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Flashcards in OS 206 Compre Deck (325)
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1

1. Which of the following principal control mechanisms involved in GI function regulation is represented by serotonin (syn. 5-hydroxy-trptamine)?
a. Endocrine
b. Paracrine
c. Neural
d. Combination

D

2

2. Which of the following combination is incorrect?
a. Gastrin-endocrine
b. Histamine-paracrine
c. Acetylcholine-neural
d. Cholecystokinin-paracrine

D

3

3. Which of the following cells in the liver protects against infections secondary to translocation of intestinal bacteria?
a. Hepatic stellate cell
b. Hepatocyte
c. Kupffer cell
d. Gallbladder epithelial cell

C

4

4. In which of the following do Cytochrome P450 enzymes play an important role?
a. Bile acid formation
b. Glycogen synthesis
c. Steroid hormone formation
d. Detoxification of drugs

D

5

5. Xerostamia, or dry mouth, is caused by impaired salivary secretion. Which of the following is not an expected complication of this clinical correlation?
a. Tooth decay
b. Esophageal erosions
c. Difficulty swallowing
d. Gastric ulceration

D

6

6. After complete hepatectomy, a rise of which of the following substances would be expected?
a. Glucose
b. Fibrinogen
c. Conjugated bilirubin
d. Estrogen

D

7

7. Which of the following neurotransmitters act mainly by elevating the Ca++ concentration in the cytosol?
a. Acetylcholine
b. Cholecystokinin
c. Substance P
d. Vasoactive intestinal polypeptide (VIP)

A

8

8. In a patient with acute liver failure, which of the following laboratory finding is expected to be low?
a. Blood glucose
b. Ammonia
c. Vitamin B12
d. Cholesterol

A

9

9. The following are true statements on the regulation of gastric secretion, except:
a. Parietal cell is regulated by a combination of pathways
b. Ach directly activates parietal cells
c. Enterochromaffin cells release histamine
d. Gastrin acts via the paracrine pathway to stimulate the parietal cell.

D

10

10. Which of the following hormone is released to inhibit a meal-stimulated gastrin secretion?
a. Secretin
b. Gastrin
c. Gluco-insulinotropic peptide (GIP)
d. Somatostatin

D

11

11. Which of the following proteins facilitates entry of free bilirubin into the liver cells?
a. Peptide transporter 1 (PepT1)
b. Multidrug resistance protein-2 (MRP-2)
c. Hormone binding proteins
d. Organic anion transporting polypeptides (OATP)

D

12

12. Which of the following enzymes catalyzes the conjugation of bilirubin in the cytoplasm of the hepatocyte?
a. Bilirubin reductase
b. Glucoronyl transferase
c. Heme-oxygenase
d. Glutamyltranspeptidase

B

13

13. Which of the following transmembrane proteins actively secretes conjugated bilirubin into the bile canalliculus
a. Organic anion transporting polypeptides (OATP)
b. Multidrug resistance protein-2 (MRP-2)
c. Gamma Glutamyltranspeptidase
d. Bilirubin reductase

B

14

14. Jaundice (yellowing of the skin and sclerae) is initially manifested at which of the following levels of total plasma bilirubin?
a. >5 mg/dl
b. >4 mg/dl
c. >3 mg/dl
d. >2 mg/dl

D

15

15. What are the primary drugs used in the management of hyperacidity is expected to be more potent?
a. Histamine 2 blockers
b. Proton pump inhibitors
c. Calcium blockers
d. Beta-blockers

B

16

16. Which of the following will not result in an increase in plasma unconjugated bilirubin?
a. Severe infection
b. Abnormal transmembrane protein
c. Decreased albumin binding
d. Stone in the biliary tree

D

17

17. Which of the following will result in an increase in plasma conjugated bilirubin?
a. Abnormality og the OATP
b. Bile canaliculus stasis
c. ABO incompatibility
d. Deficiency of glucoronic acid

B

18

18. Which of the following plasma proteins is quantitatively the most significant protein synthesized by the liver?
a. C3
b. C-reactive protein
c. Albumin
d. Globulin

C

19

19. Which of the following components comprise 65% of the dry weight of bile?
a. Lipids
b. Proteins
c. Bile acids
d. Bilirubin

C

20

20. Which of the following are considered primary bile acids
a. Cholic acid and deoxycholic acid
b. Cholic acid and lithocholic acid
c. Cholic acid and chenodeoxycholic acid
d. Chenodeoxycholic acid and deoxycholic acid

D

21

21. Which of the following processes accounts for ta concentrated bile?
a. Passive transport of Na+
b. Facilitated diffusion of Na+
c. Active transport Na+
d. Endocytosis of bile acids

C

22

22. What is the most potent stimulus for gallbladder emptying
a. Cholecystokinin (CCK)
b. Vasoactive Intestinal polypeptide (VIP)
c. Bombesin
d. Gastrin

A

23

23. Of the 12-36 grams daily secretion of bile acids, how much goes through the enterohepatic circulation?
a. Around 97%
b. Around 85%
c. Less than 75%
d. Less than 50%

A

24

24. Which of the following enzymes would specifically test liver cell injury?
a. ALT
b. AST
c. AP
d. GGT

A

25

25. Which of the following may be normally elevated in a 7-year old, active well-nourished boy?
a. ALT
b. AST
c. AP
d. GGT

C

26

26. In a 2-month old exclusively breastfed infant brought to the clinic for jaundice but otherwise very well baby, which of the following would you expect to be likely increased?
a. Unconjugated bilirubin
b. Conjugated bilirubin
c. AST
d. GGT

A

27

27. Which of the following ratio of conjugated to unconjugated bilirubin would you consider as cholestatic?
a. >10
b. 20
d. <20

C

28

28. Which of the following will likely be increased in a patient who has been taking alcohol regularly for almost 15 years?
a. GGT
b. AP
c. Prothrombin time
d. Albumin

A

29

29. Which of the following laboratory tests are considered synthetic functions of the liver?
a. GGT and glucose
b. Glucose and albumin
c. Prothrombin and Albumin
d. ALT and prothrombin time

C

30

30. Which vitamin B requires intrinsic factor for absorption
a. B
b. B2
c. B6
d. B12

D

31

31. A 10-year old boy complains of recurrent abdominal pain. He recalled being “kicked” in the stomach during his taekwondo about 2 weeks ago. The ER resident is considering pancreatitis. Which of the following tests is expected to be elevated?
a. Bilirubin
b. Lipase
c. ALT
d. Amylase

B

32

32. Liver function tests were obtained from a 3-year old well-nourished boy taking anti-tuberculosis drugs (known to be toxic to the liver). If there is hepatocyte injury, which of the following will be elevated?
a. ALT
b. AP
c. Indirect bilirubin
d. Cholesterol

A

33

33. A medical student complains of bloating and flatulence after eating specific foods such as cheese and cereals with milk. If a breath hydrogen test is performed, what will be the “cut-off value” that is considered positive result?
a. >10 ppm above baseline
b. >20 ppm above baseline
c. >50 ppm above baseline
d.

