Gastrointestinal physiology: medium-chain triglycerides: 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 · Gastrointestinal physiology: medium-chain triglycerides

Sample item

A 9-month-old with biliary atresia after a Kasai procedure has steatorrhoea and poor weight gain. A formula rich in medium-chain triglycerides is introduced. Why does this help?

AThey are packaged more efficiently into chylomicronsBThey strongly stimulate bile acid secretionCThey are absorbed without micellar solubilisation and enter portal blood directlyDThey are hydrolysed by gastric lipase alone

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

The answer and the reasoning

C. They are absorbed without micellar solubilisation and enter portal blood directly

Long-chain fats require bile salt micelles and are reassembled into chylomicrons that travel through lymphatics. Medium-chain triglycerides are more water soluble, are hydrolysed readily and their fatty acids pass directly into portal blood bound to albumin, bypassing the need for bile.

Option by option

A. They are packaged more efficiently into chylomicrons
Medium-chain fatty acids are not incorporated into chylomicrons in significant amounts.
B. They strongly stimulate bile acid secretion
They do not stimulate bile secretion, and in biliary atresia none could be delivered.
C. They are absorbed without micellar solubilisation and enter portal blood directly (correct)
Correct. Absorption is independent of micelles and chylomicrons.
D. They are hydrolysed by gastric lipase alone
Pancreatic lipase also acts on them, and gastric lipase does not account for their benefit.

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 C, They are absorbed without micellar solubilisation and enter portal blood directly. Long-chain fats require bile salt micelles and are reassembled into chylomicrons that travel through lymphatics.

Why is "They are packaged more efficiently into chylomicrons" not the answer?

Medium-chain fatty acids are not incorporated into chylomicrons in significant amounts.

Why is "They strongly stimulate bile acid secretion" not the answer?

They do not stimulate bile secretion, and in biliary atresia none could be delivered.

Why is "They are hydrolysed by gastric lipase alone" not the answer?

Pancreatic lipase also acts on them, and gastric lipase does not account for their benefit.

What concept does this question test?

It tests Gastrointestinal physiology: medium-chain triglycerides in Physiology. Medium-chain triglycerides are more water soluble, are hydrolysed readily and their fatty acids pass directly into portal blood bound to albumin, bypassing the need for bile.

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 Gastrointestinal physiology: medium-chain triglycerides?

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.