Stomach: dumping syndrome: practice question

A General Surgery 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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General Surgery · Stomach: dumping syndrome

Sample item

Six months after a gastric bypass, a woman has sweating, tremor and palpitations about 2 hours after sugary meals. Symptoms settle with food. What is the mechanism?

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

The answer and the reasoning

C. Rapid carbohydrate absorption causing exaggerated insulin release and reactive hypoglycaemia

Early dumping occurs within 30 minutes of a meal, when hyperosmolar chyme enters the small bowel, draws fluid into the lumen and releases vasoactive gut hormones, causing cramps, diarrhoea and palpitations. Late dumping occurs 1 to 3 hours after meals; rapid glucose absorption provokes an excessive insulin surge and reactive hypoglycaemia. Small, frequent, low-carbohydrate meals help, with acarbose or octreotide in refractory cases.

Option by option

  • A. Osmotic shift of fluid into the jejunal lumen with vasoactive peptide release

    This describes early dumping, which occurs within about 30 minutes of a meal, not 2 hours later.

  • B. Adrenal insufficiency from stress of surgery

    Adrenal insufficiency would not produce symptoms timed to sugary meals that settle with food.

  • C. Rapid carbohydrate absorption causing exaggerated insulin release and reactive hypoglycaemia (correct)

    This is late dumping: an insulin surge after rapid absorption leads to hypoglycaemia.

  • D. Excess gastrin secretion from retained antral mucosa

    Excess gastrin is a feature of Zollinger-Ellison syndrome or retained antrum, causing ulcers.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Rapid carbohydrate absorption causing exaggerated insulin release and reactive hypoglycaemia. Early dumping occurs within 30 minutes of a meal, when hyperosmolar chyme enters the small bowel, draws fluid into the lumen and releases vasoactive gut hormones, causing cramps, diarrhoea and palpitations.

Why is "Osmotic shift of fluid into the jejunal lumen with vasoactive peptide…" not the answer?

This describes early dumping, which occurs within about 30 minutes of a meal, not 2 hours later.

Why is "Adrenal insufficiency from stress of surgery" not the answer?

Adrenal insufficiency would not produce symptoms timed to sugary meals that settle with food.

Why is "Excess gastrin secretion from retained antral mucosa" not the answer?

Excess gastrin is a feature of Zollinger-Ellison syndrome or retained antrum, causing ulcers.

What concept does this question test?

It tests Stomach: dumping syndrome in General Surgery. Late dumping occurs 1 to 3 hours after meals; rapid glucose absorption provokes an excessive insulin surge and reactive hypoglycaemia. Small, frequent, low-carbohydrate meals help, with acarbose or octreotide in refractory cases.

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 Stomach: dumping syndrome?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.