B

34

34. Which of the following is responsible for our experiencing the “coolness of menthol” or the “sting of ammonia”
a. Olfactory cells
b. Gustatory cells
c. Common chemical sense
d. Mucus cells of the tongue

C

35

35. Which of the following is not a response in the cephalic phase of digestion?
a. Hypothermia (decreased temp)
b. Increased flow of saliva
c. Increased HR
d. Change in urine osmolarity

A

36

36. Which of the following hormones stimulates an enzyme-rich pancreatic secretion?
a. Secretin
b. CCK
c. Somatostatin
d. VIP

B

37

37. Which of the following is the enzyme responsible for secretion of HCL by the parietal cell?
a. Na-K-ATPase
b. H-K-ATPase
c. Carbonic anhydrase
d. Adenylate cyclase

B

38

38. Which of the following hormones stimulates a HCO3-rich pancreatic secretion?
a. Secretin
b. CCK
c. Samatosatin
d. VIP

A

39

39. Which is the primary physiologic control for salivary secretion?
a. Sympathetic
b. Parasympathetic
c. Hormonal
d. Paracrine

B

40

40. Which of the following agonists of pancreatic acinar secretion is not mediated by an increased intracellular calcium?
a. Acetycholine
b. CCK
c. Gastrin
d. Secretin

D

41

hat is the main stimulant of primary peristalsis of the esophagus?
a. Retained food
b. Gastric acid
c. Swallowing
d. Burping

C

42

42. The ability of the stomach to accommodate food and fluid without significant increase in gastric pressure is known as
a. Emptying
b. Retropulsion
c. Transit
d. Receptive relaxation

D

43

43. Slow wave rate from highest to lowest is seen in:
a. Stomach, Duodenum, Jejunum, Ileum
b. Duodenum, Jejunum, Ileum, Stomach
c. Jejunum, Ileum, Stomach, Duodenum
d. Ileum, Stomach, Duodenum, Jejunum

C

44

44. What phase of fast Migratory Motor Complex (MMC) moves undigested food over long distances in the intestines?
a. I
b. II
c. III
d. IV

C

45

45. Which sphincter prevents reflux of chime from the duodenum to stomach?
a. UES
b. LES
c. Pyloric Sphincter
d. Sphincter of Oddi

C

46

46. Which of the following neurotransmitter plays a major role in the receptive relaxation of the stomach?
a. VIP
b. Motilin
c. Enkephalin
d. Gastrin

A

47

47. The major factor responsible for vomiting is:
a. Reflex relaxation of the LES
b. Decreased interthoracic pressure
c. Contractor of abdominal muscles
d. Diaphragmatic contraction

C

48

48. Migarting motor complex is most probably mediated by:
a. Motilin
b. Gastrin
c. Secretin
d. Nitric oxide

A

49

49. Which of the following isocaloric meals will stay in the stomach in the lest amount of time?
a. Meal with rice and boiled fish
b. Meal with 2 oz beef tenderloin
c. Light meal of clear soup gelatin and sugar
d. Meal with pizza and French fries

D

50

50. Which functional layer of the GIT is concerned with propulsion?
a. Mucosa
b. Submucosa
c. Muscularis
d. Serosa

C

51

51. The storage function of the stomach is performed mainly by:
a. Fundus
b. Distal body
c. Antrum
d. Pylorus

A

52

52. Normally, the movement of the contents of the GIT is fastest along this segment:
a. Esophagus
b. Stomach
c. Small intestines
d. Colon

A

53

53. Which phase of swallowing is voluntary
a. Oral
b. Pharyngeal
c. Esophageal
d. Gastric

A

54

54. Swallowing is associated with esophageal peristalsis:
a. Tone
b. Retropulsion
c. Receptive relaxation
d. Enterogastric reflex

C

55

55. Which of the following is the most potent inhibitor of gastric emptying
a. Secretin
b. CCK
c. GIP
d. Motilin

B

56

56. Which of the following will make the GI smooth muscle is resting membrane potential more negative?
a. Sympathetic stimulation
b. Acetylcholine
c. Parasympathetic agents
d. Distension

A

57

57. The GI contents stay approx. 4 hours in the:
a. Esophagous
b. Stomach
c. Small intestines
d. Colon

C

58

58. Which of the following is true of fructose absorption in the apical membrane
a. It is inhabited by the absorption of glucose of galactose
b. It is facilitated by SGLT1
c. It is independent of sodium concentration
d. It requires a passive diffusion transport mechanism

C

59

59. Transport of galactose in the apical membrane is an example of:
a. Primary active transport
b. Secondary active transport
c. Facilitated transport
d. Passive diffusion

B

60

60. The digestion of the major foodstuff in the GIT is a process of:
a. Sulfation
b. Decarboxylation
c. Hydrolysis
d. Amidation

C

61

61. Parasympathetic innervation to the small intestines is provided by the
a. Celiac plexus
b. Vagus nerve
c. Sacral plexus
d. Pelvic nerve

B

62

62. What is the most potent stimulus for relaxation of Sphincter of Oddi and gal bladder contraction?
a. VIP
b. Bombesin
c. CCK
d. Gastrin

C

63

63. Procarboxypeptidase is directly activated by
a. Chymotrypsin
b. Trypsin
c. Pepsin
d. Enterokinase

B

64

64. Phospholipids are digested into:
a. Monoglyceride and cholesterol
b. Cholesterol and lysolecithin
c. Fatty acids and lysolecithin
d. Lysilecithin and monoglyceride

C

65

65. Which of the following is responsible for apical transport of fructose in enterocytes?
a. SGLT1
b. GLUT 2
c. GLUT 4
d. GLUT 5

D

66

66. Reesterification of monoglyceride and fatty acids occur in the enterocyte:
a. Cytosol
b. Smooth ER
c. Golgi apparatus
d. nucleus

B

67

67. What digestive enzyme is necessary for the hydrolysis of phospholipids?
a. Cholesterol easter hydrolase
b. Phospholipiase A2
c. Pancreatic lipase
d. Lingual lipase

B

68

68. Extensive injury of the ileum will gratly affect the absorption of:
a. Vitamin C
b. Fructose
c. Cyanocobalamin
d. Amino acids

C

69

69. Which of the following monosaccharides will be absorbed first?
a. Pentose
b. Arabinose
c. Galactose
d. Glucose

C

70

70. Intrinsic factor is necessary for the absorption of Vitamin:
a. B1
b. B2
c. B6
d. B12

D

71

71. Which of the following fats will you recommend for a healthy life?
a. Palm Oil
b. Trans fat
c. Canola Oil
d. Coconut Oil

C

72

72. How much sodium will a 55-year old hypertensive diabetic female be advised to take daily (mg)?
a. 500
b. 1500
c. 2400
d. 3400

B

73

73. If an overweight Medical Student wishes to lose 1lb/week, how much less kilocalories of her daily energy allowance must be take per day?
a. 125
b. 250
c. 375
d. 500

D

74

74. Which of the following is least associated with increased cardiovascular risk?
a. WHC 23
c. High dietary intake of omega 3 fatty acid
d. Diet with 400 mg of cholesterol per day

