GI physiology: dumping syndrome: 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 · GI physiology: dumping syndrome

Sample item

A 48-year-old man after partial gastrectomy develops sweating, tremor and light-headedness 2 hours after a carbohydrate-rich meal, with a capillary glucose of 2.6 mmol/L. What is the mechanism?

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

The answer and the reasoning

A. Rapid delivery of carbohydrate to the small intestine causes excessive insulin release and reactive hypoglycaemia

In late dumping, rapid emptying of carbohydrate causes an early large rise in blood glucose and an exaggerated insulin response, partly through incretins such as GLP-1. The surplus insulin then causes hypoglycaemia one to three hours after the meal. Early dumping, in contrast, occurs within 30 minutes due to hyperosmolar fluid shifts, and is managed by small frequent low-carbohydrate meals and acarbose or octreotide.

Option by option

  • A. Rapid delivery of carbohydrate to the small intestine causes excessive insulin release and reactive hypoglycaemia (correct)

    An exaggerated insulin response to rapid carbohydrate absorption causes late hypoglycaemia.

  • B. Delayed gastric emptying causing prolonged glucose absorption

    Emptying is accelerated after gastrectomy, not delayed.

  • C. Excess glucagon release from the stomach remnant

    Glucagon is not secreted by the stomach in a way that explains the picture.

  • D. Failure of insulin secretion because of loss of gastric hormones

    Insulin secretion is excessive, not deficient, in this syndrome.

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 A, Rapid delivery of carbohydrate to the small intestine causes excessive insulin release and reactive hypoglycaemia. In late dumping, rapid emptying of carbohydrate causes an early large rise in blood glucose and an exaggerated insulin response, partly through incretins such as GLP-1.

Why is "Delayed gastric emptying causing prolonged glucose absorption" not the answer?

Emptying is accelerated after gastrectomy, not delayed.

Why is "Excess glucagon release from the stomach remnant" not the answer?

Glucagon is not secreted by the stomach in a way that explains the picture.

Why is "Failure of insulin secretion because of loss of gastric hormones" not the answer?

Insulin secretion is excessive, not deficient, in this syndrome.

What concept does this question test?

It tests GI physiology: dumping syndrome in Physiology. The surplus insulin then causes hypoglycaemia one to three hours after the meal. Early dumping, in contrast, occurs within 30 minutes due to hyperosmolar fluid shifts, and is managed by small frequent low-carbohydrate meals and acarbose or octreotide.

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 GI physiology: dumping syndrome?

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.