Bile
| Excretion | Mainly by the kidney (lithium is excreted unchanged) or bile. | In kidney disease lithium accumulates and becomes toxic. |
What our notes say
- | Excretion | Mainly by the kidney (lithium is excreted unchanged) or bile. | In kidney disease lithium accumulates and becomes toxic. | (Introduction to Psychopharmacology)
- If the bile duct is blocked, bilirubin cannot reach the gut, so no urobilinogen forms. (Internal Medicine 4th Year 1st Semester CAT: HIV and the gut, liver disease and )
- Some intrahepatic bile ducts are obliterated, but there is no interface hepatitis. (Gastrointestinal and liver — Past Paper Questions & Answers)
- Gallbladder hypotonia and more lithogenic bile raise the risk of gallstones and cholestasis. (Reproductive Health 1 End of Trimester CAT: November 2018)
- Primary biliary cirrhosis begins by damaging small bile ducts, giving a pre-sinusoidal block early on. (Internal Medicine 4th Year 1st Semester CAT: HIV and the gut, liver disease and )
- | Cholestatic | ALP and GGT high | Gallstones in the bile duct, tumour, primary biliary cholangitis | (Hepatitis B and the approach to hepatitis)
Study material on Bile
- Liver Histology & Physiology
- Liver Histology & Physiology
- Liver Function Tests (LFTs)
- KIDNEY FUNCTION TESTS & GASTRIC FUNCTION
- CRUSH COURSE (PART 2) Clinical Chem Patho
- MEDICAL PHYSIOLOGY II ESsays
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- Medical Physiology Paper II MCQs
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- Medical Physiology Section A - Complete Questions and Comprehensive Answers
- Weekly Year 2: GIT Physiology Exam - March 27, 2026 (Section A: MCQs)
- Liver Histology, Physiology and Pathology — Practice Questions
- Medical Physiology Ii
- Weekly Year 2: GIT Physiology Exam - April 21, 2026 (Section A: MCQs)
- Weekly Year 2: GIT Physiology Exam - April 17, 2026 (Section A: MCQs)
- Weekly Year 2: GIT Physiology Exam - April 10, 2026 (Section A: MCQs)
Practice questions on Bile
Which statement about bile is true?
- Bile is produced by the gallbladder.
- Bile salts emulsify fats in the stomach.
- Bile aids in the absorption of fat-soluble vitamins.
- Bile is acidic.
Answer: C. Bile is produced by the liver and stored in the gallbladder. Bile salts are crucial for fat emulsification in the small intestine and help in the absorption of fat-soluble vitamins (A, D, E, K). Bile is alkaline.
Which statement about bile is true?
- Bile is primarily composed of water, bilirubin, and cholesterol.
- Bile salts are synthesized in the liver and reabsorbed in the ileum.
- Bile aids in carbohydrate digestion.
- Bile is secreted in response to sympathetic stimulation.
Answer: B. Bile salts are synthesized from cholesterol in the liver and are crucial for fat digestion and absorption. They are actively reabsorbed in the terminal ileum and returned to the liver via the enterohepatic circulation. Bile primarily aids in fat digestion and emulsification, not carbohydrate digestion. Bile secretion is stimulated by parasympathetic activity and hormones like CCK.
Which statement about bile is true?
- A. Bile is primarily produced by the gallbladder.
- B. Bile salts are recycled to the liver via the portal circulation in the enterohepatic circulation.
- C. Bile contains digestive enzymes for fat digestion.
- D. The main function of bile is to neutralize gastric acid in the duodenum.
Answer: B. Bile salts are essential for fat digestion and absorption. After aiding digestion in the small intestine, approximately 95% of bile salts are reabsorbed in the terminal ileum and returned to the liver via the portal vein for reuse, a process known as enterohepatic circulation. Bile is produced by the liver, stored and concentrated by the gallbladder. Bile does not contain digestive enzymes. While it is alkaline, its
Which of the following hormones stimulates the gallbladder to release bile?
- Enterokinase
- Secretin
- Cholecystokinin
- Gastrin ✅ Answer: C. Cholecystokinin
Answer: A. Cholecystokinin is the physiologically correct answer per standard MBChB-level teaching on this topic. ---
A liver lesion in a 35-year-old male reveals a central stellate scar and radiating fibrous septa containing anomalous arteries and bile ductules. What is the most likely diagnosis?
- Hepatocellular Carcinoma
- Fibrolamellar Carcinoma
- Focal Nodular Hyperplasia (FNH)
- Hepatic Angiosarcoma
Answer: C. Focal Nodular Hyperplasia is characterized by a central stellate scar and a 'spoke-wheel' vascular pattern. It is a regenerative response to a pre-existing vascular malformation. ---
Bile is formed by
- Sinusoidal endothelium
- Stromal cells
- Lymphocytes
- (von) Kupffer cells
- Hepatic cells (hepatocytes)
Answer: E. ** Hepatocytes are the main functional cells of the liver and are responsible for bile production. Kupffer cells are liver macrophages. --- ---