A

75

75. Absorption of fat digestion products and fat soluble vitamins is by what transport mechanism?
a. Primary active
b. Secondary active
c. Facilitated diffusion
d. Passive diffusion

D

76

76. Dipeptides and tripeptides are absorbed by the intestines with which ion?
a. Sodium
b. Chloride
c. Hydrogen
d. potassium

C

77

77. Which of the following explains the lack of disinterest of the elderly in food?
a. Increase in bitter receptors in the tongue
b. Over-enhancement of taste sensations
c. Increased esophageal emptying
d. Decreased salivary production

D

78

79. What is the mechanism responsible for early satiety in the elderly?
a. Decreased resistance of the gastric mucosa to damage
b. Increased numbers of parietal cells
c. Decreased salivary production
d. Slower gastric emptying time

D

79

80. Which segment of the GIT is least affected by aging?
a. Esophagous
b. Stomach
c. Small intestines
d. Large intestines

C

80

81. Osteopenia and bone loss in the elderly are related to changes in which segment of the GIT?
a. Esophagus
b. Stomach
c. Small intestines
d. Large intestines

C

81

81. Osteopenia and bone loss in the elderly are related to changes in which segment of the GIT?
a. Esophagus
b. Stomach
c. Small intestines
d. Large intestines

C

82

83. The brown colour of the liver of the elderly is due to the long-term deposition of which molecule?
a. Alcohol dehydrogenase
b. Hepcidin
c. Iron
d. Lipofuscin

D

83

85. Which hepatic phase reactions decrease linearly with age?
a. 1
b. 2
c. 3
d. 4

A

84

86. Which of the following is true regarding significant age-related changes of the life
a. Weight increases
b. Blood flow increases
c. Drug elimination decreased
d. Regeneration is impaired

C

85

87. An increase in the likelihood for gallstones in the elderly may be due to an increase in which of the following?
a. Blood flow
b. Bile acid synthesis
c. Cholesterol secretion
d. Hepatobiliary transport

C

86

88. What may increase the risk of elderly patients who has diarrhea?
a. Non-compliance with medication
b. Avoidance of food
c. Achlorhydria
d. calcium

C

87

89. What is the most common complaint in the elderly?
a. Constipitation
b. Fecal impaction
c. Incontinenece
d. Diarrhea

A

88

90. Which of the following decreases due to age-related changes to the small intestines
a. Absorption
b. Motility
c. Transit time
d. Villus height

D

89

91. Which of the following decreases due to age-related changes in the GIT?
a. Diameter of the pancreatic duct
b. Fat absorption
c. Lipase
d. Fibrosis

D

90

92. Which of the following increases with age in terms of effectiveness?
a. Electrical activity
b. Exercise
c. Enemas
d. Abdominal plain

B

91

At what level does the esophagus pierces the diaphragm
A. T8
B. T10
C. T12
D. L1

B

92

Which normally does NOT have gas in its lumen?
A. Stomach
B. Rectum
C. Sigmoid
D. Gall bladder

D

93

The posterior area of origin of the diaphragm that forms anterior to the psoas muscle is the:
a. medial arcuate ligament
b. costal part
c. median arcuate ligament
d. lateral arcuate ligament

C

94

A knife thrusts into your abdomen, piercing your AAL. What layers does it traverse?

Superficial fascia, EO, IO, TA, TF

95

Outermost covering of spermatic cord as it exits the superficial inguinal ring
A. Cremasteric Muscle
B.Internal Spermatic Fascia
C. External Spermatic Fascia
D. Processus Vaginalis

C

96

In the inguinal trigone, the structure seen medial to the deep inguinal ring
A. Inferior Epigastric artery
B. Inguinal ligament
C. Conjoint Tendon
D. Rectus Abdominis

C

97

What is the normal position of the uterus?
A. Anteverted and Anteflexed
B. Anteverted only
C. retroverted and retroflexed
D. retroverted only

A

98

Case of old woman: Cyst that does not dissolve in 10 weeks
A. Physiologic cyst
B. hemorrhagic cyst
C. corpus luteum cyst
D. endometrioma

D

99

What passageway can be found on the central tendon of the diaphragm?
A. Esophageal hiatus
B. Caval Opening
C. Aortic hiatus
D. Sternocostal hiatus

B

100

Arterial supply of prostate and seminal vesicle
a. superior vesical and middle rectal
b. inferior vesical and inferior rectal
c. inferior vesical and middle rectal

C

101

Bile and blood from a ruptured segment 2 of the liver will likely gravitate first to
a. Left subhepatic space
b. hepatorenal space

A

102

Dull sensation and hypoesthesia of penis and scrotum result from an injury of the
a. iliohypogastic nerve
b. ilioinguinal nerve
c. inguinal branch of genitofemoral
d. obturator nerve
e. spermatic nerve

B

103

. Patient diagnosed to have developed retroperitoneal hemorrhage following blunt trauma. Positive Cullen sign appreciated meaning a discoloration in this area
a. Epigastric area
b. flank
c. umbilical region
d. inguinal region
e. lumbar

C

104

. A hematoma that originates initially in this zone would immediately be investigated regardless of the cause
a. centromedial
b. anterior
c. lateral
d. posterior

A

105

. Due to the presence of short gastric and left gastroepiploic arteries in the ______ ligament, these vessels may be destroyed during splenectomy
a. splenorenal
b. phrenicosplenic
c. gastrosplenic
d. hepatoduodenal

C

106

Acute cholecystitis referred pain in:
A. RUQ
B. Shoulder
C. Hypogastric
D. LUQ

A

107

A 40-year old obese woman with a history of gallstones was brought to the hospital. Gallstones from a ruptured cyst may descend to the
a. ileum
b. colon
c. all of the above
d. none of the above

B

108

The gall stones ulcerate into
A. Colon
B. Duodenum
C. Both
D. Neither

A

109

Which artery does not supply the pancreas
a. gastroduodenal
b. SMA
c. IMA
d. splenic

C

110

At the midinguinal level, at a horizontal plane, what covers the rectus abdominis posteriorly?
A. External Oblique Aponeurosis
B. Internal Oblique Aponeurosis
C. Transverse Abdominal Aponeurosis
D. Transversalis Fascia

D

111

Most movable part of duodenum.

first part

112

[T/F] The duct of Santorini drains the anterosuperior head of the pancreas along with the uncinate process

T

113

[T/F] The impacted site of the Ampulla of Vater can be approached by an incision in the 4th part of duodenum

F

114

[T/F] Gastroesophageal junction has a true anatomical landmark

T

115

In the CT of a hepatic tissue (?), one may find:
(a) branch of hepatic artery
(b) hepatic portal vein
(c) bile duct)
(d) lymph vessel
(e) all of the above

E

116

Which of the following features of a female pelvis is not favorable for childbirth?
a. wider sacrosciatic notch
b. wider pubic angle
c. greater iliac flaring
d. shallow pelvic cavity

C

117

Marker for the pudendal nerve block
a. Ischial tuberosity
b. Pubic symphysis
c. ischial spine
d. sacral promontory

B

118

Most variable branch of the internal iliac artery
a. obliterated umbilical
b. obturator
c. inferior gluteal
d. superior gluteal

B

119

By the phrase "bridge over water", what vessel passes over the ureter?
A. Something a.
B. uterine artery
C. Inferior vesicular a.
D. Superior vesicular a.

