Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Leila's Yr 5 Pathology > Immunology 7 - Malabsorption CPC > Flashcards

Immunology 7 - Malabsorption CPC Flashcards

1
Q

What type of disease is coeliacs?

A

Polygenic autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q 
Hb
Fe
TIBC/transferrin
Transferrin saturation
Ferritin in IDA
A 
Hb low
Fe low
TIBC/Transferrin raised
Transferrin saturation low
ferritin low
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q 
Hb
Fe
TIBC/transferrin
Transferrin saturation
Ferritin in ACD
A 
Hb low
Fe low
TIBC/transferrin normal or low
Transferrin saturation normal
Ferritin Normal OR high (APP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of low MCV anaemia

A

IDA
Thalassaemia
ACD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

For iron studies, what stain is used?

A

Giesma stain (Shows nuclei as dark blue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What signs on blood film in iron deficiency?

A

Hypochromic microcytic anaemia
anisopoikilocytosis
NO basophilic stippling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Blood film in megaloblastic, hyposplenism

A

Hypersegmented neutrophils
Target cells (codocytes)
Howell-Jolly bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are main blood film findings in coeliacs indicative of?

A

Iron deficiency, B12/folate deficiency, hyposplenism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypochromic, microyctic cells … ddx?

A

IDA, thalassaemia trait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Poikilocytes (Tear drop cells) + Anisopoikilocytes (elliptocytes)

A

IDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Basophilic stippling

A

Beta thal trait
Lead poisoning
Alcoholism
sideroblastic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Target cells/codocytes differentials

A

Iron deficiency
Thalassaemia
Hyposplenism
Liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Howell-Jolly bodies sign of…

A

Hyposplenism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Blood film in hyposplenism

A

Target cells and Howell jolly bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of hyposplenism

A

Trauma/therapeutic (absent spleen)

Poorly functioning spleen (IBD, Coeliac’s, SCD, SLE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Deficiencies seen in coeliacs

A

Vitamin D def
Vit B12/folate
Hyposplenism
Iron deficiency

One unifying diagnosis = malabsorption

17
Q

Deficiencies seen in Crohn’s and why

A

Bile salts and B12 (TERMINAL ILEUM COMMONLY AFFECTED)

18
Q

What is faecal elastase a test for?

A

Pancreatic insufficiency

19
Q

HLA associations with coeliacs

A

HLADQ2 (most common)

HLADQ8

20
Q

T-cell response to gluten

A

Peptides from gluten i.e. gliadin are deaminated by TTG
The deaminated gliadin via HLA molecules DQ2 or DQ8 are presented by APCs to CD4+ T cells
cD4+ T-cell activation –> secretion of IFN gamma and increased IL-15 secretion
IL-15 activates intraepithelial lymphocytes (IELs)
IELs kill epithelial cells via NKG2D receptors –> damage of gut wall

21
Q

IELs type of T cell

A

Gamma delta T cell

22
Q

B cell response to gluten

A

TTG deaminates gliadin
APC takes up gliadin peptides and primes CD4 Tcells
Primes T cells provide B cell help via CD40L:CD40 to B cells underoing GC reactions
B cells under. go isotype switching and affinity maturaiotn –> gliadin specifc memory and plasma cells

23
Q

Anti-gliadin antibodies

A

IgA more sensitive than IgG but both unrealiable

24
Q

Which antibodies most reliable to screen for coeliacs?

A

anti-TTG and anti-endomysial (anti-TTG gold standard)

25
Q

In which population are these serology tests redundant?

A

IgA deficient individuals (1 in 600)

26
Q

1st line DIAGNOSIS for coeliacs/gold standard

A

> /=4 dudoenal biopsy

multiple biopsies taken to ensure you get a coeliac diseased part

27
Q

Endoscopy findings of coeliacs

A

Lack of mucosal folds and flattened villi

28
Q

Histopathology of coeliacs

A

Villous atrophy with crypt hyperplasia

Intra-epithelial lymphocytes

29
Q

Normal villi:crypt ratio and in coeliacs

A

Normal 3-5:1

coeliacs: 1:1 or 1:3

30
Q

Normal IEL levels

A

<20 IELs/100 epithelial cells

Coeliac’s >20/100

31
Q

One other cause of vilious atrophy

A

Tropical sprue

32
Q

Ohter causes of IELs

A

Giardiasis, CMPA, drugs (NSAIDs)

33
Q

What foods is gluten present in

A

Wheat, barley, rye and some oats

34
Q

Complications of coeliacs

A 
Malabsorption
Osteomalacia and osteoporosis
Neurological disease
Lymphoma (multifocal T-cell lymphoma - v difficult to treat)
Hyposplenism
35
Q

How to test patient adhering to gluten free diet

A

Serology: TTG should be NEGATIVE

36
Q

whAT MIGHT A +ttg SUGGEST IN PT WITH COELIACS?

A

noT ADHERING TO DIET

lyMPHOMA

37
Q

What imagine do coeliac patients have and how often?

A

DEXA of spine and hip every 3-5 years

38
Q

How long after sticking to gluten free diet does mortality return to normal?

A

3-5 years

39
Q

Associations with coeliacs

A

Dermatitis herpetiformis
T1DM
Autoimmune thyroid disdase
Down’s syndrome

Leila's Yr 5 Pathology (100 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions