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Physiology · General physiology: secondary active transport
Sample itemA 5-year-old child with cholera has profuse watery diarrhoea. Oral rehydration solution is effective even though the toxin drives secretion, mainly because:
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Sodium-glucose cotransport at the enterocyte brush border stays intact and pulls in sodium and water
Cholera toxin raises cAMP in crypt cells and opens CFTR chloride channels, causing secretion. The villus enterocyte SGLT1 symporter, which moves one glucose with two Na+ down the Na+ gradient set by the basolateral Na+-K+ ATPase, is not damaged. Water follows the absorbed solute, so glucose-containing solutions rehydrate.
Option by option
A. Glucose stimulates the crypt cell Na+-K+-2Cl- cotransporter and so reverses the net secretion
Secretion arises from cAMP-driven CFTR opening, and glucose does not reverse it through the crypt cotransporter.
B. Glucose crosses the brush border by GLUT2, which is not affected by the toxin and carries water along
GLUT2 is the basolateral exit route; the apical entry route is SGLT1.
C. Sodium-glucose cotransport at the enterocyte brush border stays intact and pulls in sodium and water (correct)
SGLT1 is a secondary active transporter whose function persists, so glucose and sodium absorption drive water uptake.
D. Luminal glucose inactivates cholera toxin so that chloride secretion by the crypt cells stops
Glucose does not inactivate the toxin, which acts through irreversible activation of adenylyl cyclase.
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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