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CAS 3 Flashcards

1
Q

Which of the following vessels vascularize the developing midgut

A
  • Superior mesenteric artery
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2
Q

A sample of muscle obtained from an experimental animal is bathed in a solution containing nutrients necessary to support normal activity. stretching of the muscle produce a contraction. The muscle was likely obtained from which of the following sites

A
  • Trapezius
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3
Q

A 9-month-old infant is brought to the emergency department by his mother because of vomiting for the past 24hrs. she says, “he spits up whatever I feed his formula and his stomach is making gurgling noises.”

The infant has been otherwise healthy and his growth and development has been normal. he was a product of a normal pregnancy and delivery and his vaccines are up to date. Vital signs are normal. The baby is coughing and there is increased salivation but he otherwise appears well. faint expiratory wheezes are heard on auscultation of the lungs. 🫁

Which of the following is the most appropriate next step

A

CT scan of the chest

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4
Q

Which of the following is the primary chemical signal for stimulation of secretion from gastric parietal cells during the cephalic phase of digestion secretion

A

Gastrin

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5
Q

Which of the following structures is peritoneal during development but becomes retroperitoneal later in life

A

Kidney

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6
Q

A healthy 14yrs old boy fast in preparation for a physical examination and blood test. following an 18hrs fast serum glucose concentration is still within the reference range.

which of the following hepatic processes best explain the maintenance of serum glucose concentration

A
  • Glycogenolysis. (breaking of glucose from glycogen that is stored)
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7
Q

which of the following structures is regenerated within three days after mechanical or chemical trauma

A

myenteric plexus

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8
Q

which of the following supplies reducing equivalents (NADPH) for fatty acid synthesis

A

Ribose-5-phosphate HMP shunt

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9
Q

which of the following compound can serve as precursor for gluconeogenesis

A

Alanine

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10
Q

A 55 yrs old man undergoes total gastrectomy cancer for the stomach. which of the following groups of the lymph nodes should examined as the most likely site of the initial metatasis

A

Celiac

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11
Q

A 24yrs old man participate in study of mechanisms of appetite suppression. During the study, he is given a large meal and asked to eat as much as he wants. after consuming 75% of the food he stops eating because he feels full.

A decrease in which of the following hormones is most likely the cause of THE DECREASE IN APPETITE

A
  • Ghrelin
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12
Q

Which of the following process in heme synthesis is controlled by end-product feedback inhibition?

A
  • Glycine + succinyl CoA ➡️ 5- aminolevulinate (delta- ALA)
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13
Q

A 29 yrs old woman developed internal bleeding after a blunt trauma to the abdomen undergoes an exploratory laparotomy. During the operation, a segment of the gastrointestinal tract with small tags of attached is found.
this bowel segment is most likely

A

The colon

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14
Q

A 28yrs old man is brought to the ER one hour after being found unresponsively by neighbor. he has a four year history of alcoholism and malnutrition. He is only responsive to painful stimuli. His pulse is 150/min, and his blood pressure is 90/60mmHg.

physical examination shows a strong odor of ethanol and sparse subcutaneous fat. His serum glucose concentration is 25mg/dL. treatment with Intravenous glucose result and some improvement in responsiveness. The hepatic concentration of the following is most likely to be in present in this patient with a healthy individual

A

NADH

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15
Q

According to the chemiosmotic theory of how oxidation and phosphorylation are coupled, which of the following processes produces the chemical gradient that drives the generation of ATP and ADP

A
  • Electron transport causes H+ into the intermembrane space
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16
Q

A 30yrs old man with Crohn disease has an operation for recurrent intestinal pain when her abdomen is touched. Fasting serum total cholesterol concentration is 210mg/dL ( N= 45-182), serum TAG concentration is 1840mg/dL ( N= 30-86), and serum amylase activity is increased. This child will require a lifelong low fat diet because of which of the following genetic defects

A

Increased HMG-CoA reductase activity

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17
Q

Which of the following labeled cells have membrane receptors for Histamine and acetylcholine

A

C. Pariatal cells

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18
Q

A 28yrs old man is brought to the ER because of a 6 hour history of dull, aching pain in the periumbilical area. Abdominal examination shows tenderness to palpation around the umbilicus. A CT scan of the abdomen shows a 6cm fingerlike pouch arising from the anti- mesenteric border of the terminal iluem. which of the following development events is most likely cause of this pouch

A

Persistence of the Vitelline duct

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19
Q

A 17yrs boy is brought to the ER after being shot in the abdomen. Emergency laparotomy shows severe damage to the second part of the duodenum, which requires resection of the structure. Ligation of arteries supplying the region of the damaged duodenum is mostly to affect arteriaal blood supply to which of the following

A

Head of the pancreas

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20
Q

Digestion of starch occurs in the absence of the pancreatic secretion because of the actions of which of the following enzymes

A

Salivary Amylase

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21
Q

A blood clot in the coronary artery will decrease blood flow to a part of the heart muscle. In the area of decreased flow, which of the following will occur immediately with respect to glycogenolysis, glycolysis or both?

