Gastroenterology: coeliac disease: practice question

A Pediatrics 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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Pediatrics · Gastroenterology: coeliac disease

Sample item

A 2-year-old has chronic diarrhoea, abdominal distension, failure to thrive and irritability after the introduction of wheat. Which is the best initial serological test?

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

The answer and the reasoning

A. Anti-tissue transglutaminase IgA with total IgA

Anti-tTG IgA is the preferred screening test for coeliac disease and must be done on a gluten-containing diet. Total IgA is checked for deficiency. Biopsy shows villous atrophy and crypt hyperplasia, and treatment is a lifelong gluten-free diet.

Option by option

  • A. Anti-tissue transglutaminase IgA with total IgA (correct)

    Correct. Anti-tTG IgA with total IgA.

  • B. Sweat chloride

    Sweat chloride is for cystic fibrosis.

  • C. Stool fat only

    Stool fat does not identify the cause.

  • D. Anti-smooth muscle antibody

    Anti-smooth muscle antibody is for autoimmune hepatitis.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Anti-tissue transglutaminase IgA with total IgA. Anti-tTG IgA is the preferred screening test for coeliac disease and must be done on a gluten-containing diet.

Why is "Sweat chloride" not the answer?

Sweat chloride is for cystic fibrosis.

Why is "Stool fat only" not the answer?

Stool fat does not identify the cause.

Why is "Anti-smooth muscle antibody" not the answer?

Anti-smooth muscle antibody is for autoimmune hepatitis.

What concept does this question test?

It tests Gastroenterology: coeliac disease in Pediatrics. Total IgA is checked for deficiency. Biopsy shows villous atrophy and crypt hyperplasia, and treatment is a lifelong gluten-free diet.

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: coeliac disease?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.