GI imaging: coeliac disease on small bowel imaging: practice question

A Radiology 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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Radiology · GI imaging: coeliac disease on small bowel imaging

Sample item

A patient with chronic diarrhoea and iron deficiency has a small bowel study showing fewer jejunal folds than usual and an increase in ileal folds. What is this pattern called?

AThumbprinting of ischaemic bowelBJejunisation of the ileum with reversal of the fold pattern in coeliac diseaseCLead pipe pattern of ulcerative colitisDString sign of Crohn disease

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

The answer and the reasoning

B. Jejunisation of the ileum with reversal of the fold pattern in coeliac disease

In coeliac disease, jejunal folds are lost or reduced while the ileum shows an increased number of folds, a reversal of the usual pattern. Other signs include dilated loops, flocculation of barium and intussusception.

Option by option

A. Thumbprinting of ischaemic bowel
Thumbprinting describes thickened haustral folds from oedema or ischaemia.
B. Jejunisation of the ileum with reversal of the fold pattern in coeliac disease (correct)
Correct. Reduced jejunal and increased ileal folds mark coeliac disease.
C. Lead pipe pattern of ulcerative colitis
Lead pipe describes loss of haustra in ulcerative colitis.
D. String sign of Crohn disease
String sign describes a narrowed terminal ileum in Crohn 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.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Jejunisation of the ileum with reversal of the fold pattern in coeliac disease. In coeliac disease, jejunal folds are lost or reduced while the ileum shows an increased number of folds, a reversal of the usual pattern.

Why is "Thumbprinting of ischaemic bowel" not the answer?

Thumbprinting describes thickened haustral folds from oedema or ischaemia.

Why is "Lead pipe pattern of ulcerative colitis" not the answer?

Lead pipe describes loss of haustra in ulcerative colitis.

Why is "String sign of Crohn disease" not the answer?

String sign describes a narrowed terminal ileum in Crohn disease.

What concept does this question test?

It tests GI imaging: coeliac disease on small bowel imaging in Radiology. Other signs include dilated loops, flocculation of barium and intussusception.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 GI imaging: coeliac disease on small bowel imaging?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.