Flash Card

Question 1

“How many grams of sodium are secreted in the intestines per day?

A. 20-30 grams
B. 25-35 grams
C. 25-35 grams
D. 4-9 grams”

Answer 1

“A. 20-30 grams

“Twenty to 30 grams of sodium are secreted in the intestinal secretions each day…the intestines must absorb 25 to 35 grams of sodium each day, which is equal to about one seventh of all the sodium present in the body. “-Guyton and Hall, Chapter 65, p.814”

Question 2

“What catalyzes the energy process of sodium absorption?

A. Adenosine triphosphatase
B. SGLT1
C. SGPT
D. SGOT”

Answer 2

“A. Adenosine triphosphatase

“This active transport obeys the usual laws of active trans- port: it requires energy, and the energy process is cat- alyzed by appropriate adenosine triphosphatase enzymes in the cell membrane.“ -Guyton and Hall, Chapter 65, p.814”

Question 3

“It is absorbed along with sodium that are mainly passively “dragged” by the positive electrical charges.

A. Water
B. Phosphate
C. Chloride
D. Calcium”

Answer 3

“C. Chloride

“Part of the sodium is absorbed along with chloride ions; in fact, the negatively charged chloride ions are mainly passively “dragged” by the positive electrical charges of the sodium ions.”
- Guyton and Hall, Chapter 65, p.814”

Question 4

“Chloride ion absorption is rapid and occurs mainly by diffusion in what part of the GI tract?

A. Transverse colon
B. Small intestine
C. Ascending colon
D. Stomach”

Answer 4

“B. Small intestine

ñIn the upper part of the small intestine, chloride ion absorption is rapid and occurs mainly by diffusion.î-Guyton and Hall, Chapter 65, p.815”

Question 5

“All carbohydrates in the food are absorbed in the form of?

A. Monosaccharides
B. Starch
C. Sucrose
D. Polysaccharide”

Answer 5

“A. Monosaccharides

ñEssentially all the carbohydrates in the food are absorbed in the form of monosaccharides; only a small fraction are absorbed as disaccharides and almost none as larger carbohydrate compounds. ñ-Guyton and Hall, Chapter 65, p.815”

Question 6

“Water is absorbed through the intestinal mucosa into the blood and can conversely be transported in the opposite direction, from plasma into chyme in what condition?

A. When chyme is diluted enough
B. When there is hyperactive bowel movement in cases of GI disturbances.
C. When hyperosmotic solutions are discharged from the stomach into the duodenum.
D. When there is hypoactive bowel movement in cases of GI disturbances.”

Answer 6

“C. When hyperosmotic solutions are discharged from the stomach into the duodenum.

ñWhen the chyme is dilute enough, water is absorbed through the intestinal mucosa into the blood of the villi almost entirely by osmosis.
Conversely, water can also be transported in the opposite direction„from plasma into the chyme. This occurs especially when hyperosmotic solutions are dis- charged from the stomach into the duodenum. ñ
- Guyton and Hall, Chapter 65, p. 814”

Question 7

“In cases of dehydration, increase of its absorption causes secondary increases in absorption of chloride ions, water and other substances.

A. Potassium
B. Sodium
C. Phosphate
D. Calcium”

Answer 7

“B. Sodium

ñWhen a person becomes dehydrated, large amounts of aldos- terone almost always are secreted by the cortices of the adrenal glands. Within 1 to 3 hours this aldosterone causes increased activation of the enzyme and trans- port mechanisms for all aspects of sodium absorption by the intestinal epithelium. And the increased sodium absorption in turn causes secondary increases in absorption of chloride ions, water, and some other substances. ñ
- Guyton and Hall, Chapter 65, p. 814
“

Question 8

“In cases of dehydration, our body normally secretes large amounts of aldosterone to compensate by increaseing its activation and transport mechanisms. Therefore, aldosterone is especially important in the colon because?

A. it allows virtually no loss of sodium chloride in the feces and therefore increases water loss.
B. it allows virtually no loss of sodium chloride in the feces and also decreases apetite.
C. it allows virtually no loss of sodium chloride in the feces and also increases apetite which makes patient crave for food.
D. it allows virtually no loss of sodium chloride in the feces and also decreases apetite which may sometimes lead to anorexia”

Answer 8

“C. it allows virtually no loss of sodium chloride in the feces and also decreases water loss.

ñThis effect of aldosterone is especially important in the colon because it allows virtually no loss of sodium chloride in the feces and also little water loss. Thus, the function of aldosterone in the intestinal tract is the same as that achieved by aldosterone in the renal tubules, which also serves to conserve sodium chloride and water in the body when a person becomes dehydrated. ñ
- Guyton and Hall, Chapter 65, p. 814”

Question 9

“Stimulation of formation of escess cyclic adenosine monophosphate opens chloride channels. As chloride ions flow rapidly, what would most likely happened?

A. Activate a sodium pump that pumps sodium ions into the crypts to go along water.
B. Activate a sodium pump that pumps sodium ions into the crypts to go along potassium.
C. Activate a sodium pump that pumps sodium ions into the crypts to go along choride ions.
D. Activate a sodium pump that pumps sodium ions into the crypts to go along the bile”

Answer 9

“C. Activate a sodium pump that pumps sodium ions into the crypts to go along choride ions.

ñExtreme diarrheal secretion is initiated by entry of a subunit of cholera toxin into the epithelial cells. This stimulates formation of excess cyclic adenosine monophosphate, which opens tremendous numbers of chloride channels, allowing chloride ions to flow rapidly from inside the cell into the intestinal crypts. In turn, this is believed to activate a sodium pump that pumps sodium ions into the crypts to go along with the chlo- ride ions. ñ
- Guyton and Hall, Chapter 65, p. 815”

Question 10

“Kate has been taking calcium supplement regularly as part of maitaining a healthy lifestyle. What vitamin greatly enhances cakcium absorption?

A. Vitamin D
B. Vitamin C
C Thiamine
D. Cyanocobalamine”

Answer 10

“A. Vitamin D

ñOne important factor controlling calcium absorption is parathyroid hormone secreted by the parathyroid glands, and another is vitamin D. Parathyroid hormone activates vitamin D, and the activated vitamin D in turn greatly enhances calcium absorption. ñ
- Guyton and Hall, Chapter 65, p. 815”

Question 11

“What is the MOST common cause of Pancreatitis?

A.Blockage of the ampulla of vater
B.Excess alcohol ingestion
C.Excess food intake
D.Both A and B

”

Answer 11

“A.Blockage of the ampulla of Vater

The most common cause of pancreatitis is drinking excess alcohol, and the second most common cause is blockage of the papilla of Vater by a gallstone; the two causes together account for more than 90 percent of all cases. When a gallstone blocks the papilla of Vater, the main secretory duct from the pancreas and the common bile duct are blocked. The pancreatic enzymes are then dammed up in the ducts and acini of the pancreas. ñƒî (chapter 67 Guyton and Hall p. 845 13thE)”

Question 12

“Diarrhea means?

A.Rapid movement of fecal matter through the large intestines
B.Slow movement of fecal matter through the small intestines
C.Rapid movement of fecal matter through the small intestines
D.Slow movement of fecal matter through the large intestines”

Answer 12

“A.Rapid movement of fecal matter through the large intestines

Diarrhea results from rapid movement of fecal matter through the large intestine. (chapter 67 Guyton and Hall p. 846 13thE)”

Question 13

“Zaldo, a 1st year medical student went to a party, he was given a drink then soon after had diarrhea, the drink was known to have milk in it. As a future Bedan doctor Zaldo lacks what enzyme for him to be called Lactose Intolerant?

A.Galactase
B.Lactase
C.Lactose Hydrolase
D.Lactin
"

Answer 13

“B.Lactase

Lactase degrades lactose to glucose and galactose. Lactose intolerance results from the absence of brush border lactase and, thus, the inability to hydrolyze lactose to glucose and galactose for absorption. Nonabsorbed lactose and H2O remain in the lumen of the GI tract and cause osmotic diarrhea. (chapter 6 BRS Physiology p. 210-211 5thE)”

Question 14

“Lack of pancreatic secretion in the small intestines usually occurs because of the following EXCEPT?

A.Pancreatitis
B.Hyperthropy
C.Malignancy
D.Obstruction of the pancreatic duct
"

Answer 14

“B.Hyperthropy

Lack of pancreatic secretion frequently occurs (1) in persons with pancreatitis (discussed later), (2) when the pancreatic duct is blocked by a gallstone at the papilla of Vater, or (3) after the head of the pancreas has been removed because of malignancy. (chapter 67 Guyton and Hall p. 845 13thE)”

Question 15

“The ampulla of Vater is usually obstructed causing decreased pancreatic enzyme release in the small intestines, as a Bedan Doctor it is important to know the anatomical position of the sphincter is located at the?

A.Superior part of the duodenum
B.Descending part of the duodenum
C.Inferior part of the duodenum
D.Horizontal part of the duodenum”

Answer 15

“B.Descending part of the duodenum

The main pancreatic duct and bile duct usually unite to form the short, dilated hepatopancreatic ampulla (of Vater), which opens into the descending part of the duodenum at the summit of the major duodenal papilla. (chapter 2 Moore Clinically Oriented Anatomy p. 267 7thE)”

Question 16

“Constipation basically means?

A.Fast movement of feces through the small intestines
B.Slow movement of feces through the large intestines
C.Fast movement of feces through the large intestines
D.Slow movement of feces through the small intestines”

Answer 16

“B.Slow movement of feces through the large intestines

Constipation means slow movement of feces through the large intestine. (chapter 67 Guyton and Hall p. 846 13thE)”

Question 17

“Constipation happens because of the following EXCEPT?

A.Excess absorption of fluid in the large intestines
B.Insufficient fluid intake
C.Spasm of the sigmoid colon
D.Pathology of the intestines like Tumors”

Answer 17

“C.Spasm of the sigmoid colon

Constipation is often associated with large quantities of dry, hard feces in the descending colon that accumulate because of excess absorption of fluid or insufficient fluid intake. Any pathology of the intestines that obstructs movement of intestinal contents, such as tumors, adhesions that constrict the intestines, or ulcers, can cause constipation. (chapter 67 Guyton and Hall p. 846 13thE)”

Question 18

“A 4 year old boy was admitted in the hospital, he was known to have untreated Hirschprung Disease (megacolon) associated with deficiency of ganglion cells in the myenteric plexus of the sigmoid colon. As a future Bedan Doctory you know that all of the following would be affected EXCEPT?

A.Ascending colon
B.Rectum
C.Descending colon
D.Transverse Colon”

Answer 18

“B.Rectum

One cause of megacolon is lack of or deficiency of ganglion cells in the myenteric plexus in a segment of the sigmoid colon. As a consequence, neither defecation reflexes nor strong peristaltic motility can occur in this area of the large intestine. The sigmoid becomes small and almost spastic while feces accumulate proximal to this area, causing megacolon in the ascending, transverse, and descending colons. (chapter 67 Guyton and Hall p. 846 13thE)”

Question 19

“Miguel a 4th year intern of San Beda College of Medicine will be handling his first surgery, he was really tensed and anxious prior to the surgery then suddenly experienced diarrhea, what caused this?

A.Excessive stimulation of the parasympathetic nervous system
B.Increased intestinal motility
C.Increased Intestinal secretion
D.Decreased intestinal absorption”

Answer 19

“A.Excessive stimulation of the parasympathetic nervous system

Psychogenic Diarrhea. Most people are familiar withthe diarrhea that accompanies periods of nervous tension, such as during examination time or when a soldier is aboutto go into battle. This type of diarrhea, called psychogenic emotional diarrhea, is caused by excessive stimulation of the parasympathetic nervous system, which greatly excites both (1) motility and (2) excess secretion of mucus in the distal colon. These two effects added together can cause marked diarrhea. (chapter 67 Guyton and Hall p. 846-847 13thE)”

Question 20

“Daniel Padilla was diagnosed with Ulcerative Colitis which is idiopathic, as a Bedan Doctor what would you expect in his Bowel movement?

A.Constipated
B.Diarrhea
C.Constipated bowel then followed by diarrhea
D.Diarhea then followed by constipation
"

Answer 20

“B.Diarrhea

Ulcerative Colitis. Ulcerative colitis is a disease in which extensive areas of the walls of the large intestine become inflamed and ulcerated. The motility of the ulcerated colon is often so great that mass movements occur much of the day rather than for the usual 10 to 30 minutes. Also, the colonÍs secretions are greatly enhanced. As a result, the patient has repeated diarrheal bowel movements. (chapter 67 Guyton and Hall p. 847 13thE)”

Question 21

“What is the important peptic enzyme of the stomach which is also most active at pH 2.0 to 3.0 and inactive at a pH above 5.0?

A. Trypsin
B. Chymotrypsin
C. Pepsin
D. Proastase”

Answer 21

“C. PEPSIN

Pepsin, an important peptic enzyme of the stomach, is most active at a pH of 2.0 to 3.0 and is inactive at a pH above about 5.0. This enzyme can digestion of protein, the stomach juices must be acidic. (GUYTON & HALL 13th EDITION, Chapter 66 p. 834) “

Question 22

“What is the most important enzyme for digestion of the triglyceride which is present in enormous quantities in pancreatic juice?

A. Enteric lipase
B. Pancreatic Lipase
C. Lingual lipase
D. Liver Lipase”

Answer 22

“B. Pancreatic Lipase

Most important enzyme for digestion of the triglycerides is pancreatic lipase, present in enormous quantities in pancreatic juice, enough to digest within 1min all triglycerides that it can reach. (GUYTON & HALL 13th Edition, Chapter 66 p. 836)”

Question 23

“When food is chewed, it is mixed with saliva which contains what digestive enzyme that is secreted mainly by the pancreatic glands?

A. Ptyalin
B. Elastase
C. Trypsin
D. Proelastase”

Answer 23

“A. Ptyalin

When food is chewed, it is mixed with saliva, which the digestive enzyme ptyalin (an alpha-amylase) secreted mainly by the parotid glands. This enzyme hydrolyzes starch into the disaccharide maltose and other small polymers of glucose that contain three to nine glucose molecules. (GUYTON & HALL 13th EDITION, Chapter 66 p. 833-834)”

Question 24

“What are the four enzymes that line the villi of the small intestine?

