Gastrointestinal pathology: malabsorption: practice question

A Pathology 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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Pathology · Gastrointestinal pathology: malabsorption

Sample item

A woman with iron deficiency anaemia and chronic diarrhoea has positive anti-tissue transglutaminase antibodies. What is the expected duodenal biopsy finding?

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

The answer and the reasoning

C. Villous atrophy, crypt hyperplasia and increased intraepithelial lymphocytes

In coeliac disease, gluten-triggered T cell injury produces intraepithelial lymphocytosis, crypt hyperplasia and villous flattening. It is associated with HLA-DQ2 and DQ8, and with dermatitis herpetiformis.

Option by option

  • A. Normal villi with lamina propria lymphangiectasia

    Lymphangiectasia is a protein-losing enteropathy with normal villi.

  • B. Non-caseating granulomas in the submucosa

    Non-caseating granulomas suggest Crohn disease.

  • C. Villous atrophy, crypt hyperplasia and increased intraepithelial lymphocytes (correct)

    Correct. This is the typical triad of coeliac histology.

  • D. Foamy macrophages containing PAS-positive material in the lamina propria

    PAS-positive foamy macrophages indicate Whipple disease.

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 Pathology question

What is the answer to this Pathology question?

The best answer is C, Villous atrophy, crypt hyperplasia and increased intraepithelial lymphocytes. In coeliac disease, gluten-triggered T cell injury produces intraepithelial lymphocytosis, crypt hyperplasia and villous flattening.

Why is "Normal villi with lamina propria lymphangiectasia" not the answer?

Lymphangiectasia is a protein-losing enteropathy with normal villi.

Why is "Non-caseating granulomas in the submucosa" not the answer?

Non-caseating granulomas suggest Crohn disease.

Why is "Foamy macrophages containing PAS-positive material in the lamina prop…" not the answer?

PAS-positive foamy macrophages indicate Whipple disease.

What concept does this question test?

It tests Gastrointestinal pathology: malabsorption in Pathology. It is associated with HLA-DQ2 and DQ8, and with dermatitis herpetiformis.

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 Gastrointestinal pathology: malabsorption?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.