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Flashcards in Coeliac Disease Deck (23)
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1
Q

Which organ does coeliac disease affect?

A

Small intestine

2
Q

What is gluten?

A

A protein found in wheat

3
Q

Explain the difference between macro- and microcytic anaemia.

A

Anaemia = decreases in amount of RBC’s or Hb

Macrocytosis = increases RBC MCV

Macrocyctic anaemia = reduced RBC number with remaining having increased MCV

Microcytic anaemia follows the same rule but for reduced MCV

4
Q

What can a low folate indicate?

A

May be due to not being absorbed properly, meaning in GI terms celiac or crohns due to where it s absorbed from

5
Q

What is the main serological test for coeliac?

A

The connective sheath around smooth muscle = endomysium

Anti-endomysial antibodies (EMA) produced in coeliac

Anti-transglutaminase (Anti-tTG)

IgA TTG and EMA therefore serological tests

6
Q

What structural changes occur in coeliac disease?

A

1) crypt hyperplasia (enlargement)

2) villous atrophy

7
Q

What type of disease is coeliac?

A

It is an auto-immune disease (T-cell mediated)

8
Q

What is the treatment of coeliac?

A

Strict gluten free diet

9
Q

Describe the genetics surrounding coeliac including genes associated?

What do these genes code for?

A

All CD sufferers have:

  • HLADQ2 (95%)
  • HLADQ8 (5%)

But not all positive for this gene have CD (does not work both ways)

These code for MHC

10
Q

What is the gold standard for coeliac diagnosis?

What other tests/steps can help confirm diagnosis?

A

OGD with duodenal biopsy looking for structural changes associated with CD

Others = antibody testing, reversal with gluten free diet

11
Q

What is the name of the classification for duodenal biopsies?

A

Marsh classification

12
Q

What is the most common associated malignancy with coeliac disease?

A

Enteropathy-associated T-cell lymphoma (EATL)

13
Q

What is affected in coeliac due to the structural changes seen?

A

Absorption

14
Q

Why do coeliacs become anaemic?

A

Deficient absorption = reduced iron uptake = anaemia

15
Q

What kind of anaemia is associated with reduced iron intake?

A

Microcytic

16
Q

What is coeliac incidence?

Are males or females more affected?

A

1:100

1% of population

Females X2 more likely

17
Q

Does smoking increase coeliac risk?

A

No

18
Q

What are some key determinants between coeliac and IBD?

A

Pain (sometimes)

Bleeding

19
Q

Giardia can be a differential for coeliac type symptoms.

What is it?

What are it’s symptoms and how can it be differentiated from other GI pathology?

A

A water bourne parasite

Symptoms come and go in cycles

20
Q

What serology measurement can rise with infection, therefore is important to check against the CRP?

A

Ferratin

21
Q

A deficiency of what can cause macrocytic anaemia?

A

Folate and B12

22
Q

Why does coeliac disease cause iron deficient anaemia (microcytic) and not B12 deficient anaemia (macrocytic)?

A

Coeliac affects the proximal small bowel = iron absorption here

B12 = distal small bowel (ileum) = not affected by coeliac

23
Q

What region of the small bowel is biopsies in suspected coeliac?

A

Duodenum = D2