A. Lactase, sucrase, maltase and alpha dextrinase
B. Lactase, sucrase, maltase ang alpha amylase
C. Lactase, sucrase, peptidase, fructose
D. Lactase, pectins, sucrase, galactose”

Answer 24

“A. Lactase, Sucrase, Maltase and Alpha dextrinase

The enterocytes lining the villi of the small intestine contain the four enzymes (Lactase, sucrase, maltase, and alpha-dextrinase), which are capable of splitting the disaccharides lactose, sucrose and maltose, plus other small glucose polymers, into their constituent monosaccharides. (GUYTON & HALL 13th Edition, Chapter 66 p. 834)”

Question 25

"The first step in fat digestion is physically to break the fat globules into very small sizes so the water soluble digestive enzymes can act on the globule surfaces, this process is called _____. A. Pinocytosis B. Emulsification C. Facilitated Diffusion D. Bile Micelles"

Answer 25

"B. Emulsification The first step in fat digestion is to physically break the fat globules into small sizes so that the water-soluble digestive enzymes can act on the globule surfaces. (GUYTON & HALL 13th EDITION, Chapter 66 p. 836)"

Question 26

"What are the enzymes involved for carbohydrates digestion? A. Ptyalin, pancreatic amylase and brush border enzymes B. Amylopectin, amylose and alpha dextrins C. Pancreatic lipase, ptyalin and trypsin D. Trypsin, chymotryspin, carboxy peptidase"

Answer 26

"A. Ptyalin, pancreatic amylase and brush border enzymes In carbohydrate digestion, the enzymes involved are Ptyalin, pancreatic amylase and brush border enzymes. (Lecture Note)"

Question 27

"What are the enzymes needed in hydrolysis of proteins? A. Pancreatic lipases B. Trypsin, chymotrypsin, carboxypeptidase and di/tri-peptidases C. Proelastase, elastase, and trypsin D. Aminipolypeptidase and dipeptidase"

Answer 27

"B. Trypsin, chymotrypsin, carboxypeptidase and di/tri-peptidases In Hydrolysis of protein, the enzymes involved are Trypsin, chymotrypsin, carboxypeptidase and di/tri-peptidases (Lecture Note)"

Question 28

"What are the enzymes involved in hydrolysis of fats? A. Trypsin, chymotrypsin, carboxypeptidase B. Pancreatic lipase, cholesterol esterase, phospholipase, intestinal lipase C. Ptyalin, pancreatic amylase, brush border enzymes D. Aminopolypeptidase and dipeptidase"

Answer 28

"B. Pancreatic lipase, cholesterol esterase, phospholipase, intestinal lipase In Hydrolysis of fats, the enzyme s involved are Pancreatic lipase, cholesterol esterase, phospholipase, intestinal lipase (Lecture Note)"

Question 29

"Enterocyte of the small intestine contain additional lipase, but it is usually not needed in triglycerides digestion, which is ____. A. Enteric Lipase B. Lingual Lipase C. Intestinal Lipase D. Pancretic Lipase"

Answer 29

"A. Enteric Lipase Enterocyte of the small intestine contain additional lipase, known as enteric lipase, but it usually not needed in triglycerides digestion. (GUYTON & HALL 13th EDITION, Chapter 66 p. 836)"

Question 30

"Most protein digestion results from action of Pancreatic Proteolytic enzymes (PPEs). What is/are the PPEs? A. Trypsin, Chymotrypsin, carboxypolypeptidase & proelastase B. Trypsin, Chymotrypsin, aminopolypeptidase & proelastase C. Trypsin, Chymotrypsin, carboxypolypeptidase, aminopolypeptidase & elastase D. Trypsin, Chymotrypsin, carboxypolypeptidase & elastase "

Answer 30

"D. Trypsin, Chymotrypsin, carboxypolypeptidase & elastase Immediately upon entering the small intestine from the stomach, the partial breakdown products of the protein foods are attacked by the major proteolytic pancreatic enzymes tyrpsin, chymotrypsin, carboxypolypeptidase and elastase. (GUYTON & HALL 13th EDITION, Chapter 66 p. 835)"

Question 31

"In protein digestion, what is the significance of elastase in our body? A. Digestion of elastin fibers that completely holds the meat together B. Digestion of elastin fibers that partially holds the meat together C. Digestion of collagen fibers that partially holds the meat together D. Digestion of collagen fibers that completely holds the meat together."

Answer 31

"B. Digestion of elastin fibers that partially holds the meat together Proelastase, in turn, is converted into elastase, which then digests elastin fibers that partially holds the meat together. (GUYTON & HALL 13th Edition, Chapter 66 p. 835)"

Question 32

"You are the top student in SBCM, your classmate tests you and asks if you know the significance of lingual lipase in our body. Your answer will be: A. You know that small amount of Triglycerides is digested in the stomach by lingual lipase B. You know that small amount of Cholesterol is digested in the stomach by lingual lipase C. You know that small amount of Phospholipid is digested in the stomach by lingual lipase D. You will tell your classmate to better read guyton "

Answer 32

"A. You know that small amount of Triglycerides is digested in the stomach by lingual lipase A small amount of triglycerides is digested in the stomach by lingual lipase secreted by lingual glands in the mouth & swallowed with the saliva. (GUYTON & HALL 13th EDITION, Chapter 66 p. 836)"

Question 33

"As a 1st-year SBCM student, you know that pepsin is an important peptic enzyme of the stomach. However, you must remember that one of the important features of pepsin digestion is to digest which protein: A. Hepatoglobin B. Polypeptides C. Collagen D. Amino acids"

Answer 33

"C. Collagen One of the important features of pepsin digestion is its ability to digest the protein collagen, an albuminoid type of protein that is affected little by other digestive enzymes to penetrate meats and digest the meat proteins. (GUYTON & HALL 13th EDITION, Chapter 66 p. 835)"

Question 34

"Chicharon is one of the best delicacies in the Philippines but you know that this food is high in cholesterol. As a Future Bedan Doctor, you know that most cholestetol in diet is in the form of cholesterol ester and it is hydrolyzed by two lipases in the pancreatic secretion. What are the two lipases? A. Cholesterol ester hydrolase & Phospholipase A1 B. Cholesterol hydrolase & Phospholipase A1 C. Cholesterol ester hydrolase & Phospholipase A2 D. Cholesterol hydrolase & Phospholipase A2 "

Answer 34

"C. Cholesterol ester hydrolase & Phospholipase A2 In the pancreatic secretion, cholesterol ester hydrolase to hydrolyze the cholesterol ester and phospholipase A2 to hydrolyze the phospholipid. (GUYTON & HALL 13th EDITION, Chapter 66 p. 837)"

Question 35

"In fat digestion, It is the ""ferrying"" free cholesterol and phospholipid molecule digestates that they play in ferrying monoglycerides and free fatty acids? A. Hydrolysis B. Pancreatic lipase C. Lecithin D. Bile salt micelles"

Answer 35

"D. Bile salt micelles The Bile salt micelles play the same role in ferrying free cholesterol and phospholipid molecule digestates. Indeed, essentially no cholesterol is absorbed without the function of the micelles. (GUYTON & HALL 13th Edition, Chapter 66 p. 837)"

Question 36

"It is a condition in which the lower esophageal sphincter fails to relax during swallowing? A. Achalasia B. Achlorhydria C. Hypochlorhydria D. Botulism "

Answer 36

"A. Achalasia Acchalasia is a condition im which the LES fails to relax during swallowing. As a result, food swallowed into the esophagus fails to pass from the esophagus into the stomach. (GUYTON & HALL 13th EDITION, Chapter 67 p. 843)"

Question 37

"When swallowing mechanism is partially or totally paralyzed, the abnormalities that can occur includes the following except: A. Complete abrogation of the swallowing act so that swallowing cannot occur B. Failure of the glottis to close so that food passes into the lungs instead of the esophagus C. Failure of the soft palate and uvula to close the posterior nares so that food refluxes into the nose during swallowing D. Failure of the hard palate and uvula to close the anterior nares so that food refluxes into the nose during swallowing "

Answer 37

"D. Failure of the hard palate and uvula to close the anterior nares so that food refluxes into the nose during swallowing When the swallowing mechanism is partially or totally paralyzed, the abnormalities that can occur include (1) complete abrogation of the swallowing act so that swallowing cannot occur, (2) failure of the glottis to close so that food passes into the lungs instead of the esophagus, and (3) failure of the soft palate and uvula to close the posterior nares so that food refluxes into the nose during swallowing. (GUYTON & HALL 13th Edition, Chapter 67 p. 843) "

Question 38

"Gastric contents are propelled up to the esophagus during vomiting by: A. Forceful contraction of abdominal muscles B. Sucked up by deep inspiratory movement C. Spastic contraction of gastric walls D. Forceful expansion of the thorax "

Answer 38

"A. Forceful contraction of abdominal muscles Next comes a strong downward contraction of the diaphragm along with simultaneous contraction of all the abdominal wall muscles, which squeezes the stomach between the diaphragm and the abdominal muscle, building the intragastric pressure to a high level. Finally, the LES relaxes completely allowing explusion of the gastric content upward through the esophagus. (GUYTON & HALL 13th Edition, Chapter 67 p. 848)"

Question 39

"A patient has been diagnosed with gastroesophageal reflux disease (GERD) complains of heartburn. To decrease the heartburn, the doctor should instruct the patient to eliminate which if the following food from his diet? ``` A. Lean beef B. Air- popped popcorn C. Hot chocolate D. Raw vegetables " ```

Answer 39

"C. Hot chocolate Caffeine containing beverages like coffee, tea and chocolate lower LES (lower esophageal sphincter) pressure and will further cause GERD"

Question 40

"You are a new board passer Physician in Quirino Medical Center in the ER and you're assigned with the junior interns. The patient arrives & complains that she cannot swallow. Upon assessing the patient, she said that she has poliomyelitis. You suspected her with Paralysis of swallowing. But one of the junior interns ask you ""How poliomyelitis contribute to the clinical diagnosis?"" A. Poliomyelitis or encephalitis can prevent normal swallowing by damaging the swallowing center in the brain stem B. Poliomyelitis cannot contribute to the clinical diagnosis because the patient cannot swallow C. There's no association at all D. You will tell the intern to better read guyton again"

Answer 40

"A. Poliomyelitis or encephalitis can prevent normal swallowing by damaging the swallowing center in the brain stem Damage to the fifth, ninth or tenth cerebral nerve can cause paralysis of significant portion of the swallowing mechanism. In addition, a few diseases, such as Poliomyelitis or encephalitis, can prevent normal swallowing by damaging the swallowing center in the beain stem. (GUYTON & HALL 13th EDITION, Chapter 67 p. 843)"

Question 41

"This nerve innervates parietal cells and stimulates H+ secretion directly A. Vagus nerve B. Facial nerve C. Abducens nerve D. Trigeminal nerve"

Answer 41

"A. Vagus nerve Vagal stimulation increase H+ secretion by a direct and indirect pathway. The direct pathway, the vagus nerve innervates parietal cells and stimulates H+ secretion directly. The indirect path, the vagus nerve innervates G cells and stimulates gastrin secretion, which then stimulates H+ secretion by an endocrine action.-BRS Physiology 4th edition & Textbook of Medical Physiology 11th edition Guyton and Hall"

Question 42

"It is a gastro intestinal hormone from duodenum (I cells) that inhibits H+ secretion. A. Cholecystokinin B. Secretin C. Peptide YY D. Glucoinsulinotropic peptide"

Answer 42

"A. Cholecystokinin Cholecystokinin is from duodenum (I cells) that can inhibit gastric emptying and H+ secretion.Book sources: BRS Physiology 4th edition & Textbook of Medical Physiology 11th edition Guyton and Hall"

Question 43

"This phase occurs even before food enters theæstomach and the sensory aspect of food influences eating behaviors A. Cephalic phase B. Gastric phase C. Intestinal phase D. Geno phase"

Answer 43

"A. Cephalic phase Cephalic phase of digestion, the anticipation of food prepares the body for the digestion, absorption and use of nutrients in food. The sensory aspect of food, such as the sight and smell, influences eating behaviors. Book sources: BRS Physiology 4th edition & Textbook of Medical Physiology 11th edition Guyton and Hall"

Question 44

"In this phase there is a continuous secretion of hydrochloric acid and pepsin which aids in the digestion of food. A. Gastric phase B. Cephalic phase C. Intestinal phase D. Geno phase"

Answer 44

"A. Gastric phase The gastric phase of digestion begins when food enters the stomach, then the stomach continues to release the digestive chemicals hydrochloric acid and pepsin to help in deigestion of food. Book sources: BRS Physiology 4th edition & Textbook of Medical Physiology 11th edition Guyton and Hall"

Question 45

"The gastric secretion in this phase is 10% due to response of duodenum to the arriving chyme A. Intestinal phase B. Cephalic phase C. Gastric phase D. Geno phase"

Answer 45

"A. Intestinal phase Theæintestinal phaseæis a stage in which theæduodenumæresponds to arrivingæchymeæand moderates gastric activity through hormones and nervous reflexes. Also this process appetite decreases in order to stop food consumption. Book sources: BRS Physiology 4th edition & Textbook of Medical Physiology 11th edition Guyton and Hall"

Question 46

"Functions of gastrin except A. Increased secretory activity of periparietal cells B. Growth of gastric mucosa is inhibited C. Decreased secretory activity of parietal cells D. H+ secretion is increased"

Answer 46

"D. H+ secretion is increased This is the action of gastric cells. Textbook of Medical Physiology 11th edition Guyton and Hall"

Question 47

"Which of the following can be a stimuli for gastric secretion? A. Meals containing small peptides and amino acids B. Somatostatin C. Gastrin-releasing peptide D. A and C" "A patient presented with the following symtoms: Abdominal pain, nausea, vomiting, gastrointestinal bleeding and weight loss. Upon diagnosis it was discovered that he has Zollinger-Ellison syndrome. What is the cause of this disease? A. CFTR gene mutation B. A non-beta cell, gastrin secreting tumor of the pancreas C. A non-delta cell, gastrin secreting tumor of the pancreas D. A and B"

Answer 47

"D. A and C Somatostatin inhibits gastrin release Textbook of Medical Physiology 11th edition Guyton and Hall"

