This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': 'The histological features of the coeliac disease include all of the following Except – \nSelect and explain. \nA. Crypt hyperplasia, B. Increase in thickness of the mucosa, C. Increase in intraepithelial lymphocytes, D. Increase in inflammatory cells in lamina propyria', 'role': 'user'}, {'content': 'Answer: B \nExplanation: In celiac disease, the proximal intestine is commonly involved while in tropical sprue whole of the intestine is involved.\nBiopsy of intestine in celiac sprue demonstrates.\nVillous atrophy, loss of microvilli brush border\nThe crypts are hyperplastic and become elongated.\nPresence of following cells on lamina propria → Plasma cells, Lymphocytes, Macrophages, Eosinophils, Mast cells.\n\nRemember that overall mucosal thickness remains same in celiac sprue\n\nCeliac ds. is associated with dermatitis herpetiformis.\n\nPathological features\n\nCeliac disease is caused by the action of acidic peptides containing the gliadin fraction of wheat.\nThe basic abnormality is thought to be an increased rate of loss of epithelial cells. Crypt cells show increased activity. This causes hypertrophy of crypt. But even this increased activity cannot keep pace with the loss of cells, resulting in a progressive decrease in height of villi causing villous atrophy\nThe epithelial cells show decreased cytoplasm and mucus\nThe intestinal biopsy shows decreases in the villus: crypt ratio. Normally the villi are 3-4 times the height of the crypts (ratio of 3-4: 1); in celiac disease, the ratio decreases progressively (partial, subtotal and total villous atrophy). Total villous atrophy is seen in severe celiac ds and is quite characteristic of celiac ds (partial villous atrophy may be seen in many other conditions).', 'role': 'assistant'}]