skip to main content

Coeliac Disease — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyGastroenterologyCoeliac DiseaseRACP Adult Medicine

A 35-year-old woman presents with chronic watery diarrhoea, bloating, and iron deficiency anaemia. Anti-tissue transglutaminase (anti-tTG) IgA is strongly positive. Total IgA is normal. She has dermatitis herpetiformis on the elbows. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Coeliac disease

Chronic diarrhoea with iron deficiency, positive anti-tTG IgA, and dermatitis herpetiformis is coeliac disease. Anti-tTG IgA is >95% sensitive and specific. Confirmation with duodenal biopsies (Marsh 3: villous atrophy, crypt hyperplasia, intraepithelial lymphocytosis) while on a gluten-containing diet. Treatment is lifelong strict gluten-free diet. Monitor anti-tTG for adherence.

Reference: GESA – 2024 – Coeliac Disease; eTG Gastrointestinal 2024