Question 48

"A patient presented with the following symtoms: Abdominal pain, nausea, vomiting, gastrointestinal bleeding and weight loss. Upon diagnosis it was discovered that he has Zollinger-Ellison syndrome. What is the cause of this disease? A. CFTR gene mutation B. A non-beta cell, gastrin secreting tumor of the pancreas C. A non-delta cell, gastrin secreting tumor of the pancreas D. A and B"

Answer 48

"B. A non-beta cell, gastrin secreting tumor of the pancreas Zollinger-Ellison syndrome is caused by a non-beta cell, gastrin secreting tumor of the pancreas. CFTR gene mutation would cause cystic fibrosis and not Zollinger-Ellison syndrome. - www.emedicine.medscape.com"

Question 49

"Hormones that stimulate the secretory activity of the pancreas A. VIP B. Sequestrin C. Cholecystokinase D. A and B"

Answer 49

"A. VIP VIP, Secretin and CCK would increase the HCO3- secretion of the pancreas. Book sources: BRS Physiology 4th edition & Textbook of Medical Physiology 11th edition Guyton and Hall"

Question 50

"In general, pancreatic secretion are: A. Have enzymes for the digestion of protein, carbohydrates and fat B. Contains HCO2- C. Can neutralize basic chime D. Both A and B"

Answer 50

"A. Have enzymes for the digestion of protein, carbohydrates and fat Pancreatic secretion have enzymes for the digestion of protein, carbohydrates and fat. It also contains HCO3- and can neutralize acidic chime. Book sources: BRS Physiology 4th edition & Textbook of Medical Physiology 11th edition Guyton and Hall"

Question 51

"A patient presents to the hospital with complaints of heartburn, weight loss, and stomach pain between meals. The doctor suspects a peptic ulcer disease and ordered diagnostic tests. One of the diagnostic tests was ordered to rule out H. Pylori. What would you expect the doctor to perfrom? A. Instructing the patient to drink a solution of C-urea, which is converted to CO2 by urease and measured in the expelled air B. Instructing the patient to take an acid-blockingæmedication, such as those used to treatæheartburn, for a short period of time to see if symptoms improve C. Ordering an endoscopy to visualize the stomach for abnormalities D. Instructing the patient to drink a thick white liquid (barium) that helps stomach and small intestine show up on X-rays "

Answer 51

"A. Instructing the patient to drink a solution of C-urea, which is converted to CO2 by urease and measured in the expelled air the diagnostic test for H. Pylori involves drinking a solution of C-urea, which is converted to CO2 by urease and measured in the expelled air. (BRS 4th ed.)"

Question 52

"One of the causes of peptic ulcer disease is the Zollinger-Ellison syndrome. What and How can the Zollinger-Ellison cause peptic ulcer A. It is a gastrin-secreting tumor of the pancreas that produce a gram negative H. Pylori bacteria that causes peptic ulcer disease B. It is a gastrin-secreting tumor of the pancreas that inhibits COX-1 causing gastric mucus damage resulting to peptic ulcer disease C. It is a gastrin-secreting tumor of the pancreas that increases H+ secretion causing peptic ulcer disease D. It is a gastrin-secreting tumor of the pancreas inhibits prostaglandin resulting to peptic ulcer disease "

Answer 52

"C. It is a gastrin-secreting tumor of the pancreas that increases H+ secretion causing peptic ulcer disease Zollinger-Ellison is a gastrin-secreting tumor of the pancreas that increases H+ secretion. H+ secretion continues unabated because the gastrin secreted by pancreatic tumor cells is not subject to negative feedback inhibition by H+ (BRS 4th ed.)"

Question 53

"A type of peptic ulcer disease that when there is too much intake of food, the pain worsens ``` A. Zollinger-Ellison syndrome B. Duodenal Ulcers C. Gastric Ulcers D. Gastritis " ```

Answer 53

"b. Duodenal Ulcers duodenal ulcers gastrin secretion in response to a meal is increased (Guyton 9th ed)"

Question 54

"A patient was admited with a diagnosis of peptic ulcer disease caused by an H. Pylori bacteria. The student doctor is aware that H. pylori bacteria can live in an acidic environment like the stomach in what way? A. H. Pylori contains urease, which converts urea to NH3, thus alkalinizing the local environment. B. H. Pylori blocks the parietal cells that release HCl acid C. H. Pylori inhibits gastrin that stimulates gastric acid secretion. D. H. Pylori destroys gastric mucosa thereby preventing release of gastric juices that is responsible for the acidity of the stomach"

Answer 54

"a. H. Pylori contains urease, which converts urea to NH3, thus alkalinizing the local environment H. Pylori contains urease, which converts urea to NH3, thus alkalinizing the local environment and permitting H. Pylori to survive in the otherwise acidic gastric lumen. (Guyton 9th ed)"

Question 55

"What glycoprotein combines with vitamin b12 that makes the vitamin b12 absorvable by the gut? a. Extrinsic factor b. Mucin c. Intrinsic factor d. Miraculin"

Answer 55

"c. Intrinsic factor the parietal cells of the gastric glands secrete a glycoprotein called intrinsic factor, which combines with vit. B12 of the food and makes the B12 available for absorption by the gut. (guyton 9th ed)"

Question 56

"A 20 year old patient presented in the hospital with symptoms of pernicious anemia. Pernicious anemia is a decrease in RBC that occurs when the intestines cannot properly absorb vitamin b12. Which part of the intestine are vitamin b12 absorbed. a. Duodenum b. Ileum c. Jejunum d. Cecum"

Answer 56

"b. Ileum Vitamin b12 is absorbed in the ileum and requires intrinsic factor. The intrinsic factor binds to specific receptor sites on the brush border membranes of the mucosal cells in the ileum. (guyton 9th ed)"

Question 57

"A 47 year old patient consulted a doctor and presents pallor in appearance with complaints of generalized weakness, and dizziness. Laboratory results showed a low RBC count. Patient also had a previous gastrectomy. The doctor suspects the patient to have what kind of anemia? a. Iron deficiency anemia b. Sickle cell anemia c. Aplastic anemia d. Pernicious anemia"

Answer 57

"d. Pernicious anemia gastrectomy results on the loss of gastric parietal cells, which are the source of intrinsic factor. (guyton 9th ed)"

Question 58

"Frequent use of laxatives can lead to what disorder of the large intestine? a. Megacolon b. Enteritis c. Psychogenic diarrhea d. Constipation "

Answer 58

"d. Constipation overuses of laxatives to take the place of natural bowel function, the reflexes themselves become progressively less strong over a period of time and the colon becomes atonic. (guyton 9th ed)"

Question 59

"A patient with constipation asked an advice regarding the best time to defecate to prevent development of constipation. The best time would be? a. In the evening after dinner b. In the morning after breakfast c. In the afternoon after lunch d. After every meal"

Answer 59

"b. In the morning after breakfast if a person establishes regular bowel habits early in life, usually defecating in the morning after breakfast when the gastrocolic and duodenocolic reflexes cause mass movements in large intestine, the development of constipation in later life can generally be prevented. (Guyton 9th ed)"

Question 60

"A type of ulcer that is relieved by intake of food a. Gastric ulcer b. Duodenal ulcer c. Stress ulcer d. Both a and b"

Answer 60

"a. Gastric ulcer food neutralizes the acidity of the stomach in gastric ulcers. "

Question 61

"In the acinus, what composition similar to plasma produces an initial saliva? a.Na+, K+, Cl-, Ca+ b .Na+, K+, Cl-, HCO3- c.Na+, Ca+, H+, HCl- d.Na+, K+, HCO3-"

Answer 61

"b .Na+, K+, Cl-, HCO3- The acinus produces an initial saliva with a composition similar to plasma. This initaial saliva is isotonic and has the same Na+, K+, Cl-, and HCO3- concentrations as plasma. (BRS 4th Ed)"

Question 62

"A 49 year old male patient with severe CrohnÍs disease has been unresponsive to drug therapy and undergoes ileal resection. After the surgery, he will have steatorrhea because: a. The liver bile acid pool increases b. Chylomicrons do not form in the intestinal lumen c. Micelles do not form in the intestinal lumen d. Dietary triglycerides cannot be digested"

Answer 62

"c. Micelles do not form in the intestinal lumen Ileal resection removes the portion of the small intestines that normally transports bile acids from the lumen of the gut and recirculates them to the liver. Because this process maintains the bile acid pool, new synthesis of bile acids is needed only to replace those bile acids that are lost in the feces. With ileal resection, most of the bile acids are secreted or excreted in the feces, and the liver pool is significantly diminished. Bile acids are needed for micelle formation in the intestinal lumen to solubilize the products of lipid digestion so that they can be absorbed. Chylomicrons are formed within the intestinal epithelial cells and are transported to lymph vessels. (BRS 4th Ed.)"

Question 63

"Which of the following is the site of secretion of intrinsic factor? a. Gastric antrum b. Gastric fundus c. Duodenum d. Ileum"

Answer 63

"b.Gastric fundus Intrinsic factor is secreted by the parietal cells of the gastric fundus (as HCl). It is absorbed with vitamin B12 in the ileum. (BRS 4th Ed.)-Add guyton 11th 795"

Question 64

"Which of the following is the site of Na+ bile acid transport? a. Gastric antrum b. Duodenum c. Ileum d. Colon"

Answer 64

"c.Ileum Bile salts are recirculated to the liver in the enterohepatic circulation via Na+ bile acid co-transporter located in the ileum of the small intestine. (BRS 4thEd.) "

Question 65

"When parietal cells are stimulated, they secrete: a. HCl and intrinsic factor b. HCl and pepsinogen c. HCl and HCO3- d. HCO3- and intrinsic factor"

Answer 65

"a.HCl and intrinsic factor The gastric parietal cells secrete HCl and intrinsic factor. The chie cells secrete pepsinogen. (BRS 4th Ed.)"

Question 66

"What type of cell ejects saliva into the mouth? a.Acinar cells b.Parietal cells c.Myoepithelial cells d.Ductal cells "

Answer 66

"c.Myoepithelial cells Saliva is formed by 3 major glands: parotid, sublingual, and submandibular. The structure of each gland is similar to a branch of grapes. The acinus is lined with acinar cells and secretes an initial saliva. A branching duct system is lined with columnar epithelial cells, which modify the initial saliva. When saliva production is stimulated, myoepithelial cells, which line the acinus and initial ducts, contract and eject saliva into the mouth. (BRS 4th Ed)"

Question 67

"Saliva is characterized by the following except a.Presence of lingual lipase b.Low Na+ and Cl- concentrations c.Hypertonicity d.Presence of alpha lipase "

Answer 67

"c.Hypertonicity Salive becomes hypotonic in the ducts because the ducts are relatively impermeable to water. Because more solute than water I s reabsorbed in the ducts, the saliva becomes dilute relative to plasma. (BRS 4th Ed)"

Question 68

"A digestive enzyme responsible for initial triglyceride digestion: a. Amylase b. Lingual lipase c. Pepsin d. Gastrin"

Answer 68

"b.Lingual lipase Initial starch digestion by amylase (ptyalin) and initial triglyceride digestion by lingual lipase. (BRS 4th Ed"

Question 69

"Daily average volume of saliva produced in a human being is: a. 100-150 liters b. 1-1.5 liters c. 3-5 liters d. 8-10 liters"

Answer 69

"b.1-1.5 liters In humans, the daily secretion of saliva is 1-1.5 liters or 1000ml. (Guyton & Hall)"

Question 70

"In the absence of salivation, which is more likely to occur in the mouth? a. Increased lubrication of the mouth. b.Acid reflux c.Ulceration and infection of oral tissue d.Increased secretion of potassium "

Answer 70

"c.Ulceration and infection of oral tissue Saliva contains significant amounts of protein antibodies that can destroy ORAL bacteria, including those that cause dental caries. Therefore, in the absence of salivation, the oral tissues become ulcerated and otherwise infected, and caries of the teeth become rampant. (Guyton & Hall)"

Question 71

"It is the mechanism in which fructose is being absorb in the small intestine? a. Facilitated diffusion b. Passive Diffusion c. Active Diffusion d. Osmosis "

Answer 71

"a. Facilitated diffusion Fructose is transported exclusively by facilitated diffusion: therefore it cannot be absorbed against a concentration gradient.(BRS Physiology 5th Edition)"

Question 72

"An enzyme that breaks down protein by hydrolyzing interior peptide bond? a. Endopeptidases b. Exopeptidases c. Protease d. Pepin "

Answer 72

"a. Endopeptidases Endopeptidases degrades protein by hydrolysing the interior peptide bond. (BRS Physiology 5th Edition)"

Question 73

"Abetalipoproteinemia is a disorder that interferes with the normal absorption of fat and fat-soluble vitamins from food. This is due to lack of ? a. Apoprotein B b. Bile acid c. Pancreatic lipase d. Apoprotein A "

Answer 73

"a. Apoprotein B Lack of Apoprotein B results in the inability to transport chylomicrons out of the intestinal cell and causes abetalipoproteinemia. (BRS Physiology 5th Edition)"

Question 74

"Inadequate intestinal calcium absorption can cause rickets in children and oesteomalacia in adults. This is due to? a. Vitamin D deficiency b. Vitamin A deficiency c. Vitamin E deficiency d. Vitamin K deficiency"

Answer 74

"a. Vitamin D deficiency Vitamin D greatly enhances calcium absorption in the duodenum (Guyton and Hall Textbook of Medical Physiology 12th edition)"

Question 75

"The optimum pH for pepsin is between pH? a. 1 and 3 b. 4 and 6 c. 5 and 7 d. 6 and 8 "

Answer 75

"a. 1 and 3 When the pH is > 5 pepsin is denatured. In the intestine, as bicarbonate is secreted in pancreatic fluids, duodenal pH increases and pepsin is inactivated. (BRS Physiology 5th edition)"

Question 76

"It increase the surface area for absorption in the small intestine? a. Brush border b. Villi c. Peyer's patches d. Stereocilia "

Answer 76

"a. Brush border The surface area for absorption in the small intestine is greatly increased by the presence of the brush border. (BRS Physiology 5th edition)"

Question 77

"It has an emulsifying/detergent action on fat particles in the food? a. Bile salts b. Pancreatic lipase c. Lingual lipase d. Protease"

