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Quiz: Celiac Disease and Food Reactions

Test your understanding of Chapter 12. Choose the best answer, then click Show Answer to check.

Question 1

Which grains naturally contain gluten?

  1. Rice, corn, and potatoes
  2. Wheat, barley, and rye
  3. Oats, quinoa, and buckwheat
  4. Wheat, rice, and soy
Show Answer

The correct answer is B. Gluten is a group of proteins found naturally in wheat, barley, and rye. Rice, corn, potatoes, quinoa, and buckwheat are naturally gluten-free. Oats don't naturally contain gluten but are often contaminated with other grains, which is why option C is a tempting mistake.

Concept Tested: Gluten Bloom's Level: Remember

Question 2

What are intestinal villi?

  1. Muscle rings that squeeze food through the small intestine
  2. Glands in the stomach that make acid
  3. Bacteria that live on the lining of the colon
  4. Tiny finger-like projections of the small intestine's lining that increase its surface area for absorption
Show Answer

The correct answer is D. Villi are about 0.5 to 1 millimeter long, are covered in microvilli, and give the small intestine a huge surface for absorbing nutrients. Option A describes the gut's smooth muscle, which moves food but doesn't absorb it.

Concept Tested: Intestinal Villi Bloom's Level: Remember

Question 3

Which antibody drives immediate allergic reactions, such as those in many food allergies?

  1. Immunoglobulin E (IgE)
  2. Tissue transglutaminase
  3. Lactase
  4. Gluten
Show Answer

The correct answer is A. IgE is the class of antibody behind immediate allergic reactions; it sits on immune cells and triggers them to release chemicals within minutes. Tissue transglutaminase (option B) is a body enzyme, and antibodies against it are a marker of celiac disease, which doesn't involve IgE.

Concept Tested: Immunoglobulin E Bloom's Level: Remember

Question 4

Why does carrying the HLA-DQ2 or HLA-DQ8 gene variant NOT mean a person has celiac disease?

  1. Because the gene test is usually wrong
  2. Because only people over 40 can develop celiac disease
  3. Because about 30% of people carry these variants, but only about 3% of carriers develop celiac disease
  4. Because these variants cause wheat allergy instead
Show Answer

The correct answer is C. The variants are almost always needed for celiac disease (nearly everyone with it has one), but they are not sufficient: about 30% of people carry them and only about 3% of carriers develop the disease. That's why a negative gene test helps rule celiac disease out, but a positive one can't rule it in. Option A is wrong because the test reliably detects the variants; the issue is what they mean.

Concept Tested: HLA-DQ2 and HLA-DQ8 Bloom's Level: Understand

Question 5

Why does villous atrophy in celiac disease often lead to anemia and fatigue?

  1. Because gluten directly destroys red blood cells
  2. Because flattened villi give less surface for absorbing nutrients such as iron
  3. Because the villi make red blood cells
  4. Because the gluten-free diet lacks iron
Show Answer

The correct answer is B. When the villi shrink and flatten, the small intestine has much less surface touching digested food, so it absorbs less iron and other nutrients, which can cause iron-deficiency anemia and tiredness. Option D reverses cause and effect: the anemia comes from the untreated disease, and a well-planned gluten-free diet helps the lining heal.

Concept Tested: Villous Atrophy Bloom's Level: Understand

Question 6

What is the key difference between lactose intolerance and a milk allergy?

  1. Lactose intolerance is a digestion problem without an immune attack, while a milk allergy is an immune reaction to milk protein.
  2. Lactose intolerance is an immune reaction, while a milk allergy is a digestion problem.
  3. They are the same condition with different names.
  4. Lactose intolerance damages the villi, while milk allergy does not.
Show Answer

The correct answer is A. In lactose intolerance, the small intestine makes too little lactase to digest all the milk sugar, and colon bacteria break down the rest, causing gas and bloating. A milk allergy is an immune system disorder that can be dangerous. Option B swaps the two, which is the most common confusion.

Concept Tested: Lactose Intolerance Bloom's Level: Understand

Question 7

Dev, 16 (fictional), has had belly pain and tiredness for months. His appointment for celiac testing is in three weeks, and he plans to stop eating gluten today "to get a head start." What is the best response, based on this chapter?

  1. Good idea, because a gluten-free diet makes the tests more accurate.
  2. Good idea, because if he feels better, he won't need the tests.
  3. It doesn't matter, because celiac tests don't depend on what he eats.
  4. He should talk to his doctor first, because going gluten-free before testing can make the tests look falsely normal.
Show Answer

The correct answer is D. Both the tTG antibody test and the biopsy detect the immune response to gluten, and removing gluten lets that response fade. NIDDK says doctors don't recommend starting a gluten-free diet before testing. Option B is a trap: feeling better on the diet doesn't show what caused the symptoms.

Concept Tested: Tissue Transglutaminase Antibody Bloom's Level: Apply

Question 8

Within 10 minutes of eating a peanut cookie, Aaliyah (fictional) gets hives and her lips swell. Which condition does this pattern fit best?

  1. Celiac disease
  2. Lactose intolerance
  3. A food allergy, likely driven by IgE
  4. Non-celiac gluten sensitivity
Show Answer

The correct answer is C. A fast reaction (within minutes) involving the skin and lips fits an IgE-mediated food allergy, in which IgE on immune cells triggers a rapid chemical release. This kind of reaction can become serious and needs a doctor's evaluation. Celiac disease (option A) involves the immune system too, but it doesn't use IgE and its damage builds over weeks to years.

Concept Tested: Food Allergy Bloom's Level: Apply

Question 9

In the 2018 Skodje trial, adults with self-reported gluten sensitivity secretly ate gluten, fructan, or placebo for a week each. Average symptom scores were 33.1 (gluten), 38.6 (fructan), and 34.3 (placebo). What is the best conclusion?

  1. In this group, fructan raised symptoms more than gluten, and gluten was no worse than placebo.
  2. Gluten caused the most symptoms, proving gluten sensitivity is common.
  3. The participants have undiagnosed celiac disease.
  4. Placebo caused more symptoms than fructan.
Show Answer

The correct answer is A. Fructan produced the highest average score, and gluten (33.1) was about the same as placebo (34.3). That suggests fructans, a FODMAP in wheat, may be the trigger for many people who think they react to gluten, though one small, short study can't prove it for everyone. Option C is wrong because celiac disease had been ruled out before the study.

Concept Tested: Fructan Bloom's Level: Analyze

Question 10

A friend without celiac disease cut out gluten, dairy, and several other foods after reading a wellness post, and says, "It can't hurt." Which response best analyzes the risks of an unneeded restrictive diet?

  1. There are no risks, because gluten-free foods are always healthier.
  2. Restriction can delay or hide a real diagnosis, leave nutrient gaps, cost more, and add stress, so diet changes should start with a doctor.
  3. The only risk is that it might be boring.
  4. Restriction is risky only for people with celiac disease.
Show Answer

The correct answer is B. Cutting foods without a diagnosed reason can make celiac tests falsely negative, remove sources of nutrients like calcium and vitamin D, raise food costs, and make eating stressful. Option A is a common belief, but a large study of women without celiac disease found no benefit of low gluten intake for thinking scores.

Concept Tested: Unneeded Restrictive Diet Bloom's Level: Analyze