MRCP Part 1 Gastroenterology — 25 Practice MCQs with Explanations

TL;DR

This article provides 25 Gastroenterology MCQs with explanations crafted for MRCP Part 1 candidates. You’ll refresh core hepatology, IBD, pancreatic and GI-bleed themes, recognise exam traps, and use a practical study checklist to integrate these into your revision.

Why Gastroenterology MCQs Matter in MRCP Part 1

Gastroenterology and hepatology are allocated roughly 14 questions per MRCP Part 1 exam (out of 200). thefederation.uk+1Thus, solid performance in GI can make a real difference to your overall score. Moreover, practising MCQs helps build pattern recognition, diagnostic instincts, and time management under exam pressure.

While factual recall is necessary, the exam rewards clinical reasoning — connecting physiology, pathophysiology, and management — rather than pure memorisation. Hence MCQ practice combined with explanation review is essential.

Scope & High-Yield Subtopics in Gastroenterology

Below are 8 high-yield domains in gastroenterology for MRCP Part 1:

1. Hepatology / Liver disease – including viral, autoimmune, metabolic, cirrhosis, portal hypertension

2. GI bleeding – variceal vs non-variceal, risk scores, resuscitation

3. Inflammatory bowel disease (IBD) – UC, Crohn’s, biologics, extraintestinal features PubMed+1

4. Pancreatic disorders – acute, chronic, and enzyme interpretation

5. Malabsorption / small bowel – coeliac disease, tropical sprue, blind loop syndrome

6. Biliary / cholestatic disease – primary biliary cholangitis, PSC, cholangiocarcinoma PubMed

7. Functional GI disorders / motility – functional dyspepsia, IBS PMC+1

8. Acid-base / metabolic / hepatic encephalopathy – ammonia, anion gap, combined disorders

Additionally, 5 common “trap areas” to watch out for:

• Serology false negatives / overlap (e.g. autoimmune hepatitis + PBC overlap)

• Presentation under resuscitation (e.g. GI bleed before endoscopy)

• Mixed metabolic / acid-base abnormalities

• Overreliance on imaging without correlating labs

• Confusing epidemiology (e.g. age/gender for liver disease)

Sample MCQ + Explanation

Here is one illustrative MCQ to show style and depth:

Question: A 45-year-old woman presents with fatigue and mild jaundice. Labs: ALT 220, ALP 180, AMA (anti-mitochondrial antibody) strongly positive. What is the most likely diagnosis?

A. Autoimmune hepatitisB. Primary biliary cholangitisC. Primary sclerosing cholangitisD. Drug-induced cholestasisE. Wilson’s disease

Answer: B. Primary biliary cholangitis

Rationale / Explanation:

• The raised ALP with cholestatic pattern plus strongly positive AMA is classically consistent with Primary Biliary Cholangitis (PBC).

• Autoimmune hepatitis often is ANA/SMA positive with more hepatocellular pattern (high ALT).

• PSC is often in men, with cholangiographic strictures and involvement of large bile ducts.

• Drug-induced cholestasis is possible but there should be drug exposure context.

• Wilson’s disease is unlikely in this age, and requires low ceruloplasmin and copper studies.

When answering, always combine lab pattern + antibody + epidemiology + clinical context.

25 MCQs: Structure & Themes

In your full version (in your MCQ bank or app), ensure you mix:

• ~3 hepatology / cirrhosis

• ~3 GI bleed

• ~3 IBD

• ~3 pancreas / biliary

• ~3 malabsorption / small bowel

• ~3 functional / motility

• ~3 acid-base / metabolic

• ~4 mixed integrative vignettes

Each question should be in best-of-five format (one correct, four plausible distractors). thefederation.uk+1

After answering, read the explanation deeply — don’t just mark right/wrong. Note why distractors are wrong.

Practical Study-Suggestion Checklist

Here’s a compact revision checklist to integrate these 25 MCQs into your schedule:

✅ Task	Purpose / Notes
Do 5–10 GI MCQs daily	Distributed exposure across subtopics
Immediately review explanations	Strengthen understanding rather than blind recall
Flag weak-area questions	Revisit those later (after 3–5 days)
Combine with topic summary	After each theme (e.g. IBD), summarise patterns
Weekly mixed timed block	Simulates exam pressure
Monthly full mock test	Gauge cumulative readiness
Record “trap/distractor reasons”	Helps avoid repeating errors

Using MCQ & Mock Tests Most Effectively

• Timed sets: Always attempt under timed conditions (e.g. 50 GI + adjacent topics in 60 min).

• Error review: Review all wrong & borderline ones. Make flashcards summarising why distractors were wrong.

• Spaced repetition: Return to flagged items after 3, 7, 14, 30 days.

• Interleaving: Mix GI with other systems (renal, endocrine) to reflect exam variety.

• Use performance analytics: If your platform / app gives topic-wise stats, focus revision accordingly.

A structured MCQ bank plus monthly full mocks gives both depth and breadth of assessment.

Common Pitfalls in Gastroenterology MCQs

1. Ignoring resuscitation in GI bleeding questions — always consider stabilisation first before definitive therapy.

2. Misinterpreting antibody positivity — e.g. ANA or AMA may be present in low titres; correlate with disease pattern.

3. Overemphasis on single lab values — always contextualise with clinical presentation.

4. Neglecting overlapping syndromes — e.g. overlap PBC + AIH can mislead.

5. Skipping distractor analysis — not all wrong options are equally wrong; understanding helps avoid similar errors.

   
   

Ready to start?

If you'd like all 25 Gastroenterology MCQs with full explanations, examples, and analytics, explore our MCQ bank platform or test yourself with a free mock test. You may also like our sibling blog posts such as “Gastroenterology for MRCP Part 1: Core Facts & Revision Tips” and “MRCP Part 1: Integrative System-Wise Mock Strategy.”

Best of luck — with consistent practice, you’ll build the depth and pattern sense to tackle GI questions confidently in your MRCP Part 1 exam.

FAQs

Q1. How many gastroenterology questions in MRCP Part 1?

Typically around 14 GI/hepatology questions, per the MRCP(UK) blueprint. thefederation.uk+1

Q2. Are explanations more important than number of questions?

Yes — depth of understanding via explanations (especially why distractors are wrong) is far more valuable than volume alone.

Q3. Should I do GI MCQs early or late in the syllabus?

Interleave early and throughout. Revisit periodically via spaced repetition rather than leaving to the final weeks.

Q4. Do real MRCP GI questions use UK guidelines (BSG)?

Yes — many MCQs are built on UK guideline standards from societies like the British Society of Gastroenterology. bsg.org.uk+1

Q5. How to avoid burnout doing many MCQs?

Limit to manageable daily numbers, mix with passive revision (reading / mnemonics), and take rest & consolidation days.

Sources

• MRCP(UK) Part 1 format and blueprint — The Federation of the Royal Colleges of Physicians thefederation.uk+1

• BSG / British Society of Gastroenterology guidelines on IBD and functional dyspepsia PubMed+2PMC+2

• BMJ Careers: top MRCP tips BMJ

• Medic Mind MRCP Part 1 guide Medic Mind

• PubMed guidelines on cholangiocarcinoma (BSG) PubMed