Answer 77

"a. Bile salts Bile salts has detergent/emulsifying action on the fat particles in the food .(Guyton and Hall Textbook of Medical Physiology 12th edition)"

Question 78

"Absorption of these ions cause in the absorption of water in the large intestine. a. Sodium, Chloride b. Sodium, Potassium c. Chloride, Calcium d. Chloride, Magnesium"

Answer 78

"a. Sodium, Chloride Absorption of sodium and chloride ions creates an osmotic gradient across the large intestinal mucosa, which in turn cause absorption of water. (Guyton and Hall Textbook of Medical Physiology 12th edition)"

Question 79

"When a person is dehydrated this hormone is secreted to prevent further loss of sodium and other ions. a. Aldosterone b. Estrogen c. Androgen d. Pepsinogen"

Answer 79

"a. Aldosterone Aldosterone causes increased activation of the enzyme and transport mechanism for all aspects of sodium absorption by the intestinal epithelium. And the increased absorption in turn causes secondary increased in absorption of chloride ions, water and some other substances. (Guyton and Hall Textbook of Medical Physiology 12th edition)"

Question 80

"Hypersecretion of gastrin, in which gastric H+ secretion is increased and the duodenal pH is decreased. Can lead to? a. Malabsorption of lipid b. Malabsorption of protein c. Malabsorption of carbohydrate d. Malabsorption ofwater"

Answer 80

"a.Malabsorption of lipid Low duodenal pH inactivates pancreatic lipase. (BRS Physiology 5th edition)"

Question 81

"This is a condition that the constipation is so severe that the bowel movements occur only once every several days, thus accumulating fecal matter and distending the diameter of the colon up to 3 ? 4 inches. This condition is also called ""Megacolon"" A, HirschsprungÍs Disease B. Wilson's Disease C. Kawasaki's Disease D. Parkinson's Disease"

Answer 81

"A, HirschsprungÍs Disease The descriptions of Hirschsprung's Disease or so called MEGACOLON, as the name implies it is the enlargement of the colon to 3 ? 4 inches is caused by the severe constipation resulting in ribbon-like stools, this constipation is caused by lack of or deficiency of ganglion cells in the myenteric plexus in a segment of the sigmoid colon (Reference ? Guyton and Hall 13th Edition page 846)"

Question 82

"Mike 65 years old male was diagnosed of colon cancer and his oncologist you referred him to you for colectomy. The surgery went well and after two days you noticed that the patient farted, what does it mean? A. An accumulation of a bacteria in the colon B. Return of peristalsis C. The suture site was not stitched well so the air gets in the colon and being expelled to the anus D. The patient ate too many sweet potato"

Answer 82

"B. Return of peristalsis Having the patient pass gas or having flatus is a good sign for patients who undergone abdominal surgery, thus indicating return of peristalsis (Reference ? Guyton and Hall Medical Physiology 13th Edition page 848-849)"

Question 83

"Daniel 22 years old male came to the Emergency department with a complaint of Nausea. After assessing the patient you gave him metoclopramide to eliminate the sensation. With the knowledge you have regarding nausea all of the following below are causes of nausea. EXCEPT. A. Irritative impulses coming from the gastrointestinal tract B. Impulses that originate in the lower brain associated with motion sickness C. Impulses from the cerebral cortex to initiate vomiting D. Irritative contractions of the diaphragm"

Answer 83

"D. Irritative contractions of the diaphragm According to Guyton the common causes of nausea are; Irritative impulses coming from the gastrointestinal tract, Impulses that originate in the lower brain associated with motion sickness and Impulses from the cerebral cortex to initiate vomiting. Irritative contractions of the diaphragm doesnÍt have anything to do with the sensation of nausea (Reference ? Guyton and Hall Medical Physiology 13th Edition page 848)"

Question 84

"Chandler 37 year old male was rushed to the ER due to persistent vomiting, after the assessment you found out that the patient have pyloric stenosis. Knowing the concept acid-base homeostasis, what would you anticipate to occur in the patient? A. Respiratory Alkalosis B. Metabolic Alkalosis C. Respiratory Acidosis D. Metabolic Acidosis"

Answer 84

"B. Metabolic Alkalosis This is due to the excessive loss of hydrogen ions from the stomach and can result in various degrees of whole-body metabolic alkalosis. (Reference ? Guyton and Hall Medical Physiology 13th Edition page 847)"

Question 85

"In severe cases of sprue, in addition to malabsorption of fats, impaired absorption of proteins, carbohydrates, calcium, vitamin K, folic acid, and vitamin B12 also occurs. All are experienced by the patient, Except A. Severe nutritional deficiency, which often results in wasting of the body B. Inadequate blood coagulation caused by lack of vitamin K C. macrocytic anemia of the pernicious anemia type, resulting from diminished vitamin B12 and folic acid absorption D. Microcytic anemia of the iron deficiency anemia type, resulting from diminished iron absorption"

Answer 85

"D. Microcytic anemia of the iron deficiency anemia type, resulting from diminished iron absorption Iron deficiency doesnÍt have anything to do with sprue. In the case of sprue there is inflamed lining mucosa of the small intestines causing a deficiency in the absorption electrolytes, folic acid and vitamin B12 causing pernicious anemia (marcocytic anemia), lack of vitamin K results in inadequate blood accumulation. (Reference ? Guyton and Hall Medical Physiology 13th Edition page 845-846) "

Question 86

"The mechanism that controls the watery secretions of watery fluids by the crypts of Lieberkuhn is believed to involve at least 2 active secretory processes, which are? A. Active secretion of calcium and bicarbonate ions B. Active secretion of sodium and chloride ions C. Active secretion of chloride and bicarbonate ions D. Active secretion of calcium and sodium ions"

Answer 86

"C. Active secretion of chloride and bicarbonate ions The secretion of both chloride and bicarbonate ions causes electrical drag of positively charged sodium ions through the membrane and into the secreted fluid as well. Finally, all these ions together cause osmotic movement of water. (Reference ? Guyton and Hall Medical Physiology 13th Edition page 831)"

Question 87

"Other than the emulsifying function, bile salts help in the absorption of the following except A. Fatty acids B. Monosaccharides C. Monoglycerides D. Cholesterol"

Answer 87

"B. Monosaccharides Monosaccharides are absorbed with the help of amylase. Bile salts specifically contributes to the emulsification and absorption of lipids. (Reference ? Guyton and Hall Medical Physiology 13th Edition page 836)"

Question 88

"The small quantities of bile salts lost into the feces are replaced by new amounts formed continuously by the liver cells. This recirculation of the bile salts is called the A. Enterohepatic circulation of bile salts B. Gastrohepatic circulation of bile salts C. Hepatopancreatic circulation of bile salts D. Gastrointestinal circulation of bile salts"

Answer 88

"A. Enterohepatic circulation of bile salts According to Guyton The small quantities of bile salts lost into the feces are replaced by new amounts formed continuously by the liver cells. This recirculation of the bile salts is called the enterohepatic circulation of bile salts. (Reference ? Guyton and Hall Medical Physiology 13th Edition page 830)"

Question 89

"BrunnerÍs glands function is to protect the duodenal wall from digestion by the highly acidic gastric juice emptying from the stomach. Which of the following activities promotes the function of the gland A. Sleeping B. Running C. Boxing D. Fornication"

Answer 89

"A. Sleeping Parasympathetic actions promotes the function of the gland, generally the GI tract. On the other hand sympathetic actions inhibits the GI (Reference ? Guyton and Hall Medical Physiology 13th Edition page 831)"

Question 90

"Secretin and its relation to pancreatic secretion a. ææææææ Increases HCO3- secretion b. ææææææ Secreted from the pancreatic ductal cells c. ææææææ Inhibits the pancreatic acinar cell proliferation d. ææææææ A and B"

Answer 90

"a.ææææææ Increases HCO3- secretion Secretin is released by the S cells of the duodenum and acts on the pancreatic ductal cells to increase HCO3- secretion. Book sources: BRS Physiology 4th edition & Textbook of Medical Physiology 11th edition Guyton and Hall"

Question 91

"Saliva's secretion is stimulated by: A. Parasymphatetic Nervous System B. Symphatetic Nervous System C. Both Parasympathetic and Sympathetic Nervous System D. Central Nervous System"

Answer 91

"C. Both Parasympathetic and Sympathetic Nervous System Gastrointestinal unit secretes saliva that is stimulated by parasympethetic nervous system and sympathetic nervous system. (BRS Physiology, 5th Ed. Page 199)"

Question 92

"Which is NOT a function of Saliva? A. Protection B. Lubrication C. Digestion D. Poison"

Answer 92

"D. Poison Saliva is used for Lubrication of ingested food by mucus, Digestion and lastly Protection of the mouth and esophagus by dilution and buffering of ingested foods. (BRS Physiology, 5th Ed. Page 200)"

Question 93

"It produces the initial saliva with a composition similar to plasma. A. Acinus B. Mucous C. Tounge D. Buccal"

Answer 93

"A. Acinus The acinus produces an initial saliva with a composition similar to plasma. This initial saliva is isotonic and has the same Na+, K+, Cl?, and HCO3? concentration as plasma. (BRS Physiology, 5th Ed. Page 200)"

Question 94

"Which is CORRECT about the saliva? A. At the lowest flow rates, saliva has the highest osmolarity and highest Na+, Cl-, and HCO3? concentrations, but has the highest K+ concentration. B.At the lowest flow rates, saliva has the lowest osmolarity and lowest Na+, Cl-, and HCO3? concentrations, but has the highest K+ concentration. C. At the lowest flow rates, saliva has the highest osmolarity and lowest Na+, Cl-, and HCO3? concentrations, but has the highest K+ concentration. D. At the lowest flow rates, saliva has the lowestosmolarity and lowest Na+, Cl-, and HCO3? concentrations, but has the lowest K+ concentration."

Answer 94

" B. At the lowest flow rates, saliva has the lowest osmolarity and lowest Na+, Cl-, and HCO3? concentrations, but has the highest K+ concentration. The composition of saliva varies with the salivary flow rate where the lowest flow rates, saliva has the lowest osmolarity and lowest Na+, Cl-, and HCO3? concentrations, but has the highest K+ concentration. (BRS Physiology, 5th Ed. Page 199)"

Question 95

"Saliva is composed of: A. High K+ B. Low K+ C. Moderate K+ D. Absent K+"

Answer 95

"A. High K+ Saliva is characterized by: High K + and HCO3? concentrations. (BRS Physiology, 5th Ed. Page 199)"

Question 96

"In Parasympathetic stimulation of Saliva, production is: A. Decreased B. Inhibits C. Increased D. Normal production"

Answer 96

"C. Increased Parasymphatetic stimulation (cranial nerves VII and IX) increases saliva production by increasing transport processes in the acinar and ductal cells and by causing vasodilation. (BRS Physiology, 5th Ed. Page 202)"

Question 97

"This region relaxes to allow food bolus to enter the stomach. Also, this region includes the antrum and the distal body. A. Caudad Region B. Orad Region C. Duodenum Region D. Distal Region."

Answer 97

"A. Caudad Region The caudad region of the stomach includes the antrum and the distal body. This region is responsible for the contractions that mix food and propel it into the duodenum. (BRS Physiology, 5th Ed. Page 197)"

Question 98

"Which is WRONG about the stomach? A. Slow waves in the caudad stomach occur at a frequency of 3-5 waves/min. They depolarize the smooth muscle cells. B. The stomach has three layers of smooth muscle the usual longitudinal and circular layers, and a third oblique layer. C. A wave of contraction closes the distal antrum. Thus, as the caudad stomach contracts, food is propelled back into the stomach to be mixed. D. Stomach consists of three muscles, such as: Cardiac, Skeletal and Smooth muscles"

Answer 98

"D. Stomach consists of three muscles, such as: Cardiac, Skeletal and Smooth muscles The stomach consist only the smooth muscles that has three layers such as the longitudinal layer, circular layer and third oblique layer where in the caudad stomach the depolarization of smooth muscle cells is occurred through the slow waves that has a frequency of 3-5 (BRS Physiology, 5th Ed. Page 197)"

Question 99

"A 24-year-old male graduate student participates in a clinical research study on intestinal motility. Peristalsis of the small intestine. A. Mixes the food bolus B. Is coordinated by the central nervous system. C. Involves cotratcion of smooth muscle behind and in front of the food bolus. D. Involves cotratcion of smooth muscle behind the food bolus and relaxation of smooth muscle in front of the bolus"

Answer 99

"D. Involves cotratcion of smooth muscle behind the food bolus and relaxation of smooth muscle in front of the bolus Peristalsis is contractile activity that is coordinated by the enteric nervous system [not the central nervous system (CNS)] and propels the intestinal contents forward. Normally, it takes place after sufficient mixing, digestion, and absorption have occurred. To propel the food bolus forward, the smooth muscle must simultaneously contract behind it and relax in front of it. (BRS Physiology, 5th Ed. Page 220)"

Question 100

"Constipation happens because of the following EXCEPT? A.Excess absorption of fluid in the large intestines B.Insufficient fluid intake C.Spasm of the sigmoid colon D.Pathology of the intestines like Tumors"

Answer 100

"C.Spasm of the sigmoid colon Constipation is often associated with large quantities of dry, hard feces in the descending colon that accumulate because of excess absorption of fluid or insufficient fluid intake. Any pathology of the intestines that obstructs movement of intestinal contents, such as tumors, adhesions that constrict the intestines, or ulcers, can cause constipation. (chapter 67 Guyton and Hall p. 846 13thE)"

Question 101

"The phase of deglutition that is entirely voluntary: A. Oral Phase B. Mastication C. Pharyngeal Phase D. Esophageal Phase"

Answer 101

"A. Oral Phase Deglutition or swallowing involves three stages: A voluntary or oral stage (p. 549, Berne and Levy Physiology, 5th Ed.), which initiates the swallowing process; a pharyngeal stage, which is involuntary and constitutes passage of food through the pharynx into the esophagus; and an esophageal stage, another involuntary phase that transports food from the pharynx to the stomach. (p764, Guyton and Hall, 12th Ed.)"

