5.1. Intestinal Disease - Coeliac Disease Flashcards Preview

2nd Year - Alimentary Diseases > 5.1. Intestinal Disease - Coeliac Disease > Flashcards

Flashcards in 5.1. Intestinal Disease - Coeliac Disease Deck (27)
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1
Q

What is Coeliac Disease?

A

An intolerance to the Gliadin in Gluten

2
Q

What type of disease is Coeliac Disease?

A

An autoimmune Inflammatory Bowel Condition

3
Q

Is Coeliac Disease more common in Males or Females?

A

Females

4
Q

At what ages is Coeliac Disease most prevalent?

A
  1. In the 5th decade (40-50 years old)

2. In infancy - after weaning onto Gluten-Containing foods

5
Q

What are the Aetiological Agents a combination of?

A

Genetic and Environmental Factors

6
Q

What is the Familial Genetic prevalence of Coeliac Disease?

A

10-15% of 1st Degree relatives will have the Disease

7
Q

What genes are responsible for Coeliac Disease?

A

Human Leukocyte Antigen Genes (HLA Genes):

  1. HLA-DQ2
  2. HLA-DQ8
8
Q

What are the Environmental Factors which can effect Coeliac Disease?

A
  1. A High Gluten Diet

2. Breast Feeding / Age of introduction to Gluten

9
Q

What percentage of the Population is effected by Coeliac Disease?

A

1%

10
Q

What is the Pathology of Coeliac Disease?

A
  1. Gliadin in Gluten is resistant to Pepsin and Chymotrypsin Digestion so it remains in the Intestinal Lumen
  2. This can trigger an immune response which attacks the Enterocytes
11
Q

What does the immune attack on the Enterocytes cause?

A
  1. Villous Atrophy and Blunting
  2. Lymphocytosis
    Resulting in the Enterocyte Epithelial Surface to become Cuboidal
12
Q

What improves the inflammation?

A

The removal of Gluten from the Diet

13
Q

What causes a relapse in improvement?

A

The re-introduction of Gluten into the Diet

14
Q

What is the Clinical Presentation of Coeliac Disease?

A
  1. Asymptomatic (common)
  2. Malaise / Tiredness
  3. Malabsorption Symptoms
  4. Abdominal Pain
  5. Angular Stomatitis / Mouth Ulcers
  6. Neuropsychiatric Conditions
15
Q

What are the Malaise / Tiredness often associated with?

A

Anaemia

16
Q

What symptoms can occur due to the Malabsorption?

A
  1. Diarrhoea

2. Steatorrhoea

17
Q

What is the Abdominal Pain described as?

A

Distension / Bloating

18
Q

How often do Angular Stomatitis / Mouth Ulcers form?

A

They are intermittent but frequent

19
Q

What Neuropsychiatric Conditions may occur as a result of Coeliac Disease?

A
  1. Depression

2. Anxiety

20
Q

What investigations are necessary in Coeliac Disease?

A
  1. Seological Tests:
    a) Endomysial Antibodies
    b) Anti-Tissue Transglutaminase Antibodies
  2. HLA Typing
  3. Biopsy
  4. Haematological Tests
  5. Biochemistry
  6. Endoscopy / Small Bowel Follow-Through
21
Q

What is the Advantage / Disadvantage of the 2 Serological Tests?

A

Advantage - They are very sensitive (greater than 90% sensitivity)
Disadvantage - They are not always positive

22
Q

What are the prevalence’s of each of the HLA types which cause Coeliac Disease?

A

HLA-DQ2 - present in 90-95% of cases

HLA-DQ8 - is 8% of cases

23
Q

What are the Histological Changes which would be seen on a Biopsy?

A
  1. The Villous Atrophy
  2. Crypt Hperplasia
  3. Chronic inflammatory cells in the Lamina Propria
  4. Flat Cuboidal Epithelial Cells
24
Q

What are the Haematological Tests looking for?

A
  1. Anaemia
  2. Folate / Iron Deficiencies
  3. Vitamin B12 Deficiency
25
Q

What is being looked for in the Serum Biochemistry test?

A

Hypoalbuminaemia and Oesteomalacia which may appear in sever disease

26
Q

What might the Small Bowel Follow Through show?

A

Dilatation and Slow Transmit

27
Q

What is the Treatment for Coeliac Disease?

A
  1. Dietary Change (Gluten Free)

2. Diet Supplements (for anything which is low, i.e. Iron Folic Acid, Calcium, Vitamin D etc,)

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