Gastroenterology: celiac disease: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Gastroenterology: celiac disease

Sample item

A patient has chronic diarrhea, iron-deficiency anemia, weight loss, and dermatitis herpetiformis. Which test is the most appropriate initial serologic investigation while eating gluten?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. IgA anti-tissue transglutaminase with total IgA

IgA anti-tissue transglutaminase is a useful first-line celiac serology, and total IgA helps identify IgA deficiency that could yield a false-negative result. Testing should generally occur while the patient is consuming gluten.

Option by option

  • A. Fecal occult blood test alone

    Occult blood testing does not diagnose celiac disease.

  • B. Serum amylase

    Amylase is used in suspected pancreatic disease.

  • C. Antimitochondrial antibody

    Antimitochondrial antibody supports investigation for primary biliary cholangitis.

  • D. IgA anti-tissue transglutaminase with total IgA (correct)

    Correct. This paired test is the standard initial serologic approach.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, IgA anti-tissue transglutaminase with total IgA. IgA anti-tissue transglutaminase is a useful first-line celiac serology, and total IgA helps identify IgA deficiency that could yield a false-negative result.

Why is "Fecal occult blood test alone" not the answer?

Occult blood testing does not diagnose celiac disease.

Why is "Serum amylase" not the answer?

Amylase is used in suspected pancreatic disease.

Why is "Antimitochondrial antibody" not the answer?

Antimitochondrial antibody supports investigation for primary biliary cholangitis.

What concept does this question test?

It tests Gastroenterology: celiac disease in General Medicine. Testing should generally occur while the patient is consuming gluten.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology: celiac disease?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.