Question 102

"In the pharyngeal phase of swallowing, the upward movement of the larnyx causes the following events to happen, except: A. Prevention of food passage to the nose and trachea B. Enlarging the opening of the esophagus C. Lifting the glottis out of the main stream of food flow D. Closing of the posterior nares"

Answer 102

"D. Closing of the posterior nares In the pharyngeal stage of swallowing, the larnyx is pulled upward and anteriorly by the neck muscles for the main purposes of closing the trachea, opening the esophagus, and lifting the glottis out of the main stream of food flow. The movement of the soft palate upward closes the posterior nares. p764, Guyton and Hall"

Question 103

"Zaldih, a patient with a noted paralysis of the brain stem swallowing reflex, is being fed through a tube. The food fed to the patient would still move in the esophagus and into the stomach because of this reason: A. Primary peristalsis pushes food to the stomach B. The esophageal lining is distended and allows food to pass freely C. The myenteric nerve plexus of the esophagus becomes excitable enough to cause secondary peristalsis D. The vagal reflexes of the esophagus initiates secondary peristalsis"

Answer 103

"C. The myenteric nerve plexus of the esophagus becomes excitable enough to cause secondary peristalsis When the vagus nerves to the esophagus are cut, the myenteric nerve plexus of the esophagus becomes excitable enough after several days to cause strong secondary peristaltic waves even without support from the vagal reflexes. (p765, Guyton and Hall, 12th Ed.)"

Question 104

"As the esophageal peristaltic wave approaches toward the stomach: A. The entire stomach contracts B. The entire stomach relaxes C. The duodenum contracts D. No change in the stomach or the duodenum will occur"

Answer 104

"B. The entire stomach relaxes When the esophageal peristaltic wave approaches toward the stomach, a wave of relaxation, transmitted through myenteric inhibitory neurons, precedes the peristalsis. Relaxation of the stomach and, to a lesser extent, the duodenum, prepares the entry of food propelled by the esophagus. (p765, Guyton and Hall, 12th Ed)"

Question 105

"Which of the following is the correct sequence of events happening in the pharyngeal stage of swallowing? A. Soft palate closes the posterior nares ? Larynx closes the trachea and opens the esophagus ? UES relaxes ? Peristalsis pushes the food to the esophagus B. Larynx closes the trachea and opens the esophagus ? Soft palate closes the posterior nares ? UES relaxes ? Peristalsis pushes the food through the esophagus D. Soft palate closes the posterior nares ? Peristalsis occurs ? Larynx closes the trachea and opens the esophagus ? UES relaxes C. Larynx closes the posterior nares ? Soft palate closes the trachea and opens the esophagus ? UES relaxes ? Peristalsis pushes the food to the esophagus"

Answer 105

"A. Soft palate closes the posterior nares ? Larynx closes the trachea and opens the esophagus ? UES relaxes ? Peristalsis pushes the food to the esophagus The mechanics of the pharyngeal stage of swallowing starts with the soft palate being pulled upward to close the posterior nares, to prevent reflux of food into the nasal cavities; closing of the trachea by the larynx and opening of the esophagus by the larynx; Relaxation of the upper esophageal sphincter (UES); and eventully, propelling of food to the esophagus by peristalsis. (p764, Guyton and Hall, 12th Ed / p549, Berne and Levy Physiology, 5th Ed) "

Question 106

"The ""swallowing center"", which receives sensory impulses from the touch receptors in the pharynx, is located in the: A. Medulla and lower pons B. Midbrain C. Hypothalamus D. Thalamus"

Answer 106

"A. Medulla and lower pons The afferent limb of the swallowing reflex begins when ""touch receptors"", located most notably near the pharyngeal opening, are stimulated. Sensory impulses from these receptors are transmitted to the ""swallowing center"" of the medulla and lower pons. (p549, Berne and Levy Physiology, 5th Ed)"

Question 107

"The blood coming from the gut, spleen, and the pancreas flow immediately into the liver by way of the portal vein before it is emptied into the vena cava of the general circulation. The main significance of this system is to: A. To supply the hepatocytes with oxygen B. To remove bacteria that the blood coming from the GIT may contain C. To carry all the fats absorbed from the intestinal tract into the liver D. To supply the blood going to the heart with nutrients"

Answer 107

"B. To remove bacteria that the blood coming from the GIT may contain The blood that enters the liver passes through the liver sinusoids which are lined by reticuloendothelial cells that help remove bacteria or other particulate matter that might enter the blood from the gastrointestinal tract. This system prevents the direct transport of harmful agents into the remainder of the body. (p760, Guyton and Hall, 12th Ed)"

Question 108

"The blood flow in the intestinal villi during active absorption of nutrients A. remains unchanged B. increases significantly C. Decreases D. Increases significantly and remains increased for 24 hours"

Answer 108

"B. increases significantly The blood flow in all areas of the GIT is directly related to the level of local activity. During active absorption of nutrients, blood flow in the villi and adjacent regions of the submucosa is increased as much as eightfold. (p761, Guyton and Hall, 12th Ed)"

Question 109

"The following causes increased blood flow during gastrointestinal activity, except: A. Decreased oxygen concentration in the gut wall B. Increased amount of adenosine in the gut wall C. Release of kinins by the gastrointestinal glands D. Low levels of cholecystokinin in the intestinal tract"

Answer 109

"D. Low levels of cholecystokinin in the intestinal tract Vasodilator substances such as cholecystokinin, vasoactive intestinal peptide, gastrin, secretin, bradykinin, kallidin and adenosine are known to cause increased blood flow during gastrointestinal activity. (p761, Guyton and Hall, 12th Ed.)"

Question 110

"True regarding the countercurrent blood flow in the gastrointestinal mucosa: A. It enhances oxygen transport to the tips of the intestinal villi B. It enhances the delivery of nutrients to the tips of the intestinal villi C. It makes 80% of the oxygen flowing available for local metabolic functions of the villi D. Blood oxygen diffuses easily from the arterioles into the adjacent venules"

Answer 110

"D. Blood oxygen diffuses easily from the arterioles into the adjacent venules The opposite (countercurrent) flow of the arterial and venous systems in the intestinal villi allows the blood oxygen to diffuse easily from the arterioles into the adjacent venules without ever being carried in the blood to the tips of the villi. As much as 80% of the oxygen may take this route and therefore not be available for local use of the villi. (p761, Guyton and Hall, 12th Ed.)"

Question 111

"When the peristaltic wave reaches the lower esophagus, the stomach and duodenum relax. This is called: A. Receptive relaxation B. Gastroduodenal relaxation C. Law of the Gut D. Splanchnic Rule"

Answer 111

"A. Receptive relaxation Receptive relaxation occurs to prepare the stomach and duodenum to receive the food propelled into the esophagus during the swallowing act. This wave of relaxation is transmitted through myenteric inhibitory neurons. (Guyton & Hall, 11th ed. p. 783)"

Question 112

"Whenever a peristaltic wave passes down the stomach, the pyloric sphincter contracts, causing a mixing of chyme. This movement is called: A. Pyloric retropulsion B. Antral retropulsion C. Receptive Relaxation D. Law of the Gut"

Answer 112

"B. Antral retropulsion Antral retropulsion is the back-and-forth movement of chyme caused by the forceful movement of food against the closed pyloric sphincter. Each time a peristaltic wave passes down the antral wall toward the pylorus, it digs deeply into the food contents of the antrum. At the same time, the pyloric sphincter often contracts, impeding emptying into the pylorus. Therefore, most of the contents are squeezed upstream toward the body of the stomach, mixing the chyme. (Guyton & Hall, 11th ed. p. 784)"

Question 113

"The rate of gastric emptying is increased when: A. The walls of the duodenum are stretched. B. Chyme contains too much unprocessed fat. C. The walls of the stomach are stretched. D. Chyme contains too much unprocessed protein. "

Answer 113

"C. The walls of the stomach are stretched. Gastric emptying is regulated by signals from both the stomach and duodenum. Gastric factors that promote emptying include 1) increased food volume in the stomach that stretches the walls of the stomach, and 2) Gastrin. The duodenum slows gastric emptying by sending inhibitory feedback signals whenever 1)there is too much chyme in the small intestine, or 2) the chyme is excessively acidic, contains too much unprocessed protein or fat, is hypo/hypertonic, or is irritating. (Guyton & Hall, 11th ed. p. 785-6)"

Question 114

"After eating three plates of sushi at Vikings buffet, Mckayla felt like she was too full to eat any more. The following hormones are most likely present at high levels EXCEPT for: ``` A. Cholecystokinin B. Serotonin C. Leptin D. Ghrelin " ```

Answer 114

"D. Ghrelin Ghrelin is an orexigenic hormone that stimulates feeding. Serotonin, leptin and cholecystokinin are all anorexigenic, meaning they inhibit feeding. (Guyton & Hall, 11th ed. p. 869)"

Question 115

"Leptin resistance may be due to a defect in leptin receptors in the hypothalamus and will result in: A. Hyperphagia and morbid obesity B. Hypophagia and wasting C. Increased satiety D. Decreased production of appetite stimulators"

Answer 115

"A. Hyperphagia and morbid obesity Leptin is a hormone secreted by adipocytes that decreases the production of appetite stimulators in the hypothalamus. Leptin resistance will result in hyperphagia and morbid obesity due to the uncontrolled production of appetite stimulators. (Guyton & Hall, 11th ed. p. 871)"

Question 116

"This hormone is secreted by oxyntic cells of the stomach and may have possible role in stimulating feeding. ``` A. Cholecystokinin B. Ghrelin C. Secretin D. Leptin " ```

Answer 116

"B. Ghrelin Blood levels of ghrelin rise during fasting, peak just before eating, and decrease after a meal, suggesting a role in stimulating feeding. Although its physiologic role in humans is still uncertain, administration of ghrelin in experimental animals increases food (Guyton & Hall, 11th ed. p. 870)."

Question 117

"A 50-year old woman presented with epigastric pain, nausea and vomiting. History revealed frequent use of aspirin (3g/day) for her rheumatoid arthritis. An endoscopy showed that the stomach mucosa appeared red, swollen and inflamed. The woman was diagnosed with gastritis, and was advised to switch to acetaminophen because aspirin: A. inhibits COX-2, which synthesizes prostaglandins that modulate the protection of the gastric mucosa B. inhibits Lipooxygenase, the enzyme required to synthesize leukotrienes C. inhibits COX-1, which synthesizes prostaglandins that modulate the protection of the gastric mucosa D. inhibits Phospholipase A2, the enzyme required to release arachidonic acid from phospholipids"

Answer 117

"C. inhibits COX-1, which synthesizes prostaglandins that modulate the protection of the gastric mucosa Aspirin inhibits both COX 1 and 2, but it is COX 1 responsible for the the synthesis of prostaglandins that maintain normal physiologic functions. One of these functions is the protection of the gastric mucosa. Ingestion of aspirin is damaging to the protective gastric mucosal barrier. (Harper's, 30th ed. p. 239-40; Guyton & Hall, 11th ed. p. 820 )"

Question 118

"Absorption of food from the stomach directly to the blood is low due to: A. Lack of villi that increase the surface area B. Low blood supply of the stomach C. Too short time the food is in the stomach D. Gastric barrier"

Answer 118

"D. Gastric barrier The gastric barrier is an impediment to gastric absorption. The barrier consists of tight junctions between adjacent epithelial cells and a viscid, adherent mucus secreted by highly-resistant mucus cells. The gastric barrier prevents the autodigestion of the stomach. In gastritis, the permeability of the barrier is greatly increased, leading to mucosal damage. (Guyton & Hall, 11th ed. p. 820)"

Question 119

"A 60-year old woman presented with chronic tiredness, nausea and dyspnea upon exertion. Physical examination suggested jaundice, and history revealed that the patient had a gastrectomy five years ago. SchillingÍs test was performed, and it was found that 3% of oral vitamin B12 was absorbed by the body, the normal being >7.5%. When the test was repeated with intrinsic factor, 8% of the vitamin B12 was absorbed. The patient was diagnosed with pernicious anemia. Based on the diagnosis, the patientÍs peripheral blood smear would show that the erythrocytes are: A. macrocytic, hypochromic B. microcytic, hypochromic C. macrocytic, hyperchromic D. normocytic, normochromic"

Answer 119

"A. macrocytic, hypochromic Pernicious anemia is caused by poor absorption of vitamin B12, which is essential for the maturation of red blood cells. The parietal cells of the gastric glands secrete intrinsic factor, which binds with vitamin B12 to protect it from digestion by GI secretions.One of the complications of a gastrectomy is pernicious anemia, and peripheral blood smears would indicate large, oval macrocytes with flimsy membranes due to failure to mature. (Guyton & Hall, 11th ed. p. 423)"

Question 120

"A common accompaniment of chronic gastritis, gastric atrophy and achlorydia is: A. Sickle cell anemia B. Pernicious anemia C. HirschsprungÍs disease D. Flatus"

Answer 120

"B. Pernicious anemia Normal gastric secretions contain a glycoprotein called intrinsic factor, secreted by the same parietal cells that secrete hydrochloric acid. In chronic gastritis, the mucosa of the stomach atrophies until little to no gastric gland remains. This leads to a loss in stomach secretions and achlorydia, or failure to secrete hydrochloric acid. Since there are no parietal cells, there is also a failure to secrete intrinsic factor. Intrinsic factor must be present for adequate absorption of vitamin B12 from the ileum. (Guyton & Hall, 11th ed. p. 820)"

Question 121

"True action potentials is for the ______ of the smooth muscle? A.Tone B. Resting membrane C. Movement D. Hyperpolarization"

Answer 121

"C. Movement Spike potentials are true action potentials. They are called true action potential for they produces smooth muscle contraction in response to entry of calcium ions into the muscle fiber; therefore causing movement (Guyton, 12th ed. Page 755)"

Question 122

"What ion causes an electrical slow wave of the smooth muscle of GI? A. Sodium B. Calcium C. Potassium D. Sodium and Calcium"

Answer 122

"A. Sodium The slow waves do not cause calcium ions to enter the smooth muscle fiber, only sodium ions.(Guyton, 12th ed. Page 755)"

Question 123

"Known as NOT TRUE action potentials that causes undulating changes in the Resting Membrane Potential? A. Spike potential B. Hperpolarization C. Slow wave D. Depolarization"

Answer 123

"C. Slow wave The slow waves usually do not by themselves cause muscle contractions, instead they are undulating changes in the resting membrane potential. (Guyton, 12th ed. Page 754)"

