coeliac

Question 1

production of two antiboies in coeliac?

Answer 1

anti-gliadin, and anti-endomysial

Question 2

immune reaction (t cells) to what in wheat fluid?

Answer 2

gliadin

Question 3

what does immune reaction do to enterocytes and their absorption capacity?

Answer 3

damages them and reduces

Question 4

what skin condition is it associated with?

Answer 4

dermatitis herpatiformis

Question 5

when can it present?

Answer 5

childhood, middle age or adulthood

Question 6

where does it affect?

Answer 6

proximal small bowel

Question 7

what do you get on histology ?

Answer 7

loss of villous structure, loss of surface area, reduction in absorption and a flat duodenal mucosa

Question 8

“flat mucosal surface”

Answer 8

czak villous atrophy

Question 9

which test is very sensitive?

Answer 9

duodenal biopsy

Question 10

apart from biopsy, what is the test for diagnosis?

Answer 10

IgA anti tissue transglutaminase test (TTGa)

Question 11

why do you get general tiredness?

Answer 11

due to iron deficiency anaemia

Question 12

anti ttg is a type of what antibody?

Answer 12

igA

Question 13

which HLAs are associated with celiac?

Answer 13

DQ2/8

Question 14

what symptom do you get as a result of malabsorption of fats?

Answer 14

steatorrhoea

Question 15

histological findings typically?

Answer 15

hypertrophy of the crypts and atrophy of the villi, giving the villi a flattened appearance

Question 16

which two antibodies associated with coeliac?

Answer 16

anti ttg and anti endomysial

Question 17

anti ttg is a form of ?

Answer 17

IgA

Question 18

there is no criteria for diagnosis of coeliac, but you need ? (4)

Answer 18

evidence of malabsorption
villous atrophy on duodenal biopsy
weight loss
features resolve upon starting gluten free diet

Question 19

what is the most specific diagnostic test ?

Answer 19

villous atrophy on duodenal biopsy

Question 20

osteopenia is a known complication of coeliac. why would this be ?

Answer 20

due to lack of calcium absorption

Question 21

what would you therefore arrange for patients?

Answer 21

regular DEXA bone scanning

Question 22

on diagnosis, patients should be referred to dietician. what kind of foods contain gluten?

Answer 22

Pasta
Bread
Cereals
Biscuits
Pastries / pies
Crumbed foods
Pizza

Question 23

There must also be an increase in the number of inflammatory cells in the _________ for a diagnosis to be made

Answer 23

lamina propria

Question 24

what sort of diseases is coeliac linked with ?

Answer 24

other autoimmune conditions - T1DM, thyroid, addisons

Question 25

does milk contain gluten ?

Answer 25

no

Question 26

child who is changed from milk to solid foods and becomes unwell?

Answer 26

coealic

Question 27

if gluten is removed from site in coeliac - what happens?

Answer 27

symptoms disappear