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FCPS Part 1 GI and Liver MCQs
Gastrointestinal questions test secretion and digestion, absorption, gut hormones, motility, bile and bilirubin metabolism, and liver function.
Below are 5 free single-best-answer questions drawn from the most frequently examined gi and liver concepts, each with the answer and a rationale for every option. The full bank has 43 gi and liver concepts, each asked several different ways.
Free gi and liver questions
Question 1
The principal site of absorption of most orally administered drugs is the:
- A. Rectum
- B. Stomach
- C. Large intestine
- D. Oesophagus
- E. Small intestine
Show answer
Answer: E. Small intestine
The small intestine has an enormous surface area from folds, villi and microvilli, so most drugs and nutrients are absorbed there. Unabsorbed osmotic solute in this segment draws water in and causes large-volume watery diarrhoea.
Why not the others: Stomach: limited absorption, mainly alcohol. Large intestine: water and electrolyte absorption. Oesophagus: transit only. Rectum: suppository route only.
High-yield: Small intestine = main site of drug and nutrient absorption.
Question 2
Main site of the enteroendocrine S cells that secrete secretin:
- A. Stomach
- B. Jejunum
- C. Pylorus
- D. Duodenum
- E. Ileum
Show answer
Answer: D. Duodenum
Acid and fatty acids reaching the duodenum stimulate S cells of the duodenal mucosa to release secretin, which drives pancreatic and biliary bicarbonate secretion. Brunner glands and the ampulla of Vater are also duodenal.
Why not the others: Jejunum: contains some S cells but is not the main site. Ileum: no Brunner glands. Stomach: gastrin-secreting, not secretin. Pylorus: gastrin G cells in antrum. Caecum: large bowel, no S cells.
High-yield: Secretin comes from duodenal S cells; the pancreas is its target, not its source.
Question 3
Young man with intermittent mild jaundice during fasting or stress and otherwise normal liver tests has:
- A. Acute viral hepatitis
- B. Crigler–Najjar syndrome type I
- C. Rotor syndrome
- D. Dubin–Johnson syndrome
- E. Gilbert syndrome
Show answer
Answer: E. Gilbert syndrome
Mildly reduced UDP-glucuronosyltransferase activity causes unconjugated hyperbilirubinaemia without haemolysis. Jaundice appears with fasting, stress, illness or surgery, and there is no bilirubinuria because unconjugated bilirubin is albumin-bound.
Why not the others: Dubin–Johnson: conjugated, black liver. Rotor: conjugated. Crigler–Najjar type I: absent enzyme, neonatal kernicterus. HELLP: haemolysis and cholestatic picture.
High-yield: Gilbert: benign, unconjugated, normal LFTs, unmasked by fasting.
Question 4
A sac found outside the inferior epigastric vessels at the deep ring is classified as:
- A. Direct inguinal hernia
- B. Umbilical hernia
- C. Indirect inguinal hernia
- D. Femoral hernia
- E. Incisional hernia
Show answer
Answer: C. Indirect inguinal hernia
An indirect hernia enters the deep inguinal ring lateral to the inferior epigastric vessels and follows the canal, possibly into the scrotum. It results from failure of the processus vaginalis to obliterate.
Why not the others: Direct hernia: bulges medial to the vessels in older men. Femoral hernia: below and lateral to the pubic tubercle. Incisional hernia: through a previous scar. Umbilical hernia: at the umbilicus.
High-yield: MDs don't LIe: Medial = Direct, Lateral = Indirect.
Question 5
The group of vitamins needing lifelong supplementation after total gastrectomy is:
- A. Gastric enzymes
- B. Fat-soluble vitamins
- C. Vitamin A
- D. Water-soluble vitamins, especially B12
- E. Vitamin K
Show answer
Answer: D. Water-soluble vitamins, especially B12
Gastrectomy removes the parietal cells that make intrinsic factor, so vitamin B12, a water-soluble vitamin, cannot be absorbed in the terminal ileum. Replacement is needed for life and is given parenterally.
Why not the others: Fat-soluble vitamins: malabsorbed in biliary or pancreatic disease. Gastric enzymes: not a vitamin and not the deficit. Vitamin K: fat-soluble. Vitamin A: fat-soluble. Pancreatic enzymes: pancreas is unaffected.
High-yield: Gastrectomy = no intrinsic factor = lifelong B12.
Keep going with gi and liver
Anaesgen brings every concept back on a spaced-repetition schedule timed to your exam date, as a different question each time, with full mock papers for Paper 1 and 2.
Get full access Try the 5 sample questionsHigh-yield gi and liver one-liners
The most-tested gi and liver concepts, as a clue and the answer it points to:
- Oral drug absorption, nutrient absorption, osmotic diarrhoea → small intestine.
- S cells, Brunner glands, ampulla of Vater → duodenum.
- Fasting or stress jaundice, unconjugated, normal LFTs → Gilbert syndrome.
- Lateral to epigastric vessels, deep ring, reaches scrotum → indirect inguinal hernia.
- Total gastrectomy, no intrinsic factor → lifelong water-soluble vitamin (B12) replacement.
- Rectal bleeding, altered bowel habit, iron deficiency anaemia, age over 50 → colonoscopy.
- Chief cells, proenzyme, activated by HCl, vagal stimulation → pepsinogen.
- Diarrhoea, bicarbonate and K+ loss, acidosis, hypokalaemia → colon.
- Transmural, skip lesions, fistulae, granulomas, string sign → Crohn's disease.
- Lactation, painless lump, milky aspirate → galactocele.
- Mass at appendiceal base, carcinoid over 2 cm → right hemicolectomy.
- Acid in duodenum, bicarbonate, gastrinoma test → secretin.
- Table sugar, glucose + fructose, brush border → sucrase.
- Glucose gut absorption, SGLT1 (Na+), GLUT2 exit → secondary active then facilitated.
- Gastric surgery, sugary meal, diarrhoea, dizziness → dumping.
- Pain 2-3 h after meals, night pain, relieved by eating → duodenal ulcer.
- G cells, gastrin, parietal drive → gastric antrum.
- Gut pacemaker, slow waves, basal electrical rhythm → interstitial cells of Cajal.
- Benign gastric ulcer, body-antrum junction → lesser curvature at incisura.
- Positive pregnancy test, LH-receptor mimic → maintains corpus luteum and progesterone.
Other FCPS Part 1 subjects
AnatomyPharmacologyPathologyBiochemistry & GeneticsCardiovascularNeurophysiologyMicrobiologyHaematologyGeneral PhysiologyImmunologyEndocrineRespiratoryEmbryologyObstetrics & GynaeRenal & Acid-BaseHistologyPhysicsBiostatistics
New to the exam? Read the FCPS Part 1 exam guide: dates, format and a 12-week study plan.