B

120

What is the most common modality used in pelvic organ imaging?
A. CT Scan
B. Ultrasonography
C. MRI
D. HSG

B

121

To best investigate a case of possible obstruction of the fallopian tube/s , you use:
a. CT
b. Ultrasound
c. MRI
d. Hysterosalpingogram

D

122

A hysterosalpingogram is...
a. Diagnostic
b. Therapeutic
c. Both

A

123

This transducer is used for (endocavitary)
a. transvaginal
b. transrectal
c. transabdominal
d. A and B
e. A and C

D

124

Which part of the duodenum do the common hepatic duct and primary pancreatic duct empty?

2nd part of duodenum

125

Which of the following methods of GI functional GI functional control is expressed by serotonin?
a. endocrine
b. paracrine
c. neural
d. combination

C

126

Which of the ff cells in liver protect against infection secondary to translocation bacteria?
a. hepatic stellate cells
b. hepatocyte
c. Kupffer cells
d. gallbladder epithelial cells

C

127

Xerostomia or dry mouth is caused by impaired salivary reaction. Which of the following is NOT expected complication of this condition?
A. Tooth decay
B. Esophageal erosion
C. Difficulty swallowing
D. Gastric ulceration

D

128

After complete hepatectomy, which is elevated?
a. glucose
b. fibrinogen
c. conjugated bilirubin
d. estrogen

D

129

What transmembrane protein actively transports conjugated bilirubin to bile canaliculus?
a. OATD
b. MRP-2
c. bile reductase

B

130

Which of the following is most potent for hyperacidity?
a. H2 blocker
b. proton pump inhibitor
c. Ca channel blocker
d. beta-blocker

B

131

Which of the following results in increased plasma conjugated bilirubin?
a. abnormal OATP
b. bile canaliculus stasis
c. ABO compatibility
d. deficiency of glucoronic acid

B

132

What is responsible for the concentration of bile in the gall bladder?
a. passive diffusion of Na
b. active transport of Na
c. facilitated diffusion of Na
d. diffusion of Ca

B

133

A 2-month old baby fed exclusively on breastmilk comes in with jaundice but no other condition. Which of the following is expected to be elevated?
a. unconjugated bilirubin
b. conjugated bilirubin
c. GGT
d. SGT

A

134

Which among the following ratio of conjugated and unconjugated bilirubin would you consider as cholestatic?
a. >10
b. 20
d. <20

C

135

A 10-yr old boy complaining of abdominal pain was rushed to the ER. He said that he was kicked in the stomach 2 weeks ago. The ER resident suspects pancreatitis. What enzymes will be elevated?
a. Amylase
b. Lipase

B

136

Main stimulant of primary peristalsis of esophagus
A. Remaining food
B. Gastric Acid
C. Swallowing
D. Burping

C

137

Slow wave movement is fastest in the:
a. stomach, duodenum, jejunum, ileum
b. duodenum, jejunum, ileum, stomach
c. jejunum, ileum, stomach, duodenum
d. ileum, jejunum, stomach, duodenum

B

138

Neurotransmitter for receptive relaxation
a. VIP
b. motilin
c. enkephalin
d. gastrin

A

139

MMC is controlled by
a. motilin
b. secretin
c. gastrin
d. CCK

A

140

Which layer is responsible for propulsion?
a. Serosa
b. Mucosa
c. Submucosa
d. muscularis externa

D

141

Which GIT segment has the fastest emptying time?
a. esophagus
b. stomach
c. small intestine
d. colon

A

142

Most potent stimulator of relaxation of sphincter of Oddi and gallbladder contraction
a. VIP
b. Bombesin
c. CCK
d. Gastrin

C

143

What directly activates procarboxylase and proelastase?
a. chymotrypsin
b. trypsin

B

144

Which of the ff decreases due to age-related changes in the GIT?
a. diameter of pancreatic duct
b. fat absorption
c. lipase
d. fibrosis

B

145

In a radiograph of a person standing upright, the gas in the stomach will be in the:
A. Cardia
B. Fundus
C. Body
D. Ampulla

B

146

What is the anatomical demarcation that separates the stomach from the esophagus at the gastroesophageal junction?
A.) Z-line
B.) M-line
C. E-line
D. G-line

A

147

Which organ is in direct contact with the body of gallbladder?
A. visceral part of the liver
B. transverse colon
C. superior duodenum
D. AOTA

B

148

The sympathetic innervation of the stomach is from the

A. celiac ganglia
B. Superior mesenteric ganglia
C. Inferior mesenteric ganglia
D. Sacral spinal nerves

A

149

The greater sciatic foramen is covered by what muscle?
A. Coccygeus
B. Piriformis
C. Obturator internus
D. Levator ani

B

150

What muscle contributes to the pudendal canal?
A. Piriformis
B. Coccygeus
C. Obturator internus
D. Levator ani

C

151

Gonadal artery branches from...?
A. External Iliac Artery
B. Internal Iliac Artery
C. Abdominal Aorta

C

152

Which prostatic lobe is mostly fibromuscular tissue?
A. Anterior
B. Lateral
C. Posterior
D. Median

A

153

The spongy urethra passes through all of these EXCEPT:
A. Glans
B. Bulb of urethra
C. Sphincter urethrae
D. Corpus spongiosum

C

154

Where are the trigylcerides reformed in the enteroctye?
A. ribosome
B. endoplasmic reticulum
C. golgi apparatus
D. nucleus

B

155

The uterus is most commonly found in what position?
A. Anteverted and Anteflexed
B. Retroverted and Anteflexed
C. Anteverted and Retroflexed
D. Retroverted and Retroflexed

A

156

. The sacral plexus is formed on top of this muscle:
A. Levator ani
B. Coccygeus
C. Piriformis
D. Obturator internus

C

157

The living ligature of humans refers to the:
A. Uterus
B. Uterine tubes
C. Uterine muscles
D. Urinary bladder

C

Living ligatures refer to the criss-crossed oblique muscle fibers, surrounding the vessels, which contract preventing excessive bleeding during labor and delivery. These muscles are mainly present in the upper uterine segment, where the placenta is normally attached.

