GI physiology: VIPoma: 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: VIPoma

Sample item

A 45-year-old woman has profuse watery diarrhoea (more than 3 L daily) that persists during a 48-hour fast, with hypokalaemia and low gastric acid output. Which hormone excess is most likely?

AGlucagonBSomatostatinCGastrinDVasoactive intestinal peptide

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

The answer and the reasoning

D. Vasoactive intestinal peptide

VIP raises cAMP in enterocytes, causing secretion of chloride and water, and also inhibits gastric acid secretion. A VIPoma gives the WDHA (Verner-Morrison) syndrome of watery diarrhoea, hypokalaemia and achlorhydria. Because the diarrhoea is secretory, it continues during fasting and the stool osmotic gap is low.

Option by option

A. Glucagon
Glucagon excess causes hyperglycaemia and necrolytic migratory erythema, not secretory diarrhoea.
B. Somatostatin
Somatostatin excess causes diabetes, gallstones and steatorrhoea, with reduced gut secretions.
C. Gastrin
Gastrin excess causes high acid output and ulcers, not hypochlorhydria.
D. Vasoactive intestinal peptide (correct)
VIP explains secretory diarrhoea with hypokalaemia and hypochlorhydria.

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 Physiology question

What is the answer to this Physiology question?

The best answer is D, Vasoactive intestinal peptide. VIP raises cAMP in enterocytes, causing secretion of chloride and water, and also inhibits gastric acid secretion.

Why is "Glucagon" not the answer?

Glucagon excess causes hyperglycaemia and necrolytic migratory erythema, not secretory diarrhoea.

Why is "Somatostatin" not the answer?

Somatostatin excess causes diabetes, gallstones and steatorrhoea, with reduced gut secretions.

Why is "Gastrin" not the answer?

Gastrin excess causes high acid output and ulcers, not hypochlorhydria.

What concept does this question test?

It tests GI physiology: VIPoma in Physiology. A VIPoma gives the WDHA (Verner-Morrison) syndrome of watery diarrhoea, hypokalaemia and achlorhydria. Because the diarrhoea is secretory, it continues during fasting and the stool osmotic gap is low.

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 physiology: VIPoma?

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.