Question 124

"What reflex that has signal from the stomach causes evacuation of the colon? A. Enterogastric Reflex B.Gastroileal Reflex C. Intestinointestinal Reflex D. Gastrocolic Reflex"

Answer 124

"D. Gastrocolic Reflex Gastrocolic reflex mechanism is through reflexes from the gut to the prevertebral sympathetic ganglia and then back to the gastrointestinal tract . Specifically, signals from the stomach to cause evacuation of the colon is called the gastrocolic reflex. (Guyton, 12th ed. Page 757)"

Question 125

"What reflex intensifies peristalsis in the ileum and forces the remaining chyme into the cecum of the large intestine. A. Gastroileal Reflex B.Gastrocolic Reflex C. Coloileal Reflex D. Enterogastric Reflex"

Answer 125

"A. Gastroileal Reflex Gastroileal reflex intensifies peristalsis in the ileum and forces the remaining chyme through the ileocecal valve into the cecum of the large intestine. (Guyton, 12th ed. Page 769)"

Question 126

"The pacemaker of ______ is located at the interface of __________. A. Spike potential, Circular&Longitudinal muscle B. Slow wave, cardiac muscle C. Spike potential, skeletal muscle D. Slow wave, Circular&Longitudinal muscle"

Answer 126

"D. Slow wave, Circular&Longitudinal muscle Interstitial cells of Cajal, that are believed to act as electrical pacemakers for smooth muscle cells. These interstitial cells form a network with each other and are interposed between the smooth muscle layers. It can also generate slow wave activity. (Guyton, 12th ed. Page 754)"

Question 127

"What is the reflex that stop the stomach from emptying for the __________of the food in the __________ to happen? A. Enterogastric Reflex, emptying, large intestine B. Enterogastric Reflex, digestion, small intestine C. Gastrocolic Reflex, digestion, small intestine D. Gastrocolic Reflex, emptying, large intestine"

Answer 127

"B. Enterogastric Reflex, digestion, small intestine Breakdown products of protein digestion also elicit inhibitory enterogastric reflexes; by slowing the rate of stomach emptying, sufficient time is ensured for adequate protein digestion in the duodenum and small intestine. (Guyton, 12th ed. Page 768)"

Question 128

"Migrating Motor Complex is mediated by ___? A. Motilin and ENS B. Glucagon and ENS C. Secretin and ENS D. Extrinsic nerves and ENS"

Answer 128

"A. Motilin and ENS Motilin is released cyclically and stimulates waves of gastrointestinal motility called interdigestive myoelectric complexes that move through the stomach and small intestine every 90 minutes in a fasted person. (Guyton, 12th ed. Page 759 & Physiology Handouts)"

Question 129

"A 21-year-old student has a history of type 1 diabetes mellitus presents with severe constipation, abdominal distention, and severe heartburn. On physical examination she has diabetic retinopathy, orthostatic hypotension and moderately severe peripheral neuropathy, also small intestine is noted to have some nonspecific dilatations and colon is filled with feces. The abnormal bowel motility is due to? A. Diabetic retinopathy B. Loss of lower esophageal sphincter tone C. Autonomic neuropathy D. Constipation"

Answer 129

"C. Autonomic neuropathy Autonomic neuropathy due to long-standing diabetes mellitus can also affect gastric emptying. The stomach becomes flaccid and antral peristalsis is defective or lost. This condition, called diabetic gastroparesis. (The Gastrointestinal System p. 60)"

Question 130

"A 25year old teacher experiences nausea, abdominal cramps, sweating, vertigo every after eating a meal. Upon consultation, she was noted to have Dumping syndrome also called as rapid gastric emptying into small intestine. This syndrome occurs when food, especially sugar, moves from your stomach into your small bowel too quickly. What is defective or inhibited in this kind of syndrome? A. Gastrocolic Reflex B. Intestinointestinal Reflex C. Ileocolic Reflex D. Enterogastric Reflex"

Answer 130

"D. Enterogastric Reflex Signals from the colon and small intestine to inhibit stomach motility and stomach secretion (the enterogastric reflexes), (Guyton, 12th ed. Page 757)"

Question 131

"Which of the two types of movements occuring in the GI tract causes food to move orad to caudad at an appropriate rate to accommodate digestion and absorption? A. Propulsive movements B. Mixing movements C. Both D. None"

Answer 131

"A. Propulsive movements Two types of movements occur in the gastrointestinal tract: (1) propulsive movements, which cause food to move forward along the tract at an appropriate rate to accommodate digestion and absorption, and (2) mixing movements, which keep the intestinal contents thoroughly mixed at all times. (Guyton, 12th Ed. Page 759) "

Question 132

"In most cases, this serves as a stimulus for intestinal peristalsis. A. distention of the gut B. chemical irritation of the gut C. physical irritation of the gut D. strong parasympathetic nervous signals to the gut"

Answer 132

"A. distention of the gut The usual stimulus for intestinal peristalsis is distention of the gut. That is, if a large amount of food collects at any point in the gut, the stretching of the gut wall stimulates the enteric nervous system to contract the gut wall 2 to 3 centimeters behind this point, and a contractile ring appears that initiates a peristaltic movement. Other stimuli that can initiate peristalsis include chemical or physical irritation of the epithelial lining in the gut. Also, strong parasympathetic nervous signals to the gut will elicit strong peristalsis. (Guyton, 12th Ed. Page 759)"

Question 133

"All of the following are correct, EXCEPT: A. Mixing movements are the same all throughout the the alimentary tract. B. Peristalsis is the basic propulsive movement of the GI tract. C. Peristalsis, in order to be effective, requires an active myenteric plexus. D. All the statements are correct"

Answer 133

"A. Mixing movements are the same all throughout the the alimentary tract. Mixing movements differ in different parts of the alimentary tract. (Guyton, 12th ed. Page 759, See also Chapter 63 for a more detailed discussion on mixing movements in the different parts of the GI tract)"

Question 134

"Peristalsis, a basic propulsive movement, happens in which of the following? A. GI tract, glandular tracts, and ureters B. GI tract and respiratory system C. glandular ducts, GIT, and Liver D. ureters, GIT, and Spleen"

Answer 134

"A. GI tract, glandular tracts, and ureters Peristalsis is an inherent property of many syncytial smooth muscle tubes; stimulation at any point in the gut can cause a contractile ring to appear in the circular muscle, and this ring then spreads along the gut tube. Peristalsis also occurs in the bile ducts, glandular ducts, ureters, and many other smooth muscle tubes of the body. (Guyton, 12th ed. Page 759)"

Question 135

"""Peristaltic reflex plus the anal direction of movement of the peristaltsis"" A. Law of the Gut B. Defecation C. Splanchnic Rule D. Law of digestion"

Answer 135

"A. Law of the Gut The peristaltic reflex plus the anal direction of movement of the peristalsis is called the ""law of the gut"" (Guyton 12th ed. Page 759)"

Question 136

"During peristalsis, the food is allowed to be propelled more easily toward the anus than toward the mouth. This is due to: A. Receptive Relaxation B. The gut has valves that help propel food towards the anus. C. The myenteric plexus is polarized toward the oral direction D. Receptive Resolution"

Answer 136

"A. Receptive Relaxation When a segment of the intestinal tract is excited by distention and thereby initiates peristalsis, the contractile ring causing the peristalsis normally begins on the orad side of the distended segment and moves toward the distended segment, pushing the intestinal contents in the anal direction for 5 to 10 centimeters before dying out. At the same time, the gut sometimes relaxes several centimeters downstream toward the anus, which is called ñreceptive relaxation,î thus allowing the food to be propelled more easily toward the anus than toward the mouth.(Guyton 12th ed. Page 759)"

Question 137

"In congenital absence of the myenteric plexus and treatment with atropine, what are the expected results in peristalsis respectively? A. will occur as weak or not at all for both B. Weakly occurs, Strongly Occurs C. Will occur strongly for both D. Strongly occurs, weakly occurs"

Answer 137

"A. will occur as weak or not at all for both Peristalsis occurs only weakly or not at all in any portion of the gastrointestinal tract that has congenital absence of the myenteric plexus. Also, it is greatly depressed or completely blocked in the entire gut when a person is treated with atropine to paralyze the cholinergic nerve endings of the myenteric plexus .(Guyton 12th ed. Page 759)"

Question 138

"A 6 day old infant girl experiences symptoms of intestinal obstruction. The patient is later diagnosed with Hirschsprung's disease, what would be the probable cause? A. Aganglionosis B. Kernicterus C. UTI D. Ascariasis"

Answer 138

"A. Aganglionosis Congenital megacolon is characterized by a functional obstruction of the colon resulting from aganglionosis (an absence of ganglion cells) of the bowel wall. The rectum and sigmoid colon are the most common sites of involvement. Full thickness biopsy (the diagnostic procedure of choice) shows the hallmark of the disease, which is the absence of ganglion cells in the myenteric and submucosal plexuses. The absence of enteric neurons, especially those secreting nitric oxide and VIP, results in a loss of inhibitory tone necessary to counteract excitatory motor neurons that contract muscle fibers in the anal sphincter and other distal segments of the colon. Consequently, colonic contents cannot pass through the involved segment and the patient experiences symptoms of intestinal obstruction. (The Gastrointerstinal System Page 59)"

Question 139

"Treatment with Atropine results to: A. paralysis of cholinergic nerve endings of the myenteric plexus B. chemical irritation of the gastric mucosa C. causes strong and continous persitalsis D. Gastric Ulcer"

Answer 139

"A. paralysis of cholinergic nerve endings of the myenteric plexus Peristalsis is greatly depressed or completely blocked in the entire gut when a person is treated with atropine to paralyze the cholinergic nerve endings of the myenteric plexus .(Guyton 12th ed. Page 759)"

Question 140

"A 6 day old infant girl is found to have aganglionosis (the absence of ganglion cells in the myenteric and submucosal plexuses). What is its' probable effect in reference to the ""law of the gut""? A. The myenteric reflex will not occur. B. It will induce a flow of the food towards the mouth. C. It will cause food to be propelled faster. D. It will have no effect."

Answer 140

"A. The myenteric reflex will not occur. This complex pattern does not occur in the absence of the myenteric plexus. Therefore, the complex is called the myenteric reflex or the peristaltic reflex. The peristaltic reflex plus the anal direction of movement of the peristalsis is called the ñlaw of the gut.î (Guyton, 12th ed. Page 759 & The Gastrointerstinal System Page 59)"

Question 141

"A gastrointestinal disorder which is described as a loss of GI contractility is known as a. Paralytic Ileus b. GERD c. esophagitis d. alchalasia"

Answer 141

"a. Paralytic Ileus Paralytic Ileus can occur chronically from overproduction of Sympathetics. Post-Operative (Physiologic) Ileus is a very common occurrence with abdominal surgeries"

Question 142

"This is damage to the bile duct, preventing Bilirubin Glucuronide from entering intestine; it is therefore diverted to kidneys. a. Obstuctive Jaundice b. . Hemolytic Jaundice c. Zollinger Elison d. Hypertrophy of bile ducts"

Answer 142

"a. Obstuctive Jaundice Obstruction of bile duct that prevents Bilirubin Glucuronide from entering intestine is diverted to kidneys to produce excessive bilirubin in urine + big drop in fecal urobilinogen"

Question 143

"HCL mainly functions to a.Denature the proteins ingested b. Protect Vitamin B12 from pepsin produced in the stomach. c. Provide up to 50% of total lipolytic activity. d. Produce gastrin in response to stomach stretching occurring after food enters it, and also after stomach exposure to protein. "

Answer 143

"a.Denature the proteins ingested HCL denature the protein ingested as well as to destroy any bacteria or virus that remains in the food, and also to activate pepsinogen into pepsin."

Question 144

"Which of the following causes excessive secretion of electrolytes and fluid from the crypts of of Lieberkuhn in the distal ileum and colon? a. Cholera toxin b. Gluten Enteropathy c. Celiac Sprue d. laxatives"

Answer 144

"a. Cholera toxin It causes increased basal levels of cAMP in enterocytes. cAMP is not normally active ever in enterocytes. The result is that Cl- channels on luminal membrane are blocked open ------> perpetual secretion."

Question 145

"Absorption of this ion through the epithelum primarily creates electronegativity in chyme and electropositivity in the paracellular space between the epithelial cells a. sodium b. potassium C. Chloride d. zinc"

Answer 145

"a. sodium ñPart of the sodium is absorbed along with chloride ions; in fact, the negatively charged chloride ions are mainly passively ñdraggedî by the positive electrical charges of the sodium ions. - Guyton and Hall,"

Question 146

"Which of the following causes excessive secretion of electrolytes and fluid from the crypts of of Lieberkuhn in the distal ileum and colon? a. Cholera toxin b. Gluten Enteropathy c. Celiac Sprue d. laxatives"

Answer 146

"a. Cholera toxin It causes increased basal levels of cAMP in enterocytes. cAMP is not normally active ever in enterocytes. The result is that Cl- channels on luminal membrane are blocked open ------> perpetual secretion."

Question 147

"A 10 y/o boy was rushed to the hospital d/t vomitting after having a heavy meal, before vomiting occured the doctor explained that the patient experienced bloatedness that made the persistaltic movement to go in an upward manner. What activitiy/mechanism is being explained by the doctor? a. antiperistalsis b. peristaloglasia c. contraction of the esophageal-stomach sphincter d. gastroparesis"

Answer 147

"a. antiperistalsis Anti-persitalsis, the prelude to vomiting. In the early stages of excessive gastrointestinal irritation or over distention. Anti peristalsis begins to occurs often many minutes before vomiting appears. Anti peristalsis means up the digestive tract.then as the upper portion of the GI tract become overly distended. this distention becomesthe exciting factor that iniates the actual vomiting act."

Question 148

"In the parietal cells,the enzyme carbonic anhydrase causes a reaction between. a. carbon dioxide and water. b. carbonic acid and water. c. bicarbonate ions and hydrogen ions. d. hydrogen ions and potassium ions."