158

The following supplies the prostate and the seminal vesicles:
A. inferior vesical artery
B. middle rectal artery
C. AOTA
D. NOTA

C

159

The uterine artery/ureter cross at the level of the
A. Uterus
B. Uterine cervix
C. External os
D. Internal os

B

160

Why is the sigmoid colon prone to volvulus?
A. It is a redundant segment
B. Due to its s-shaped curve in the ilac fossa
C. It has a narrow omentum relative to its broad base

C

161

Radiologic feature that looks like an “OMEGA” sign, called
A. Bent inner tube sign
B. Coffee bean sign
C. Bird’s beak sign
D. Double inlet sign
E. NOTA

A

162

PE finding of acute cholecystitis:
A. Psoas sign
B. Gray Turner’s sign
C. Murphy’s sign
D. Obturator’s sign

C

163

Collateral veins will be seen in a physical exam along
a. posterior abdominal wall
b. lateral abdominal wall
c. anterolateral abdominal wall
d. anterior chest wall
e. posterior chest wall

C

164

This artery may be eroded by a duodenal ulcer as it passes down the first part of the duodenum
A. Left hepatic artery
B. Gastroduodenal artery
C. Splenic artery
D. Superior mesenteric artery

B

165

The tip of the fundus is located at the angle between the 9th intercostal cartilage and the border of the
A. rectus abdominis
B. external oblique
C. transversus abdominis
D. internal oblique

A

166

The pancreas is supplied by the following, except:
A. Superior Mesenteric Artery
B. Inferior Mesenteric Artery
C. Gastroduodenal Artery
D. Splenic Artery

B

167

Peyer’s Patches
A. Upper Jejunum
B. Lower Ileum
C. All of the Above
D. None of the Above

C

168

In the suprapubic area, the posterior rectus sheath is formed by the:
A. External oblique aponeurosis
B. Internal oblique aponeurosis
C. Transversus abdominis aponeurosis
D. AOTA
E. NOTA

E

The suprapubic area is below the arcuate line, which means all the muscular aponeuroses decussate anterior to the rectus abdominis muscle. Only the transversalis fascia, preperitoneal fat and the peritoneum can be found below the arcuate line posterior to the rectus abdominis.

169

The outermost covering of the spermatic cord within the inguinal canal?
A. cremaster muscle
B. external spermatic fascia
C. internal spermatic fascia
d. processus vaginalis

B

170

Hernia is due to the weakness of which border of the inguinal canal?
A. Anterior Wall
B. Posterior Wall
C. Roof
D. Floor

B

171

The structure that accompanies the inferior vena cava through the caval foramen is the:
A. Azygos vein
B. Splanchnic nerves
C. Vagus nerves
D. Thoracic duct
E. NOTA

E

172

If you clamp the contents of the hepatoduodenal ligament, the following events will happen except for:
A. Prevention of venous return from lower extremities and posterior wall to heart
B. Prevention of emptying of bile into duodenum
C. Cut of blood supply to liver
D. NOTA

A

173

Which demarcates the suprapubic area from the umbilical region?
A. Transpyloric plane
B. Transumbilical plane
C. Transtubercular plane
D. Subcostal plane

C

174

Anchors the duodenojejunal junction posteriorly to the right crus of the diaphragm:

Ligament of Treitz

175

Crypts of Lieberkuhn
A. Small Intestines
B. Large Intestines
C. Both A and B
D. Neither A nor B

C

176

Presence of circular folds
A. Small Intestines
B. Large Intestines
C. Both A and B
D. Neither A nor B

A

The small intestine has circular folds. The large intestine has SEMI CIRCULAR folds

177

Predominant cell in the base of the fundic gland
A. Parietal Cell
B. Chief Cell
C. Enteroendocrine Cell
D. Paneth Cell
E. Absorptive Cell

B

178

Secretes lysozymes
A. Parietal Cell
B. Chief Cell
C. Enteroendocrine Cell
D. Paneth Cell
E. Absorptive Cell

A

179

What is the normal sonographic appearance of the urinary bladder?
A. Anechoic with acoustic shadowing
B. Anechoic
C. Hypoechoic with acoustic shadowing
D. Hypoechoic

A

180

What is the best imaging modality to be used in assessing infertility secondary to fallopian tube pathology?
A. CT Scan
B. Ultrasonography
C. MRI
D. Hysterosalpingogram

D

181

Nervous system involved in digestion

ENTERIC NERVOUS SYSTEM

182

At what phase of migratory motor complex does the gallbladder start to empty?
A. Phase I
B. Phase II
C. Phase III
D. Phase IV

B

183

Which sympathetic gangling predominantly supplies the stomach

Celiac Ganglion

184

Which part of the GI tract is very active during fasting?

Small intestine

185

Reservoir function of the stomach served by

fundus

186

What food INCREASES LES pressure
a. Protein
b. Fat
c. Peppermint

A

187

Primary drug in the management of GERD

Proton Pump inihibitors

188

Hypotensive LES is

Sphincter pressure less then 10

189

What is the most common cause of GERD

Transient LES Relaxation

190

. Duodenal acidity stmulates enterogastric reflex by secreting

Secretin

191

Which part of the colon acts as a volitional reservoir?
A. Ascending
B. Transverse
C. Descending
D. Rectosigmoid

D

Volitional = voluntary

192

Which of the ff would physiologically affect would have produced defacation

increase in anorectal angle

193

which of the following reflex is stimulatory

Gastrocolic Reflex

194

Which of the ff is membrane-digestive enzyme

Sucrase

195

w.c of the ff monosaccharides would be absorbed 2nd
a. glucose
b. galactose
c. fructose
d. mannose

A

196

Which of the ff disaccharides when digested will produce the 2 different sugar so that only SGLT 1 tranporter is needed to pass through apical membrane
a. glucose
b. galactose
c. lactose
d. mannose

C

197

Pepsin will degrade ingested proteins into which of the following except.
A. Peptone
B. Dipeptides
C. Amino Acids
D. Tripeptides

C

198

Tryglyceride is digested into

monoglycerides and Fatty Acids

199

This vitamin is an intrinsic factor for absorption

B12

200

What factor would increase calcium absorption

Active Vit D

201

What factor would increase iron absorption

Ascorbic Acid

202

Which of the ff will be best absorbed in the distal small intestine

Cobalamine

203

Which of the following substances is absorbed by facilitated diffusion?
A. Galactose
B. Glucose
C. Fructose
D. Dipeptides

C

204

Which carrier protein is responsible for absorption of fructose and glucose across basolateral membrane

Glut 2

205

Sodium absorption in the distal colon involves which absorptive carrier

Epithelial Sodium channel

206

The process involving the comibination of digestion andabsorption of major nutrients

assimilation

207

Absorption usually occurs in the
A. Esophagus
B. Stomach
C. Proximal small bowel
D. Transverse colon

C

208

Reflex control of the GI system: w/c is true regarding salivary secretion?
a. under exclusive hormonal control
b. condition and uncondition reflex
c. inhibited by sympathetic stimulation
dit is induced by sleep

B

209

Approx how much saliva produced daily

1.5 liters

210

The process where food is broken down into simple substances absorbed in the blood.
A. Ingestion
B. Digestion
C. Processing
D. Divertion

B

211

what gastric cell produced Gastic Lipase

Chief Cell

212

Vagal stimulation releases acetylcholine on all of the following cells, EXCEPT:
A. Chief cell
B. G cell
C. Parietal cell
D. ECL cell

A

213

Which phase has the least acid secretion?
A. Cephalic
B. Gastric
C. Intestinal
D. Hepatic

