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Physiology · GI physiology: absorption of glucose and rehydration
Sample itemA 2-year-old with acute watery diarrhoea from cholera is treated with oral rehydration solution containing glucose and sodium. Why does glucose improve sodium and water absorption despite the toxin?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Sodium-glucose cotransport through SGLT1 remains intact and pulls water osmotically
In cholera the toxin raises cAMP and drives chloride secretion by crypt cells, but the absorptive machinery on the villus cell brush border remains normal. SGLT1 transports one glucose with two sodium ions, and water follows through osmosis and paracellular routes. This coupling underlies the ORS, which reduces the need for intravenous fluids in most patients.
Option by option
A. Glucose neutralises the cholera toxin in the lumen
Glucose does not bind or neutralise the toxin, which acts intracellularly.
B. Glucose inhibits the secretion of chloride through the cystic fibrosis channel
Glucose has no effect on the chloride channel, which stays open under the influence of cAMP.
C. Glucose increases the activity of the sodium-potassium-chloride cotransporter in crypt cells
The NKCC1 transporter supports secretion in crypt cells and is not made more active by glucose.
D. Sodium-glucose cotransport through SGLT1 remains intact and pulls water osmotically (correct)
SGLT1 couples glucose to sodium uptake, so absorption survives in cholera.
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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