Answer 148

"a. carbon dioxide and water. c02 diffuses into parietal cell and enzyme carbonic anhydrase catalyzes a reaction between the co2 and water to form carbonic acid"

Question 149

"Hydrochloric acid is formed when a. hydrogen ions and chloride ions join in the duct of the gastric gland. b. hydrogen ions and chloride ions join in the stomach lumen. c. hydrogen ions and chloride ions join in the parietal cell nucleus. d. hydrogen ions and chloride ions join in the parietal cell cytoplasm."

Answer 149

"a. hydrogen ions and chloride ions join in the duct of the gastric gland. H ions are actively transported into the duct of the gastric gland and the negatively charged chloride ions diffuse with the positively charged hydrogen ions.potassium ions are counter transported into cell in exchange for hydrogen ions, the net result is production of HCL in the parietal cells and its secretion into the duct of the gastric gland"

Question 150

"Which co transport is needed by glucose to be absorbed in the small intestines. a. Sodium transport b. Calcium transport c. diffusion d. osmosis"

Answer 150

"a. Sodium transport In the absence of sodium transport through the intestinal membrane, virtually no glucose can be absorbed because glucose absorption occurs in a co-transport mode with active transport of sodium source: Guyton and hall"

Question 151

"What GI hormone is resbonsible for the increase pancreatic buffer secretion? A. Gastrin B. Secretin C. Cholecystokinin D. Motilin"

Answer 151

"B. Secretin Secretin is responsible for inc. pancreatic buffer secretion while Gastrin, Cholecystokinin and Motilin are responsible for increased Gatric H+, Pancreatic enzyme secretion and Phase III contrations of the MMC, respectively. Guyton and Hall: Textbook of Medical Physiology 12th edition p.1410"

Question 152

"In what vessel does bile recycling occur? A. Intralobular bile ductile B. Sublobular Vein C. Portal Vein D. Central Vein"

Answer 152

"C. Portal Vein Bile recycling occurs through the portal vein. Primary bile is reabsorbed in the terminal ileum and flows back to the liver, where it can be secreted again through the bile ducts. In a typical meal, bile will be recycled 3-5 times before stored in the gallbladder. Guyton and Hall: Textbook of Medical Physiology 12th edition p.1461"

Question 153

"Other than having an emulsifying function, bile salts help absorb all of the following except? A. Fatty Acids B. Monoglycerides C. Cholesterol D. Fat lobule"

Answer 153

"D. Fat lobule Bile salts help in the absorption of fatty acids, monoglycerides, cholesterol and other lipids from the intestinal tract. They do this by forming small physical complexes with this lipids, called micelles. Guyton and Hall: Textbook of Medical Physiology 12th edition p.1461"

Question 154

"The following are causes of Gallstones except: A. Too much absorption of water from bile B.Too much absorption of bile acis in bile C. Too much cholesterol in bile D. Too much fatty acids in bile"

Answer 154

"D. Too much fatty acids in bile Causes of gallstones: Too much absorption of water, too much absorption of bile acids, too much cholesterol in bile and inflammation of epithelium Guyton and Hall: Textbook of Medical Physiology 12th edition p.1462"

Question 155

"Which of the following is not involved in the Mechanism of Secretion of Watery fluids by Lieberkuhn? A. Active secretion of Cl- ions B. Active secretion of NA+ ions C. Active secretion of Bicarbonate ions D. Drag of (+) charged sodium ions through the membrane"

Answer 155

"B. Active secretion of NA+ ions Mechanism of Secretion of the Watery Fluid The exact mechanism that controls the marked secretion of watery fluid by the crypts of LieberkÙhn is still unclear, but it is believed to involve at least two active secretory processes: (1) active secretion of chloride ions into the crypts and (2) active secretion of bicarbonate ions. The secretion of both ions causes electrical drag of positively charged sodium ions through the membrane and into the secreted fluid as well. Finally, all these ions together cause osmotic movement of water. Guyton and Hall: Textbook of Medical Physiology 12th edition p.1465"

Question 156

"Brunner's gland secrete large amounts of mucous in response to? A. Glossopharyngeal stimulation B. Tactile stimuli C. Highly basic gastric juice D. lack of gastrointestinal hormones"

Answer 156

"B. Tactile stimuli Brunner's Glands in the duodenum secrete large amounts of alkaline mucus in response to tactile or irritating stimuli on the duodenal mucosa, vagal stimulation, which causes increased Brunner's gland secretion concurrently with increase in stomach secretion and gastrointestinal hormones. Guyton and Hall: Textbook of Medical Physiology 12th edition p.1464"

Question 157

"Bile is secreted iby the_____; stored in the ____; and ejected into the _____ A. Gall Bladder; Liver; Small intestine B. Liver; Small Intestine; Gall Bladder C. Small Intestine; Gall Bladder; Liver D. Liver; Gall Bladder; Small Intestine"

Answer 157

"D. Liver; Gall Bladder; Small Intestine Guyton and Hall: Textbook of Medical Physiology 12th edition"

Question 158

"A 38 year old female complains of alternating constipation and diarrhea associated with times of stress and abdominal cramping and bloating relieved with bowel movements. AS her doctor, what would you prescribe? A. High Fiber B. High Glucose C. Increase water intake D. High Protein"

Answer 158

"A. High Fiber Cellulose-containing foods are not digestible but swell up by absorbing water and correlate with larger softer stools. The increase in dietary fiber also increases the intestinal transit time and decreases the intracolic pressure, thereby decreasing the symptoms of irritable bowel. Case Files Biochemistry 2nd Edition by Toy et al."

Question 159

"A 53-year-old male patient with elevated levels of low-density lipoprotein (LDL) cholesterol, signs of premature cholesterol gallstone disease and substantially elevated triglycerides visited his physician for a follow-up to check his current status. The patient had received various statin, HMG-CoA-reductase inhibitors therapies for the past 2 years. However, after blood work done at this follow-up visit, complications had still not subsided. This patient has similar problems as two of his siblings. Which of the following best explains this patients dyslipidemia? A. An influx of abnormal phospholipids in the gallbladder as a result B. A loss of HMG-CoA reductase function of ileal disease C. loss of CYP7A1 (cholesterol 7?-hydroxylase) function D. Elevated levels of ACAT"

Answer 159

"C. loss of CYP7A1 (cholesterol 7?-hydroxylase) function A loss in function of CYP7A1 prevents the catabolism of cholesterol to bile salts. Elevated levels of LDL cholesterol, signs of premature cholesterol gallstone disease, and substantially elevated triglycerides are all complications that can result from blocking the enzyme that breaks down cholesterol. Therefore, high levels of cholesterol accumulate in the bile and, with decreased production of bile salts to help dissolution of cholesterol, the formation of cholesterol gallstones."

Question 160

"All of the following are functions of Mucus in the large intestines except A. Protects the intestinal wall against excoriation B. Provides an adherent medium for holding fecal matter together C. Protects the intestinal wall from the great amount of bacterial activity D. Provides a barrier to keep ions formed in the feces from attacking the intestinal wall. "

Answer 160

"D. Provides a barrier to keep ions formed in the feces from attacking the intestinal wall. Mucus in the large intestine protects the intestinal wall against excoriation, but in addition, it provides an adherent medium for holding fecal matter together. Furthermore, it protects the intestinal wall from the great amount of bacterial activity that takes place inside the feces, and, finally, the mucus plus the alkalinity of the secretion (pH of 8.0 caused by large amounts of sodium bicarbonate) provides a barrier to keep acids formed in the feces from attacking the intestinal wall. Guyton and Hall: Textbook of Medical Physiology 12th edition p.1464"

Question 161

"Reflex that is stimulated by rectal distention and initiates defecation. A. Peristaltic reflex B. Vesicointestinal reflex C. Rectosphincteric reflex D. Gastroileal reflex"

Answer 161

"C. Rectosphincteric Reflex Rectosphincteric is another term for defecation reflex."

Question 162

"The following statements are TRUE about external sphincter EXCEPT: A. It is a thickening of the circular smooth muscle. B. It is composed of striated skeletal muscle. C. It is controlled by nerve fibers in the pudendal nerve. D. It is under voluntary, conscious, or at least subconscious control."

Answer 162

"A. It is a thickening of the circular smooth muscle. It is a characteristic of the internal anal sphincter. (Guyton, 11th ed, page 789)"

Question 163

"It is the largest pair of major salivary glands, located anterior to the ears. A. Parotid gland B. Submandibular gland C. Sublingual gland D. Buccal gland"

Answer 163

"A. Parotid gland The parotid glands are the largest of the major salivary glands. They are responsible for secreting approximately 30% of the total salivary output of the salivary glands. The parotid glands are located anterior to the ear, just inferior to the zygomatic arch. They are completely serous glands. Their serous secretion enters the oral cavity via Stensen's duct. (http://histologyolm.stevegallik.org/node/476)"

Question 164

"All but one are the major salivary glands. A. Sublingual gland B. Buccal gland C. Parotid gland D. Submaxillary gland"

Answer 164

"B. Buccal gland The principal glands of salivation are the parotid, submandibular, and sublingual glands; in addition, there are many very small buccal glands. (Guyton, 11th ed, pg 793)"

Question 165

"Type of secretion of buccal glands A. Serous B. Mucous C. Mixed D. Pepsin"

Answer 165

"B. Mucous The buccal glands secrete only mucus. (Guyton, 11th ed, pg 794)"

Question 166

"Type of secretion of submandibular glands. A. Serous B. Mucous C. Mixed D. Pepsin"

Answer 166

"C. Mixed The submandibular and sublingual glands secrete both serous secretion and mucus. (Guyton, 11th ed, pg 793-794)"

Question 167

"Defecation occurs when: A. Internal anal sphincter is relaxed; external sphincter is relaxed. B. Internal anal sphincter is contracted; external anal sphincter is relaxed. C. Internal anal sphincter is contracted. D. Internal anal sphincter is contracted; external anal sphincter is contracted."

Answer 167

"A. Internal anal sphincter is relaxed; external sphincter is relaxed. As the peristaltic wave approaches the anus, the internal anal sphincter is relaxed by inhibitory signals from the myenteric plexus; if the external anal sphincter is also consciously, voluntarily relaxed at the same time, defecation occurs. (Guyton, 11th ed, pg 789)"

Question 168

"Sequence of events during mass movement: A. Constrictive ring occurs- Distention of colon- 20 or more cm of colon distal to the constrictive ring lose their haustal their haustrations- Colon contracts as a unit- Propel fecal B. Distention of colon- Constrictive ring occurs- 20 or more cm of colon distal to the constrictive ring lose their haustal their haustrations- Colon contracts as a unit- Propel fecal C. Constrictive ring occurs- Distention of colon- 20 or more cm of colon distal to the constrictive ring lose their haustal their haustrations- Colon relaxes as a unit- Propel fecal D. Distention of colon- Constrictive ring occurs- 20 or more cm of colon distal to the constrictive ring lose their haustal their haustrations- Colon relaxes as a unit- Propel fecal"

Answer 168

"B. Distention of colon- Constrictive ring occurs- 20 or more cm of colon distal to the constrictive ring lose their haustal their haustrations- Colon contracts as a unit- Propel fecal material ""A mass movement is a modified type of peristalsis characterized by the following sequence of events: First, a constrictive ring occurs in response to a distended or irritated point in the colon, usually in the transverse colon. Then, rapidly, the 20 or more centimeters of colon distal to the constrictive ring lose their haustrations and instead contact as a unite, propelling the fecal material in this segment en masse further down the colon."" (Guyton, 11th ed, pg 789)."

Question 169

"Saliva has a pH between 6.0 and 7.0 because A. It is a favorable range for lubricating and protective action of mucin. B. It is a favorable range for the digestive action of ptyalin C. It helps to prevent pathogenic bacteria. D. It helps to avoid ulceration of the mouth."

Answer 169

"B. It is a favorable range for the digestive action of ptyalin Saliva has a pH between 6.0 and 7.0, a favorable range for the digestive action of ptyalin. (Guyton, 11th ed, pg 794)"

Question 170

"A patient who was diagnosed with spinal cord injury has a problem in controlling and moving his bowel. As a good physician, you will suspect that the affected spinal nerves are: A. Above S1, S2, S3 B. Below S1, S2, S3 C. Above S2, S3, S4 D. Below S2, S3, S4"

Answer 170

"D. Below S2, S3, S4 Sensory and motor fibers for defecation reflex: S2, S3, S4. Intact when spinal cord is injured at higher levels. (Physio Handout)"

Question 171

"Stimuli for pancreatic secretion a. Cholecystokin b. æææ Acetylecholine from the sympathetic vagus nerve endings c. Both A and B d. Norephineprine from the parasympathetic vagus nerve endings"

Answer 171

"A. Cholecystokin Cholecystokinin and secretin would increase pancreatic secretion. Acetylcholine from parasymphatetic vagus nerve endings would also increase pancreatic secretion."

Question 172

"A. Cholecystokin Cholecystokinin and secretin would increase pancreatic secretion. Acetylcholine from parasymphatetic vagus nerve endings would also increase pancreatic secretion."

Answer 172

"A. Trypsin Both trypsinogen and chymotrypsinogen are in their inactive form and must be converted to their active forms trypsin and chymotrypsin respectively for them to have digestive enzyme properties. Pepsinogen must come into contact with hydrochloric acid to become its activated form pepsin."

Question 173

"Which of the following statements is/are true? a. Pancreatic lipases oxidize lipids to fatty acids, triacylglycerides, cholesterol and lysolecithin b. æElastase is an example of a pancreatic protease. c. Trypsinogen is activated by enterokinase to trypsin d. Both B and C"

Answer 173

"D.ææ Both B and C Pancreatic lipases hydrolyze lipids to fatty acids, monoglycerides, cholesterol and lysolecithin."

Question 174

"Hormones that stimulate the secretory activity of the pancreas a. æSecretin b. Cholecystokinin c. Blitzkrieglin d. Both A and B"

Answer 174

"D.ææ Both A and B Secretin stimulates pancreatic HCO3- secretion while Cholecystokinin stimulates pancreatic enzyme secretion."

Question 175

"True about pancreatic secretion a.æHigh concentration of HCO2- B. Neutralizes the acidic chime in the duodenum c. Both A and B d. Low concentration of HCO2-"

Answer 175

"B. Neutralizes the acidic chime in the duodenum The pancreatic secretion have high concentration of HCO3-and not HCO2-"

Question 176

"Composition of pancreatic secretion a. Lower Cl- concentration than plasma b. Same Na+concentration than plasma c. Higher Na+concentration than plasma d. Both A and B"

Answer 176

"D. Both A and B The pancreatic secretion the same Na+ and K+ concentrations as plasma and lower Cl- concentration than plasma."

