Coeliac Disease (Malabsorption)

Question 1

What is Coeliac disease? (2 things)

Answer 1

1. AI condition
2. Exposure to gluten causes AI reaction –> small intestines inflamm

Question 2

What is the protein in gluten that causes the AI reaction?

Answer 2

Gliadin

Question 3

What % of the UK pop has Coeliac disease?

Answer 3

1%

(zolak al gabaltu be 3imma dak)

Question 4

What genes is Coeliac disease associated w? (2 things)

Answer 4

1. HLA-DQ2
2. HLA-DQ8

(like d-squared lol)

Question 5

How does Coeliac disease lead to Malabsorption? (5 steps)

Answer 5

1. Nigga eats gluten
2. Presence of Gliadin prot –> 2 Auto-Antibodies released (anti-TTG & anti-EMA)
3. Auto-antibodies –> target epithelial cells in Small Intestines (esp Jejunum)
4. Villous atrophy + Brush border loss + Crypt Hyperplasia
5. Malabsorpton of fat + fat soluble vitamins + minerals

Question 6

What are the CF of Coeliac disease? (10 things)

Answer 6

1. Often asymptomatic
2. Diarrhoea (most common)
3. Fatigue
4. Mouth ulcers
5. Nausea + vomiting
6. Abd pain + distension
7. Dermatitis herpetiformis (itchy blistering skin rash on abd)
8. Anaemia (bc iron, B12, folate deficiencies)
9. Failure to thrive in kids
10. Weight loss

Question 7

What is the diagnosis of Coeliac Disease based on? (2 things)

Answer 7

1. Immunology (antibodies)
2. Endoscopic intestinal biopsy

Question 8

What must the investigations for Coeliac disease be carried out alongside?

Why?

Answer 8

Patient STILL eating gluten

So you can detect antibodies + inflamm

Question 9

What antibodies are you checking for when investigating Coeliac disease? (2 things)

Answer 9

1. Raised anti-TTG (1^st choice)
2. Raised anti-EMA

Question 10

Why should you check total igA levels before checking for the Coeliac disease specific antibodies?

Answer 10

Because some people might have igA deficiency anyways which will clart the results, bc anti-TTG and anti-EMA are both igA’s

Question 11

What will the Intestinal Endoscopy w biopsy show in Coeliac disease? (2 things)

Answer 11

1. Crypt hypertrophy
2. Villous atrophy

Question 12

What other Manifestations will be found as a result of Coeliac disease Malabsorption? (5 things)

Answer 12

1. Bleeding
2. Microcytic anaemia
3. Macrocytic anaemia
4. Milk intolerance
5. Oedema

Question 13

What Lab finding explains the Bleeding in Coeliac disease?

Why do you get it?

Answer 13

Prolonged PT / INR

Bc X vit K absorption

Question 14

What Lab finding explains the Microcytic anaemia in Coeliac disease?

Why do you get it?

Answer 14

Low ferritin

Bc X iron absorption

Question 15

What Lab finding explains the Microcytic anaemia in Coeliac disease?

Why do you get it?

Answer 15

Low serum B12 / folic acid

Bc X B12 + B9 absorption

Question 16

What Lab finding explains the Milk intolerance in Coeliac disease?

Why do you get it?

Answer 16

Abn lactose intolerance test

Bc X lactose absorption

Question 17

What Lab finding explains the Oedema in Coeliac disease?

Why do you get it?

Answer 17

Low serum prot + albumin

Bc X a.a absorption

Question 18

What diseases is Coeliac disease associated w? (5 things)

Answer 18

1. Type 1 DM (AI)
2. AI thyroid diseases
3. AI hepatitis
4. Primary biliary cirrhosis (AI)
5. Primary sclerosing cholangitis (AI)

remember widad said a person w 1 AI condition will probs have more bc der imme system is clarted n suicidal lol

Question 19

What is the curative treatment for Coeliac disease?

Answer 19

Gluten free diet

Question 20

What foods contain gluten? (3 things)

Answer 20

1. Wheat: bread, pasta, pastry
2. Barley: beer
3. Oats

Question 21

How should Coeliac disease be monitored?

Answer 21

Checking antibodies

Question 22

What are the complications of Coeliac disease? (4 things)

Answer 22

1. Vit deficiency
2. Aneamia
3. Osteoporosis
4. Ulcerative jejunitis