C

214

Which pancreatic cell produces digestive enzymes

Acinar cells

215

Most important inorganic product of pancreatic secretion is

biocarbonate

216

GI hormone best stimulates production of increased water and bicarb in the pancreas

secretin

217

Brunner's glands secrete this substance that activates trypsin
A. Mucus
B. Glucagon
C. Neurotensin
D. Enterokinase

D

218

GI hormone that is found in the stomach, pancreas, small intestine and colon

Somatostatin

219

Excretory product of liver

billirubin

220

digestive fxn of liver involves

bile acids

221

Which of the following bile acids are secondary bile acids?
A. Cholic and chenodeoxycholic
B. Lithocholic and cholic
C. Cholic and deoxycholic
D. Lithocholic and deoxycholic

D

222

wc is the predominant bile acid absorbed in the ileum for enterohepatic circulation

deoxycholic

223

transport protein responsible for uptake of bile acids in the basolateral membrane wc is sodium dependent

sodium torocholic co transporter

224

Which GI hormone causes of gallblader contraction of relaxation of sphincter of oddi

CCK

225

PE finding with acute cholecystisis

Murphy’s sign

226

Shifting dulllness is associated with abdominal enlargement due

fluid

227

Hard nodular liver

Hepatocellular carcinoma

228

which of the following tests can be used to assess the presence of hepatic injury?
A. serum albumin
B. serum bilirubin
C. sgpt/slt (ALT)
D. prothrombin time

C

229

what subsequent blood test should be requested if a patient has elevated gamma glutamin transpeptidase and determine if it is due to a hepatic disorder

alkaline phosphatase

230

Which two tests are used to diagnose cholestasis? D
A. Conjugated bilirubin and prothrombin time
B. Prothrombin time and serum albumin
C. Alkaline phosphatase and serum albumin
D. Conjugated bilirubin and serum albumin

D

231

what is the cut off BMI for obese in western countries

30

232

. Cut off for waist circumference for females in Asian population

18 CM

233

American heart association suggests cholesterol intake for patients with heart disease should be limited

200 mg/day

234

With aging, Salivary production
A. Increase
B. Decrease
C. No change

B

235

With aging, Cholestatic function
A. Increase
B. Decrease
C. No change

A

236

With aging, Gastic Emptying time
A. Increase
B. Decrease
C. No change

A

237

With aging, Small intestinal Absorption
A. Increase
B. Decrease
C. No change

C

238

With aging, Gastric Musocal Barrier
A. Increase
B. Decrease
C. No change

B

239

With aging, Constipation
A. Increase
B. Decrease
C. No change

A

240

With aging, Cholelithiases
A. Increase
B. Decrease
C. No change

A

241

most basic structure of the kidney found mostly in:

A. Renal Capsule
B. Renal Cortex
C. Renal Column
D. Renal Pyramid
E. Renal Pelvis

B

242

At what level is are the kidneys located?
A. T 11 to L4
B. T12 to L5
C. T11 to L3
D. L1 to L5

C

243

Which is false?
A. On the frontal plane, the renal axis is directed downward and outward.
B. The kidneys lie parallel to the lateral borders of the psoas muscles on either side.
C. On the lateral plane, the renal axis is directed downward and anteriorly.
D. On the lateral plane, the renal lower pole is 2-3 cm more posterior than the upper pole.

D

244

Most dominant force in determining GFR (choices not in verbatim order)

A. tubular fluid oncotic pressure
B. plasma or capillary oncotic pressure
C. glomerular capillary hydrostatic pressure
D. Bowman’s capsule hydrostatic pressure

C

245

The bulk of calcium reabsorption happens in the
A. Proximal tubule
B. Thick ascending limb of loop of Henle
C. Distal convoluted tubule
D. Collecting tubule

A

246

The bulk of magnesium reabsorption occurs in the
A. Proximal tubule
B. Distal convoluted tubule
C. Thick ascending limb of loop of Henle
D. Collecting tubule

C

247

All are functions of the kidney except ( *Rephrased)
A. Excretion of metabolic wastes
B. Synthesis of glucose using amino acids during fasting
C. Regulation of electrolyte balance
D. Secretion of ADH

D

248

These control mechanisms are activated seconds after change in blood pressure except (paraphrased)
A. RAAS
B. baroreceptor
C. chemoreceptor
D. CNS ischemic response

A

249

What characteristic allows the detrusor to accommodate (inc. volume) without an increase in pressure?
A. Competence
B. Compliance

B

250

1. Which anatomical structure is not usually seen in a plain x-ray of the abdomen?
a. stomach
b. psoas
c. ureter
d. bladder

C

251

2. In a normal adult, the kidneys usually lie along the length of which vertrbral body?
a. T11-L3
b. T9-T12
c. L1-L4
d. T10-L1

A

252

3. In the proximal convuluted tubule, penicillin is
a. Actively secreted into tubule
b. Actively reabsorbed from tubule
c. Passively reabsorbed from tubule
d. Metabolized by tubule cells

A

253

4. In which portion of the ureter stones would tend to lodge and cause obstruction
a. Uterovesical junction
b. Uteropelvic junction
c. Crossing over iliac
d. Crossing over psoas

A

254

5. All may be found in IVP of kidney with hydronephrosis EXCEPT
a. Flattening of concavity of calyx
b. Reversal of convexity of renal papilla
c. Atrophy of renal pelvis
d. Enlarged calyx

C

255

6. Which of the ff. does not describe perirenal fascia?
a. Encloses perirenal fat
b. Known as Gerota’s fascia
c. Anchors kidney to surrounding structures and wall of abdomen
d. Innermost of 3 tissue layers surrounding the kidneys

D

256

7. What is true of the efferent arteriole
a. It branches into the glomerular capillary
b. It contains mechanoreceptors sensitive to BP
c. It branches into the peritubular capillary
d. It absorbs solutes from intestinal fluid

C

257

8. Majority of the stones of the urinary tract can be visualized radiographically. This is because of the fact that these stones are made of
a. Uric acid crystals
b. Calcium oxalates
c. Magnesium crystals
d. A&B
e. A,B&C

B

258

9. Which correctly describes the kidney
a. It is located in the zone 1 of the retroperitoneum
b. It is almost parallel to the vertebral column
c. It is primarily a retroperitoneal organ
d. It is fixed in place by renal vessels and renal fascia
e. It measure 10x1x5 cm

C

259

10. The outline to the renal shadows are visible on the plain film of abdomen because of:
a. Low density of peri-renal fat capsule
b. Uptake of contrast by the kidney
c. Low soft tissue density of the psoas
d. Surrounding bowel gas

A

260

11. A patient needs to remove one of his kidneys. During surgery the spleen is carefully lifted. What abdominal organ will be injured?
a. Pancreas
b. Spleen
c. Ovary
d. Stomach
e. Left colic flexure

C

261

12. True of ureters
a. Serosal layer derived from overlying mesentery derivatives
b. 3 muscle layers propel urine from kidney to bladder
c. transitional epithelium
d. reabsorption of small portion of filtrate is coursed through lymphatics
e. AOTA

E

262

13. Highest oncotic pressure
a. Efferent arteriole
b. Afferent arteriole
c. Midway in glomerular capillary
d. Renal artery

A

263

14. What happens to the small amount of albumin that is filtered into the tubular lumen
a. It is excreted unchanged
b. It is reabsorbed via channels in the proximal tubule and is reterurned to systemic circulation via peritubular capillaries
c. It is taken up via endocytosis and is broken down by lysozyme inside the cell. Amino acids are then reabsorbed
d. Filtered proteinases break down albumin in the lumen, amino acids are reabsorbed.

