3. Coeliac Disease

Question 1

Definition of coeliac disease

Answer 1

Sensitivity to a-gliaden component of gluten

Question 2

Aetiology of coeliac disease (3)

Answer 2

Genetics (DQW2)
T lymphocytes
Villous atrophy

Question 3

What dose gluten sensitive enteropathy involve

Answer 3

Subtotal villous atrophy of the jejunum

Question 4

Effects of jejunal atrophy (2)

Answer 4

Variable
Clinical (30-40%) - growth failure, oral ulceration
Subclinical

Question 5

Classic symptoms of coeliac disease (8)

Answer 5

Weight loss
Lassitude
Weakness
Abdominal pain/swelling
Diarrhoea
Aphthae/glossitis
Steatorrhoea
Dysphagia

Question 6

Coeliac is usually the result from the malabsorption of (4)

Answer 6

Iron
Folat
Vitamin B12
Fat

Question 7

Coeliac disease investigations (4)

Answer 7

Jejunal biopsy (capsule, endoscope)
Faecal fat
Haematinics
Auto-antibodies - serum transglutaminase, anti-gliaden/anti-endomyseal antibodies

Question 8

Management of coeliac disease

Answer 8

Adhering to gluten-free diet

Question 9

Adhering to gluten-free diet can lead to (3)

Answer 9

Reversal of jejunal atrophy
Improved well-being
Reduced risk of lymphoma

Question 10

Coeliac disease is associated with

Answer 10

Dermatitis herpetiformis

Question 11

What is dermatitis herpetiformis (2)

Answer 11

Oral disease

Involves granular IgA deposition in skin and mucosa

Question 12

Colonic carcinoma symptoms (3)

Answer 12

Relatively symptomless
Anaemia
Rectal blood loss

Question 13

Colonic carcinoma screening involves (5)

Answer 13

FOB
Barium enema
Endoscopy
CT/MRI scan
Carcinoembryonic antigen (CEA)

Question 14

Aetiology of colonic carcinoma (7)

Answer 14

Intestinal polyps
Diet
Smoking
Alcohol consumption
Reduced exercise
Genetics (p53 in 75%)
UC

Question 15

Polyps may (2)

Answer 15

Be pedunculate or flat

Bleed due to irritation and trauma

Question 16

Treatment for colonic carcinoma (4)

Answer 16

Surgery
Hepatic metastases
Radiotherapy
Chemotherapy