Gastroenterology

  • Haemochromatosis

  • Which element is in excess in hereditary haemochromatosis?

  • Iron

  • Abnormality of which gene leads to classical hereditary haemochromatosis?

  • Haemochromatosis protein (HFE) gene

  • What is the mode of inheritance of classical hereditary haemochromatosis?

  • Autosomal recessive

  • On which chromosome is the HFE gene located?

  • Chromosome 6

  • Which are the 2 common HFE variants?

  • 1) C282Y

    2) H63D

  • Homozygosity of which variant accounts for approximately 90% of hereditary haemochromatosis cases?

  • C282Y variant

  • How may the skin be affected?

  • Hyperpigmentation – bronze skin

  • Which cutaneous porphyria may occur?

  • Porphyria cutanea tarda (PCT)

  • List 2 blood tests which can aid the diagnosis

  • 1) Ferritin

    2) Transferrin saturation

  • How is the ferritin level affected?

  • Elevated

  • How is the transferrin saturation level affected?

  • Elevated

  • List 4 cardiovascular complications

  • 1) Dilated cardiomyopathy

    2) Heart failure

    3) Conduction disturbances

    4) Arrhythmias

  • List 2 hepatic complications

  • 1) Cirrhosis

    2) Hepatocellular carcinoma

  • List 4 endocrine complications

  • 1) Diabetes mellitus

    2) Hypopituitarism

    3) Hypogonadism

    4) Hypothyroidism

  • Which metacarpophalangeal (MCP) joints are commonly affected in arthropathy secondary to hereditary haemochromatosis?

  • 2nd and 3rd metacarpophalangeal joints

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