C

264

15. Primary function of active form of vitamin D
a. Increase absorption of Ca2+ in the intestines
b. Increase renal absorption of Ca2+
c. Increase renal absorption of phosphate
d. Mobilize Ca2+ stored in the bone

A

265

16. The term “autoregulation” is referred because
a. Does not need arterial blood to function
b. Kidney contains baroreceptor
c. Maintains GFR in a wide range of blood pressure
d. Does not need symphathetic nerves to function

C

266

17. All of the following solutes are reabsorbed via secondary active transport in the proximal tubule except:
a. amino acid
b. phosphate
c. sulfate
d. H+

D

267

18. Glomerulotubular refers to
a. Maintaining GFR constant in the face of changes of MAP
b. Increase in GFR in response to an increase in RBF
c. Increase in tubulo reabsorption in response to an increase filter load
d. AOTA

D

268

19. Which of the following is false
a. Fluid in int. contains hyperosmotic NaCl
b. H2O reabsorbed in last segment of DCT
c. Urea enters DLH at slower rate than efflux of NaCl
d. Osmotically abstracts H2O from ALH

D

269

20. Potassium secretion is stimulated by
a. Aldosterone
b. Anti-diuretic hormone
c. Angiotensin II
d. Angiotensin I

A

270

21. Major ICF cation
a. Na+
b. K+
c. H+
d. Ca2+

B

271

22. In a healthy individual, which of the following fluids normally has the highes pH? (most alkaline)
a. Systemic arterial blood plasma
b. Systemic venous blood plasma
c. Urine
d. AOTA, since pH is normall same for all

A

272

23. Volume expansion controlled by
a. Intrarenal hydrostatic pressure
b. Intrarenal oncotic pressure
c. Renal sympathetic nerve
d. RAAS

D

273

24. Volume contraction maybe associated with which of the following:
a. Hyperosmolarity
b. Isoosmolarity
c. Hypoosmolarity
d. AOTA

D

274

25. At which time of the day is the basal rate of gastric acid secretion the highest?
a. Night
b. Morning
c. Afternoon
d. Noon

B

275

26. An increase in renin would
a. Increase in Na excretion & increase in K+ excretion
b. Increase in Na excretione & decrease in K+ excretion
c. Decrease in Na excretion & increase K+ excretion
d. Decrease in Na excretion & decrease in K+ excretion

C

276

27. The patient’s osmolarity is 380. What is causing the osmolal gap?
a. Alcohol
b. Sodium
c. Glucose
d. Urea

A

277

28. Ammonia excreted in urine comes mainly from the metabolism of:
a. Glycine
b. Glutamine
c. Leucine
d. Alanine

C

278

29. Effect of angiotensin II
a. Inhibit thirst mechanism
b. Inhibit ADH
c. Stimulate aldosterone
d. Stimulate ANP

C

279

30. Aldosterone effects
a. Increase number of open Na+ & K+ channels at apical membrane
b. Increase rate of Na+-K+ ATPase pump
c. Both
d. Neither

C

280

31. The glucose plasma concentration at which urine starts testing positive for glucose
a. Tm
b. Renal threshold for glucose
c. Absorptive threshold
d. Splay

B

281

33. Viral diarrhea with water replaced
a. Isotonic expansion
b. Hypotonic contraction
c. Hypotonic expansion
d. Isotonic contraction

C

282

36. Bladder is full and you are 20m away from the toilet. what is activated?
a. Pelvic nerve inhibition
b. Cortical stimulation
c. Rostral pons
d. Pudendal nerve

B

283

37. Richly folded epithelium and spongy tissue within the submucosa contribute to this phenomenon that promotes continence among females?
a. Reflex resting pressure of urethra
b. Urethrovesical angulation
c. Intrapelvic position of urethra
d. Urethral seal effect

D

284

40. Bladder compliance is essential because
a. Allows slow rise in detrusor pressure as volume rises
b. Maintains pressure despite increase in volume
c. Allows complete emptying of bladder during voiding
d. Prevents reflux of uring to the ureter

A

285

41. In decreased blood pH, to determine if bicarbonate loss is through diarrhea and not impaired kidney function, one must test for increased levels of which of the following in the urine?
a. HCO3-
b. H+
c. NH4+
d. H2PO3-

A

286

42. Which is an abnormal finding in urinalysis?
a. specific gravity of 1.020
b. protein
c. amorphous crystal
d. pH 6.0

B

287

You have a patient with a stab wound at the right flank, with depth just enough to lacerate the dorsal convex border of the kidney. Assuming the kidney bled slowly, in what direction would blood preferentially dissect in the retroperitoneum?
A. Anteriorly towards peritoneal cavity
B. Posterior into fascia of Zuckerland
C. Laterally towards lateral abdominal wall fascia
D. Medially towards midline
E. Superiorly towards hepatorenal fascia and subdiaphragmatic area

D

288

If you were stabbed in the epigastric area, which organ will be least likely damaged?
A. Jejunum
B. Pancreas
C. Duodenum

A

289

A 4-mm stone migrated from calyx to ureter. Where will it lodge?
A. L1-L2
B. L3-L4
C. Pelvic Brim
D. Level of sacral promontory
E. Pelvic cavity

A

290

During a left nephrectomy, ligating near the IVC would affect which of the following organs?
A. pancreas
B. spleen
C. left colon
D. stomach
E. a portion of the jejunum

B

291

Developmental anomalies do sometime develop in both the intestinal and urinary tracts. When both tracts develop common drainage cavity, this is referred as:
A. Cloaca
B. Urachus
C. Urogenital sinus
D. Extrophy
E. Sinus bifidus

A

292

The ureteral orifices are minute openings that are not readily seen from within the bladder wall. Which are guides to see these orifices?
A. Apex of trigone
B. Interureteral ridge
C. Superolateral angles of trigone
D. Uvula
E. ABC

E

293

What normally stimulates micturition?
A. Contraction of the detrusor muscle
B. Stretching of the bladder wall
C. Relaxation of the sphincter urethra
D. Urine filling the trigone

B

294

In the renal medulla, to maintain osmotic gradient, which of the following is true?
A. the descending loop of Henle is selectively permeable to water
B. counter current flow of the urine is opposite the renal blood flow
C. only 20% of renal blood flow through medulla
D. the thick ascending limb of loop of Henle actively transports salt and water
E. all of the above

