36 Questions
What is the ratio of females to males affected by Coeliac disease?
3:1
What is the primary role of HLA-DQA and HLA-DQB genes in Coeliac disease?
They are associated with genetic markers
What is a characteristic of the symptoms of Coeliac disease?
They vary with respect to age
What is a possible complication of untreated Coeliac disease?
Recurrent abortion or infertility
Which type of healthcare professional is likely to encounter Coeliac disease?
Primary care physician, pediatrician, dermatologist, or gastroenterologist
What is a trend observed in the incidence of Coeliac disease in children?
Increasing frequency in children below 2 years of age
What is the maximum ratio of females to males in Coeliac Disease?
3:1
What type of disease is Coeliac Disease considered?
Both monogenic and polygenic
Which of the following is a risk factor for Coeliac Disease?
Type 1 diabetes
What is the usual treatment for Coeliac Disease?
Gluten-free diet
What is the consequence of untreated Coeliac Disease?
All of the above
What is a characteristic of gluten sensitivity?
All of the above
What is a common non-GI manifestation of Coeliac Disease?
Anemia
What is the purpose of HLA typing in Coeliac Disease diagnosis?
To confirm coeliac disease diagnosis
What is a common symptom of Coeliac Disease in children?
Chronic diarrhea
What is a potential neurological complication of Coeliac Disease?
Epilepsy
What is the percentage of the general population affected by coeliac disease?
1%
What is the hallmark of coeliac disease?
Severe enteropathy
What is the first-line test for the diagnosis of coeliac disease?
Serological test
What is the characteristic of coeliac disease in the small bowel?
Intraepithelial lymphocytosis, crypt hyperplasia, and villous atrophy
What is the ratio of CD child to adult?
1.06 : 3.34
What is the characteristic of the normal small intestine?
Over 35 intraepithelial lymphocytes per 100 enterocytes
What is the minimum number of intraepithelial lymphocytes per 100 enterocytes in CD?
40 IELs/100 ECs
What is the significance of Tryptase Measure in CD diagnosis?
It is a valuable tool for the diagnosis of CD
What is the characteristic of coeliac disease after one year of gluten-free diet treatment?
Signs and symptoms are completely normalized
What is the significance of deep learning in histological diagnosis of CD?
It is a useful tool for pathologists
What is the primary focus in the nutritional management of Coeliac disease?
Eliminating gluten-containing grains
What is a potential drawback of a gluten-free diet?
Low fiber content and micronutrient deficiency
What is the role of a dietitian in Coeliac disease management?
Providing dietary advice and guidance
What is the significance of the Marsh, Modified Marsh, and Oberhuber classifications?
They are methods for diagnosing Coeliac disease
What is the effect of Coeliac disease on dietary quality of life?
Significant negative effect
What is the goal of nutritional rehabilitation in Coeliac disease?
Improving macro/micronutrient status
What is the autoimmune disorder induced by gluten proteins and related gliadin fragments?
Coeliac disease
What is the significance of the Tilsolve Activation in Re-Renewal in Coeliac disease?
It is a diagnostic criterion for Coeliac disease
What is the importance of follow-up appointments in Coeliac disease management?
To provide ongoing dietary advice
What is the benefit of individualizing gluten-free dietary recommendations?
All of the above
Study Notes
Coeliac Disease (CD) Definition
- CD is a systemic autoimmune disorder characterized by gluten reactivity in genetically predisposed individuals
- A multifactorial disorder likely determined by the interaction of several factors - environmental and genetic
Genetic Factors
- Association with several genetic markers including HLA-DQA and HLA-DQB genes
- Appears to be a polygenic disease in addition to monogenic
Clinical Features
- Varying symptoms with respect to age
- Symptoms include:
- Chronic diarrhea
- Malabsorption
- Infrequent diarrhea
- Constipation
- Dental enamel defects
- Iron deficiency anemia
- Osteoporosis
- Recurrent abortion
- Infertility
Epidemiology
- Higher prevalence in females than males (up to 3:1 ratio)
- Increased frequency in children below 2 years of age
- Worldwide endemic, with increasing frequency, particularly in developing countries
Diagnosis and Testing
- Serological and histological testing
- Immunohistochemistry, PCR, test-baking challenges, and other diagnostic methods
- Diagnosis can be straightforward but may represent a clinical challenge due to heterogeneity
- Potential causes of difficulty in diagnosis/interpretation of serology and histology include:
- Mild or inconsistent intestinal damage
- Previously or currently gluten-free diet
- Prematurity and young age
- IgA deficiency
- Systemic or local immunological diseases
- Administration of immunosuppressive, anti-TNFα or GFD supplementing compounds
- Rare conditions with celiac-like enteropathy
Management and Treatment
- Lifelong adherence to a strict gluten-free diet (GFD)
- Dietary advice and referral to a registered dietitian experienced in GFD
- Follow-up assessment appointments within 6-12 months
- Importance of nutritional rehabilitation and individualized recommendations
- Gluten-free cereals, such as millet and teff, can provide a balanced diet with essential nutrients
This quiz covers the basics of Coeliac disease, a systemic autoimmune disorder, including its causes, prevalence, and effects on genetically predisposed individuals. It also touches on the role of gender in autoimmune diseases.
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