Question 177

"Actions of CCK on the pancreas a. Acts on the pancreatic acinar cells b. Decreases the action of secretin on the ductal cells c. Potentiates the action of secretin on the ductal cells d. Both A and C"

Answer 177

"D. Both A and C CCK acts on the pancreatic acinar cells to increase the secretion of amylase, lipase and protease. It also potentiates the action of secretin on the ductal cells."

Question 178

"A mutation of the CFTR gene would exhibit which of the following signs and symptoms. a. It is a stomach secretion disorder b. He will have steatorrhea c. He has a defect on his K+channels d. Both B and C"

Answer 178

"B. He will have steatorrhea Cystic fibrosis is caused by the mutation of CFTR gene. This causes a defect on Cl- channels, disorder of pancreatic secretion, malabsorption and steatorrhea."

Question 179

"A patient presented with the following symptoms: poor weight gain and growth, foul smelling stool and steatorrhea, and CFTR gene defect. What could be his disease? a. æSaitama disease b. Von GierkeÍs disease c. Cystic fibrosis d. æ Both A and C"

Answer 179

"c. Cystic fibrosis The patient has cystic fibrosis which is caused by the mutation of CFTR gene. This causes a defect on Cl- channels, disorder of pancreatic secretion, malabsorption and steatorrhea."

Question 180

"Which of the following would cause malabsorption of lipids a. Hyposecretion of gastrin b. æPancreatitis c. æCystic fibrocytemia d. æBoth A and B"

Answer 180

"B. Pancreatitis Pancreatic diseases such as pancreatitis and cystic fibrosis can cause malabsorption of lipids (steatorrhea). Hypersecretion of gastrin also inactivates pancreatic lipase causing steatorrhea."

Question 181

"The presence of a bolus of food in the mouth initiates reflex inhibition which allows the lower jaw to drop. Which of the following is inhibited? A. CN IX B. CN VII C. CN V D. CN X"

Answer 181

"C. CN V CN V also known as Trigeminal nerve innervates the muscles of mastication which allows the lower jaw to drop. CN VII- facial nerve innervates muscles of facial expression. CN IX - Glossopharyngeal innervates muscles of deglutition. CN X - innervates muscles of phonation and viscera of the neck, thorax and abdomen. -Chapter 64 Propulsion and Mixing of food in the alimentary tract. Mastication (Chewing) pg. 807 Guyton and Dr. Vibar's ppt on cranial nerves"

Question 182

"This drop initiates a stretch reflex of the jaw muscles and acts automatically raising the jaw to cause closure of the teeth. A. Rebound Relaxation B. Retropulsive Contraction C. Chewing Reflex D. Rebound Contraction"

Answer 182

"D. Rebound Contraction Rebound contraction automatically raises the jaw to cause closure of the teeth, but it also compresses the bolus again against the linings of the mouth which inhibits the jaw muscles once again, allowing the jaw to drop and rebound another time. This process is repeated again and again. -Chapter 64 Propulsion and Mixing of food in the alimentary tract. Mastication (Chewing) pg. 807 Guyton "

Question 183

"Chewing is especially important for most fruits and raw vegetables because they contain _________ and the rate of digestion is dependent on _________. A. Digestible cellulose membrane ; Surface Area B. Indigestible cellulose membranes ; Surface Area C. Indigestible cellulose membranes ; particle size D. Indigestible cellulose membranes ; chewing"

Answer 183

"B. Indigestible cellulose membranes ; Surface Area Most fruits and raw vegetables contain indigestible cellulose membranes around their nutrient portions that must be broken before th food can be digested. Rate of digestion is dependent on the total surface area exposed to the digestive secretions because digestive enzymes act only on the surface of food particles. in addition, grinding the food to a very fine particulate consistency prevents excoriation of GIT and increases the ease which food is emptied from the stomach to small intestine, then into all succeeding segements of gut. -Chapter 64 Propulsion and Mixing of food in the alimentary tract. Mastication (Chewing) pg. 807 Guyton "

Question 184

"Gastric glands secretes digestive juices of the stomach which are present in the entire wall of the body of the stomach except: A. along a narrow strip on the lesser curvature B. Along the greater curvature of the stomach C. first two thirds of the body D. orad portion"

Answer 184

"A. along a narrow strip on the lesser curvature The digestive juices of the stomach are secreted by gastric glands which are present in almost the entire wall of the body of the stomach except along a narrow strip on the lesser curvature of the stomach. These secretions come immediately into contact with the portion of the stored food lying against the mucosal surface of the stomach. -Chapter 64 Propulsion and Mixing of food in the alimentary tract. Basaic Electrical Rhytm of Stomach wall. pg. 810 Guyton"

Question 185

"Putting one's fingers around a thin distended tube then constricting the fingers sliding forward along the tube. This mechanism is analogous to A. Mixing movement B. distention of the gut C. Law of the Gut D. propulsive movement"

Answer 185

"D. propulsive movement The basic propulsive movement of the gastrointestinel tract is peristalsis. A contractile ring appears around the gut and then moves forward. Peristalsis also occur in the bile ducts, glandular ducts, ureters and many other smooth muscle tubes of the body. -Chapter 63 Propulsive Movements-Peristalsis pg. 803 Guyton"

Question 186

"These contractions are rhytmical peristaltic contractions in the body of the stomach and often occurs when the stomach has been empty for several hours or more. A. Hunger pangs B. Pyloric Pump C. Hunger contractions D. Peristaltic rush"

Answer 186

"C. Hunger contractions When successive contractions become extremely strong, they often fue to cause a continuing tetanic contraction that lasts 2 to 3 minutes. Hunger contractions are more intense in young, healthy people who have high degree of gastrointestinal tonus and they are also greatly increased by the person's having lower than the normal levels of blood sugar. Hunger pangs occur as mild pain in the pit of the stomach. -Chapter 64 Propulsion and Mixing of food in the alimentary tract. Basaic Electrical Rhytm of Stomach wall. pg. 810 Guyton"

Question 187

"Presence of food in the stomach initiates a weak peristaltic constrictor waves, begin in the mid to upper portions of the stomach wall and move toward the antrum about once every 15 to 20 seconds. What do you call these waves? A. Slow waves B. Mixing waves C. Peristaltic Action Potential D. Hunger Contractions"

Answer 187

"B. Mixing waves As long as food is in the stomach, weak peristaltic constrictor waves called mixing waves begin in the mid to upper portions of the stomach wall and move toward the antrum about once every 15-20seconds. These waves are initiated by the gut wall basic electrical rhytm consisting of electrical ""slow waves"" that occur spontaneously in the stomach wall. -Chapter 64 Propulsion and Mixing of food in the alimentary tract. Basaic Electrical Rhytm of Stomach wall. pg. 810 Guyton"

Question 188

"The constrictor rings also play an important role in mixing of the stomach contents. Which of the following is correct? A. Pyloric muscle relaxes which impedes emptying through the pylorus B. The antral contents are squeezed downstream through the peristaltic ring toward the pylorus. C. Retropulsion is not an important mixing mechanism in the stomach. D. The opening of pylorus is small that only few milliliters or less of antral contents are expelled into duodem with each peristaltic wave."

Answer 188

"D. The opening of pylorus is small that only few milliliters or less of antral contents are expelled into duodem with each peristaltic wave. The opening of the pylorus is small enough that only fe mL or less of antral contents are expelled into the duodenum. Pyloric muscle contracts which further impedes emptying through the pylorus. Therefore, most of the antral contents are squeezed upstreem through the peristaltic ring toward the body of the stomach not through the pylorus. Retropulsion is an exceedingly important mixing mechanism in the stomach. --Chapter 64 Propulsion and Mixing of food in the alimentary tract. Basaic Electrical Rhytm of Stomach wall. pg. 810 Guyton"

Question 189

"Mr. Rothman, 28 year old gymanstics instructor, presents with complaints of muscle weakness in his face that comes and goes but getting worst over the past two months. Most notably, he complains that his ""jaw gets tired"" as he chews and that swallowing has become difficult. He also noted diplopia particularly after reading for a few minutes. He was treated with Edrophonium. In this way, Mr. Rothman regain some of his muscle strength. How do this drug act? A. inhibits the enzyme AChE B. Mimics the effect of Acetylcholine C. Increases the concentration of Ach at the NMJ D. Decreases the concentration of Ach at the NMJ"

Answer 189

"A. inhibits the enzyme AChE The patient was diagnosed with Myesthenia Gravis, causes skeletal muscles to fatigue more easily than normal. Weakness of the muscle of mastication make it difficult for Mr. Rothman to chew. Edrophonium which is an anti cholinesterase drug binds and blocks AChE. Therfore, it is prevented from inactivating Ach neurotransmitter which allows Ach to build up in the NMJ to stimulate the few Ach receptors that have not been destroyed by antibodies. in this way, edrophonium helps the patient to regain some of his muscle strength. -Case Study #7 on Muscle Weakness Anatomy and Physiology Mc Graw Hill."

Question 190

"Which of the following patinets should be promptly referred for endoscopy? A. A 32 yr old whose symptoms are not relieved with ranitidine B. A 29 yr old H. pylori positive patient with dyspeptic symptoms C. A 65 yr old man with a new onset of epigastric pain and weight loss D. A 49 yr old women with intermittent right upper quadrant pain following meals"

Answer 190

"C. A 65 yr old man with a new onset of epigastric pain and weight loss Patient C has a red flag he is older than 45 yrs of age with new onset of symptoms. Patient A may benefit from reassurance of a negative endoscopic exam. Patient B may benefit from treatment of the H. pylori. Patient D could be sent for an endoscopic examination if she doesn't improve following therapy."

Question 191

"Part of the alimentary tract that functions solely as the simple passage of food A. Esophagus B. Stomach C. duodenum D. sigmoid colon"

Answer 191

"A. Esophagus ""Each part is adapted to its specific functions: some parts to simple passage of food, such as the esophagus"" -Guyton and Hall 12th edition pg 797"

Question 192

"Muscle fibers of the GIT are electrically connected with one another through____ A. desmosomes B. gap junctions c. hemidesmosomes D. cleft junctions"

Answer 192

"B. gap junctions Muscle fibers are electrically connected with one another through large numbers of gap junctions-Guyton and Hall 12th edition pg 797"

Question 193

"Most excitatory neurotransmitter of gastrointestinal activity A. Epinephrine B. Choline C. Norephinephine D. Acetylcholine"

Answer 193

"D. Acetylcholine acetylcholine most often excites gastrointestinal activity. Norephinephrine almost always inhibitsƒ - Guyton and Hall 12th edition p 800"

Question 194

"Cranial parasympathetic nerve fibers are almost entirely from___ A. CN X B. CNXI C. CNV D. CNIX"

Answer 194

" A. CN X Cranial parasympathetic nerve fibers are almost entirely in the vagus nerves (CN X). - Guyton and hall 12th edition p. 801"

Question 195

"The plexus that controls mainly the gastro intestinal movement A. Submucosal plexus B. Meissner's plexus C. Aurbach's plexus D. Mesenteric plexus"

Answer 195

"C. Aurbach's plexus Myenteric or Aurbach plexusƒ.the myenteric plexus controls mainly the gastro intestinal movements and the submucosal (meissner's) plexus controls mainly gastrointestinal secretion and local blood flow - Guyton and Hall 12th edition p. 799"

Question 196

"Which of the following is the correct order of layers of the GIT wall from the lumen towards the serosa A. Epithelium>Lamina propria>Muscularis mucosa>submucosa>Circular muscle> Myenteric plexus>longitudinal muscle B. Epithelium>Muscularis mucosa>submucosa>Circular muscle> Myenteric plexus>longitudinal muscleLamina propria C. Epithelium>Circular muscle>Lamina propria>submucosa>Muscularis mucosa> Myenteric plexus>longitudinal muscle D. Epithelium>submucosa>Lamina propria>Muscularis mucosa>Circular muscle> longitudinal muscle>Myenteric plexus"

Answer 196

" A. Epithelium>Lamina propria>Muscularis mucosa>submucosa>Circular muscle> Myenteric plexus>longitudinal muscle image: Ganong' Review of medical physiology 23rd edition"

Question 197

"Which of the following is true about the smooth muscle fibers A. When an action potentional is generated anywhere within the muscle mass, it generally travels in all direction B. smooth muscle fibers are linked from the next by loose connective tissue C. muscle contraction travels rapidly sideways than the length of the muscle bundle D. circular muscle layer extends longitudinally down the intestinal tract"

Answer 197

"A. When an action potentional is generated anywhere within the muscle mass, it generally travels in all direction Definition of syncytium which is the functionality of smooth muscles - Guyton and hall 12th edition page 797"

Question 198

"Afferent Sensory nerves can be stimulated directly by the following except: A. purgative castor oil B. stomach bloating C. gut flora D. Acetylcholine"

Answer 198

"C. gut flora ""sensory nerves can be stimulated by : 1 irrititation of the gut mucosa (castor oil), 2 excessive distention of the gut (stomach bloating) 3. presence of specific chemicaal (ach)""- Except for the parenthesis - Guyton ad Hall 12th edition p. 801"

Question 199

"Pau ate a quarter pounder burger at mcbee the some time ago, knowing your GIT physiology, which of the statement below is correct A. absorption of nutrients starts at the esophagus B. pau's meal can be temporarily be stored in the stomach C. Nutrients are only absorbed in the sigmoid colon D. Pau's meal will pass through the serosal part of the gut"

Answer 199

"B. pau's meal can be temporarily be stored in the stomach ""temporary storage of food; such as th stomach"" - guyton and hall 12th edition p. 797"

Question 200

"jeje, due to her diarrhea, was given loperamide to alleviate the discomfort felt. Loperamide is an opioid agent which blocks the release of acetylcholine. With this knowledge, which of the following is true for our case A. the agent acts a parasympatholytic B. it is a sympatholytic agent C. An increase of gastric motility is expected and therefore would increase defacation D. Acetylcholine is the inhibitory of gastric motility"

Answer 200

A. the agent acts a parasympatholytic