A

295

The membranous urethra is lined by
A. transitional epithelium
B. stratified squamous epithelium
C. pseudostratified or stratified columnar epithelium
D. simple squamous epithelium
E. NOTA

C

296

Common to renal pelvis, ureter and bladder
A. lined by thick transitional epithelium
B. covered by serosa
C. contains muscle layers involuntarily controlled
D. contains muscle layers in horizontal orientation
E. all of the above

C

297

Reabsorbed electrolytes from PCT go back to circulation through
A. vasa recta
B. arcuate arteries
C. peritubular capillaries
D. arcuate veins
E. all of the above

C

298

Component of the nephron with phagocytic properties
A. macula densa
B. JG cells
C. mesangial cells
D. principal cells
E. intercalated cells

C

299

Blood volume decreases as it passes through which structures?
A. afferent arteriole
B. efferent arteriole
C. peritubular capillaries
D. glomerular capillaries
E. all of the above

D

300

Region of the kidney with the least blood supply
A. cortex
B. outer medulla
C. papilla
D. renal columns
E. NOTA

C

301

In the adult human, the kidneys lie at the level of
A. L1-L4
B. T11-L3
C. T12-L2
D. L3-L4

B

302

Which statement is not true about phleboliths?
A. vascular structures on the face
B. have radioluscent center area surrounded by radiodense periphery
C. may be mistaken for calculi
D. are calcified arteries

D

A phlebolith is a small local, usually rounded, calcification within a vein.

303

The renal shadow is visible in the plain x-ray film in the abdomen because of
A. the low density perineal fat
B. the uptake of contrast by the kidneys
C. the soft tissue low density psoas
D. the presence of gas bowel surrounding the kidneys

A

304

The isotope used commonly for visualization of the urinary tract
A. Calcium
B. Strontium
C. Iodine
D. Technetium

C

305

Common findings on an intravenous pyelogram in patients with hydronephrosis are the following except:
A. Flattening of the normal concavity of the calyx
B. Reversal of the convexity of the renal pelvis
C. Atrophy of the renal pelvis
D. Enlarged calyces

C

306

A patient presents with massive pedal edema and ascites due to nephritic syndrome. His sodium concentration is 136 mEq/l, Posm 277 mOsm/kg H20. Urinalysis reveals Uosm 300 mOsm/kg H20, sodium 5 mEq/l, and potassium 60 mEq/l. Urine volume is 2L/day

His free water clearance is
A. 0.17 liter/day
B. 1.7 liters/day
C. 17 liters/day
D. Not enough data to calculate the CH20

A

307

A patient presents with massive pedal edema and ascites due to nephritic syndrome. His sodium concentration is 136 mEq/l, Posm 277 mOsm/kg H20. Urinalysis reveals Uosm 300 mOsm/kg H20, sodium 5 mEq/l, and potassium 60 mEq/l. Urine volume is 2L/day.

If he drinks a liter of water a day, will he develop hyponatremia?
A. Yes, because his CH20 1 liter.
C. Yes, because his electrolyte-free water clearance 1L.

D

308

. A patient with congestive heart failure may retain more fluid because of:
A. AVP release
B. Decreased effective arterial blood volume
C. RAAS Activity
D. SNS Activity

B

309

A falsely low urine specific gravity using the reagent strip
A. acidic urine
B. glucosuria
C. ketonuria
D. proteinuria

B

310

Which of the following requirements is essential for counter-current multiplier?
A. flow against concentration gradient.
B. difference in permeability of tubules carrying fluid in the same direction
C. Na/Cl pump activation
D. source of energy

B

311

Which of the following is true for the collecting duct?
A. There are 2 cell types: principal cell and dark staining intercalated cell.
B. It is lined mostly by intercalated cells that regulate sodium reabsorption.
C. It has aquaporin 3 responsible for urea reabsorption due to solvent drag.
D. It is affected by SIADH, which presents inappropriately low vasopressin levels, causing water retention.

A

312

A 30-year old male was found unconscious in a highway, probably a victim of hit and run. He was brought to the emergency room of the Philippine General Hospital and was found to have a systolic BP if 70 mmHg and feeble pulses. He was noted to be probably in shock. How will this affect Na reabsorption in the PCT?
A. Decreased Na reabsorption due to increased sympathetic nerve activity
B. Increased Na absorption secondary to increased renin-angiotensin-aldosterone system
C. Increased Na reabsorption secondary to increased renal interstitium
D. All except B
E. All except C

C

313

80 year old woman found in her bed unconscious with an empty bottle of salicylic acid on the nearby table. Obviously a victim of accidental salicylate poisoning, she was brought to the ER. If you were the intern who initially saw the victim, you would treat her with
A. sodium bicarbonate
B. ammonium chloride

A

314

Which of the following will result in the lowest FF?
A. EA dilate, AA dilate
B. EA dilate, AA constrict
C. EA constrict, AA constrict
D. EA constrict, AA dilate

B

315

If cardiac output is 6.0L, what is RBF?
A. 1.0-1.25 L/min
B. 1.25-1.50L/min
C. 1.50-2.0L/min
D. 2.0-2.50L/min

B

316

. In decreased blood pH, to determine if bicarbonate loss is through diarrhea and not impaired kidney function, one must test for increased levels of which of the following in the urine?
A. bicarbonate
B. H+
C. NH4+
D. H2PO3-

A

317

What differentiates the distal tubule from the proximal convoluted tubule?
A. presence of Na-K ATPase pump at the basolateral membrane
B. Ca reabsorption at this site is enhanced by the the parathyroid hormone
C. reabsorbed Na diffuses to the peritubular capillaries
D. presence of brush border at the luminal side

B

318

Water reabsorption from interstitial space to peritubular capillaries is by
A. interstitial hydrostatic pressure
B. interstitial oncotic pressure
C. peritubular capillary hydrostatic pressure
D. peritubular oncotic pressure

A

319

In the absence of ADH, at the same level of the medulla, which has more concentrated tubular fluid?
A. descending loop of henle
B. ascending loop of henle
C. medullary interstitium
D. collecting tubule

A

320

Compared to plasma, interstitial fluid has more:
A. K+
B. Na+
C. Mg2+
D. Cl-

D

321

How many tablets of NaCl (1 tablet = 1 gram NaCl) will you give a patient who has an estimated Na+ deficit of 102 mmoles?
A. 2
B. 4
C. 6
D. 10

C

322

Which of the following will stimulate renin release?
A. aldosterone
B. antidiuretic hormone
C. increased salt intake
D. increased sympathetic activity

D

323

In kidney failure, edema is secondary to
A. Increased capillary hydrostatic pressure
B. Decreased plasma oncotic pressure
C. Increased capillary permeability
D. Lymphatic obstruction

B

324

Bladder compliance is essential because
A. allows slow rise in detrusor pressure as volume rises
B. maintains pressure despite increase in volume
C. allows complete emptying of bladder during voiding
D. prevents reflux of urine to the ureter

A

325

The Brush Border Microvilli in the apical membrane is a distinct characteristic of:
A. glomerulus
B. bowman's capsule
C. PCT
D. DCT
E. NOTA

C