Celiac Disease: ABFM practice questions

5 board-style questions on celiac disease in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 28-year-old woman presents with chronic diarrhea, bloating, and a 10-pound unintentional weight loss over 6 months. She also has iron deficiency anemia refractory to oral iron supplementation. She follows a regular diet including bread, pasta, and cereals. Which initial serologic test is most appropriate to evaluate for celiac disease?

1. Anti-endomysial IgG antibody
2. HLA-DQ2 and HLA-DQ8 genetic testing
3. Anti-gliadin IgG antibody
4. Tissue transglutaminase IgA antibody with total serum IgA level

Sample question 2

A 34-year-old man with chronic diarrhea and fatigue has a tissue transglutaminase IgA (tTG-IgA) level that is 10 times the upper limit of normal. His total serum IgA is within normal limits. He is currently eating a gluten-containing diet. His physician recommends proceeding with upper endoscopy and duodenal biopsies. The patient asks why a biopsy is necessary given the strongly positive serology. What is the primary reason for recommending endoscopy in adult patients?

1. Endoscopy is required to rule out colorectal cancer as a cause of the diarrhea
2. Duodenal biopsy remains the standard approach in adults to confirm the diagnosis, assess the degree of villous atrophy, and exclude alternative diagnoses
3. Serologic tests for celiac disease are unreliable and cannot be trusted for diagnosis
4. Endoscopy is primarily needed to evaluate for concurrent H. pylori infection

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