skip to main content

Coeliac disease — RACP Adult Medicine MCQ

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

EasyGastroenterology and hepatologyCoeliac diseaseRACP Adult Medicine

A 34-year-old woman has iron deficiency anaemia, bloating and intermittent diarrhoea. She eats a gluten-containing diet. Her sister has autoimmune thyroid disease. Examination is unremarkable. What is the most appropriate investigation?

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

Reveal the answer and explanation

Correct answer: E — Coeliac serology with tissue transglutaminase IgA and total IgA

Coeliac serology while the patient remains on gluten is the appropriate initial test, with total IgA to detect IgA deficiency. Starting a gluten-free diet first can make testing falsely negative. Colonoscopy, faecal elastase and lactose testing may be useful in other contexts but do not test the leading diagnosis.

Reference: GESA coeliac disease guidance; Therapeutic Guidelines (eTG)