Gastrointestinal physiology: bile salts: practice question

A Physiology 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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Physiology · Gastrointestinal physiology: bile salts

Sample item

A patient after ileal resection has steatorrhoea and gallstones. Which physiological mechanism explains these findings?

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

The answer and the reasoning

D. Loss of the enterohepatic circulation of bile salts with a depleted bile acid pool

Conjugated bile salts are reabsorbed mainly in the terminal ileum by the ASBT transporter. Resection depletes the bile acid pool, so micelle formation and fat absorption fail, and the bile becomes supersaturated with cholesterol, favouring gallstones.

Option by option

  • A. Failure of pancreatic lipase secretion

    Pancreatic lipase secretion is not affected by ileal resection.

  • B. Impaired absorption of chylomicrons into portal blood

    Chylomicrons enter lymph, not portal blood, and that route is intact.

  • C. Excess secretion of cholecystokinin

    CCK is not excessive, and it does not explain malabsorption.

  • D. Loss of the enterohepatic circulation of bile salts with a depleted bile acid pool (correct)

    Correct. Reduced recycling lowers the bile salt pool.

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.

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Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is D, Loss of the enterohepatic circulation of bile salts with a depleted bile acid pool. Conjugated bile salts are reabsorbed mainly in the terminal ileum by the ASBT transporter.

Why is "Failure of pancreatic lipase secretion" not the answer?

Pancreatic lipase secretion is not affected by ileal resection.

Why is "Impaired absorption of chylomicrons into portal blood" not the answer?

Chylomicrons enter lymph, not portal blood, and that route is intact.

Why is "Excess secretion of cholecystokinin" not the answer?

CCK is not excessive, and it does not explain malabsorption.

What concept does this question test?

It tests Gastrointestinal physiology: bile salts in Physiology. Resection depletes the bile acid pool, so micelle formation and fat absorption fail, and the bile becomes supersaturated with cholesterol, favouring gallstones.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Gastrointestinal physiology: bile salts?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology 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.