccination?

explain why the phenomena in the first answer happens?

Answer 25

hyposplenism

↓Folate, lymphocytes lost through GI we think

Question 26

coeliac has a lot of complications.

which are caused by vit D loss?
-3

Answer 26

Osteoporosis
Osteomalacia
Hyperparathyroidism

Question 27

low vitamin B1 can cause what complication in coeliac?

not heart or brain

Answer 27

peripheral neuropathy

Question 28

list all complications of coeliac?

-13

Answer 28

Dermatitis herpetiformis 
Malignancy 
Hyperparathyroidism 
Vit D loss
Osteoporosis
Osteomalacia 
Microcytic anaemia 
Macrocytic anaemia
Peripheral neuropathy 
Hyposplenism 
Lactose intolerance 
infection
sub-fertility

Question 29

why can
Microcytic anaemia
Macrocytic anaemia
happen in coeliac.

Answer 29

↓Fe

↓B12, ↓Folate

Question 30

character of diarrhoea in coeliac?

Answer 30

foul smelly oily, floating

Question 31

symptoms of coeliac?

-5

Answer 31

Diarrhoea 
N&V
Abdo pain 
Fatigue 
Weight loss

Question 32

1st line Ix?

positive result in this test?

Answer 32

Coeliac serology

↑↑IgA antibody against TTG*

Question 33

after initial 1st line Ix what Ix must be done to confirm diagnosis?

positive result on this Ix?
-3

Answer 33

Duodenal biopsy

villi destroyed + crypt hyperplasia + ↑lymphocytes

Question 34

what must pt be doing leading up to Coeliac serology?

Answer 34

eating gluten

Question 35

what Ix must be done alongside coeliac serology to stop false negative and why?

Answer 35

total IgA must be measured

a small proportion of pts are IgA deficient

Question 36

what is the definitive diagnostic pathway?

- two steps

Answer 36

Serology –> biopsy

Question 37

pt has suspected coeliac and a red vesciular rash.

what is definitive Ix to investigate the rash?

Answer 37

skin biopsy

Question 38

IgA is deficient.

what blood Ix is done now instead.

Answer 38

IgG antibody against Tissue Transglutaminase or Gliadin

Question 39

What is nutshell Mx for coeliac?

- 3 things

Answer 39

Gluten free diet

pneumococcal vaccine

diet supplements if needed

Question 40

treatment for dermatitis herpetiformis?

this drug belongs to which groups of meds?
-2

Answer 40

dapsone

antibiotic
anti-inflammatory