Gastroenterology and hepatology: diabetic gastroparesis: practice question

A General Medicine 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 Medicine · Gastroenterology and hepatology: diabetic gastroparesis

Sample item

A 40-year-old man with type 1 diabetes for 15 years has early satiety, vomiting of food eaten many hours earlier and erratic glycaemic control. Endoscopy shows retained food but no obstruction. Which drug is an appropriate first-line prokinetic?

AMetoclopramideBHyoscine butylbromideCLoperamideDSucralfate

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

The answer and the reasoning

A. Metoclopramide

Autonomic neuropathy delays gastric emptying, which can be confirmed by scintigraphy once obstruction is excluded. Metoclopramide, a dopamine D2 antagonist with 5-HT4 agonist action, speeds gastric emptying. Treatment also includes small frequent meals and glycaemic control.

Option by option

A. Metoclopramide (correct)
Correct. Metoclopramide acts as a prokinetic by D2 antagonism and 5-HT4 agonism.
B. Hyoscine butylbromide
Hyoscine is an antispasmodic that slows motility, so it is unsuitable.
C. Loperamide
Loperamide slows gut motility and would worsen stasis.
D. Sucralfate
Sucralfate coats ulcers and has no prokinetic effect.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Metoclopramide. Autonomic neuropathy delays gastric emptying, which can be confirmed by scintigraphy once obstruction is excluded.

Why is "Hyoscine butylbromide" not the answer?

Hyoscine is an antispasmodic that slows motility, so it is unsuitable.

Why is "Loperamide" not the answer?

Loperamide slows gut motility and would worsen stasis.

Why is "Sucralfate" not the answer?

Sucralfate coats ulcers and has no prokinetic effect.

What concept does this question test?

It tests Gastroenterology and hepatology: diabetic gastroparesis in General Medicine. Metoclopramide, a dopamine D2 antagonist with 5-HT4 agonist action, speeds gastric emptying. Treatment also includes small frequent meals and glycaemic control.

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 Gastroenterology and hepatology: diabetic gastroparesis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.