Alimentary Formative Flashcards
Which hormone is likely to be deficient as a result of gastrectomy?
Gastrin
Excess production of which hormone will result in normal gastric mucosal appearances but delayed gastric emptying?
CCK
Function of CCK
Facilitates digestion within the small intestine
Secreted from mucosal epithelial cells in the duodenum
Stimulates delivery into the small intestine of digestive enzymes from I cells of the pancreas
Relaxes sphincter of Oddi to increase delivery of bile from the gallbladder to the duodenum
Function of bile
Contains bile acids for digestion of fats in the small intestine
Fat soluble vitamins
A, D, E, K
What mechanism is responsible for maintaining a low gastric pH?
H/K ATP pumps
What is the inactive form of digestive tract enzymes?
Zymogen
Which of the following digestive processes is most important to promote digestion of fats? A Conjugation B Emulsification C Enterohepatic circulation D Glycolysis E Phosphorylation
B Emulsification
A 23 year old male with a history of alcohol misuse presented with acute upper abdominal pain and vomiting. He was found to have a raised serum amylase.
What is the most likely diagnosis?
Acute pancreatitis
What is the normal defaecation mechanism?
Stretch receptors in the rectal wall activate parasympathetic centers in the spinal cord
A 50 year old man presented to the Emergency Department complaining of a three month history of epigastric pain and a two day history of a very high volume of vomiting.
What is the most likely anatomic site of bowel obstruction to cause this symptom?
3rd part of the duodenum
A 45 year old woman has surgical removal of her distal ileum to treat inflammatory bowel disease.
Which vitamin is she at risk of becoming deficient in?
B12
Where is intrinsic factor produced?
Parietal cells of the stomach
What is the function of intrinsic factor?
Absorption of vitamin B12 in the terminal ileum
A 24 year old man has an inherited defect and is unable to produce intrinsic factor.
The absorption of which substance is most likely to be impaired?
Vitamin B12
A 55 year old man presents with a six week history of progressive painless jaundice and weight loss. On inspection, he is jaundiced. Abdominal palpation is normal.
What is the most likely diagnosis?
Pancreatic cancer
A 30 year old man presents with jaundice. He has been complaining of intermittent right hypochondrial pain and nausea for several months, but the pain has worsened, his urine is darker than usual and his stools pale.
Which imaging test is most appropriate in the first instance?
Abdominal USS
A 45 year old man is stabbed in the lower chest. The knife cuts most of the vagus nerve fibres around the oesophagus. He makes a good recovery.
What is most likely to occur as a result of this nerve injury?
Delayed gastric emptying
A 40 year old man has a total colectomy to treat a colonic carcinoma. The operation is curative.
What is a likely side effect of this operation?
Hyponatraemia
A 70 year old woman presents with jaundice. She has been complaining of right abdominal pain and altered bowel habit for several months. On examination she has a hard craggy mass in her right iliac fossa and hepatomegaly. An abdominal ultrasound is performed.
Which one of the following is the most likely finding in the liver at ultrasound?
Multiple liver metastases
A 70 year old man presented with abdominal pain, vomiting and abdominal distension. He reported absolute constipation. An abdominal radiograph shows multiple dilated loops of bowel.
Which of the following bowel findings on abdominal x-ray would be in keeping with small bowel obstruction?
Central distribution of loops of bowel
A 45 year old smoker presents with massive haematemesis and melaena. Endoscopy reveals an actively bleeding posterior ulcer in the first part of the duodenum.
Which artery is most likely to be bleeding?
Gastro-duodenal artery