A

Activation due to decrease ATP

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22
Q

A male newborn has anemia and jaundice. A peripheral blood smear shows variable erythrocytes morphology and an increased reticulocytes count. Addition of glucose to the erythrocytes exacerbates the hemolysis. The erythrocytes shows a decreased affinity for oxygen. Defect in which of the following enzymes is most likely

A

Pyruvate kinase

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23
Q

A seven year old man comes to the position because of weakness and easy fatigue ability for six weeks. His temperature is 37C (98.6F), pulse is 90/min, respirations are 16/min and blood pressure is 8g/dL. A test of the store for occult is positive. cancer of the ascending colon is found during colonoscopy. An abdominal CT scan shows metastases in the liver. this tumor most likely spread to the liver through which of the following veins

A

Hepatic (portal vein)

24
Q

An investigator compares the metabolism of a prostate cancer cell line with that of a cell line derived from normal prostate cells. Results shows that the rate of malonvl- CoA biosynthesis is seven times greater in the tumorigenic cell than in the cell line. based on these results, the rate of biosynthesis of which of the following classes of compounds is most likely greater in cancer cells compared with normal cells

A

Fatty Acid

25
Q

Which of the following best explain why histamine H2 antagonist are effective inhibitors of gastrin-stimulated acid secretion?

A

Gastrin and histamine share receptors

26
Q

A 32 yrs old woman comes to the physician because of pain and swelling of her right cheek for 24hrs. physical examination shows a mildly swollen and tender area overlying the parotid gland, Sialolithiasis ( formation of parotid duct stone) is suspected and sialography is done. The catheter must be placed into the parotid duct, which is most likely found in which of the following location

A

Vestibule of the mouth opposite the second maxillary molar

27
Q

A 38 yrs old man is brought to the emergency department after vomiting approximately 1 pint of bright red blood. he takes 3-4 aspirin daily for sinus headaches and antacids regularly for epigastric discomfort.

Upper endoscopy shows active arterial bleeding at the base of an ulcer in the duodenal wall just distal to the pylorus.

For angiographic control of the bleeding, access to the involved vessels is best obtained via which of the following routes that originate in the aorta

A

Superior mesenteric ➡️ inferior pancreatiduodenal

28
Q

A 52yrs old man with major depressive disorders participates in a study of a novel drug that can inhibit thee conversion of vitamin B2 ( riboflavin) to its active coenzymes.

which of the following metabolic processes is most likely to be directly impaired in this patient as a result of this treatment ?

A

Production of ribose-5-phosphate from glucose-6-phosphate

29
Q

There is no net synthesis of four carbon precursors of glucose during the metabolic breakdown of acetyl CoA in the tricarboxylic acid because of which of the following reason?

a) Insufficient NADH for gluconeogenesis is produced in the mitochondrial matrix during oxidation-reduction rxn cycle

b) the mitochondrial membrane is impermeable to oxaloacetate which is trapped in the matrix

c) Two molecules of CO2 are released in every turn of the cycle

A

Two molecules of CO2 are released in every turn of the cycle

30
Q

A 3-day-old female newborn delivered at term develops a 2 day history of yellow skin and eyes. Physical examination shows no abnormalities except for scleral icterus and yellow-orangepigmentation of the skin.

The newborn is successfully treated after two sessions under high- intensity fluorescent lights and has no further complication. This newborn most likely nad jaundice due to the lack of expression of which of the following enzymes

a) 6- Aminolevulinate synthase
b) Ceruloplasmin
c) Ferrochelatase
D) Protoporphyrinogen oxidase
e) UDP- glucuronyl transferase

A

UDP- glucuronyl transferase

31
Q

A 4-yrs-old girl is brought to the physician because of recurrent bacterial and viral infections during the past 3 years. Physical examination shows developmental delay. laboratory studies shows a decreased T-lymphocytes concentration, increased of urinary purines, and decreased serum immunoglobulin concentrations. Her serum uric acid concentration is within the reference range. which of the following enzymes is most likely deficient in this patient’s cell

a) Adenosine deaminase
b) Adenosylhomocysteine hydrolase
c) Hypoxanthine- guanine phosphoribosyltransferase
d) Purine-nucleoside phosphorylase

A

Purine- nucleoside phosphorylase

32
Q

During myocardial infraction, the decreased oxygen supply to the myocardium leads to a decreased ATP concentration. Which of the following best described the most likely effect of this decrease on carbohydrate and fat metabolism in the affected myocardium?

A

Increased flux of acetyl CoA carboxylase

33
Q

A healthy 24yrs old woman who is participating in a study of diet and nutrition ingests a well balanced meal containing fats, carb, and proteins, within the next hour, various proteolytic enzymes are secreted in an inactive form into the gut lumen.

which of the following sets of substances is most likely to activate one or more proteolytic enzymes in this woman?

A
  • Pepsin = Yes
  • Trypsin = Yes
  • Enterokinase = Yes
34
Q

A 27yrs old woman comes to the physician because of a 4- days history of frequent episodes of vomiting and abdominal pain. Abdominal examination shows diffuse tenderness. A CT scan and upper gastrointestinal x-ray images of the abdomen with oral contrast are shown; the arrow indicate the defect. which of the following developmental events explains these findings

A

The stomach and duodenum rotated in an abnormal direction

35
Q

During a study of gastric secretion evoked by a variety of agents, it is found that activation or inhibition of specific membrane receptors and protein can affect the secretion of gastric acid.

Exposure to which of the following agents is most likely to result in an increase in gastric acid secretion

A

Motilin Agonist

36
Q

A researcher studying gastric physiology measures the rate of the gastric emptying under various experimental conditions. Gastrointestinal hormones are infused to mimic either submaximal (+), maximal (++) concentration observed normally during the postprandial period.

Which of the following patterns of serum hormone concentration is most likely to inhibit gastric emptying?

A
  • Gastrin (+), Cholecystokinin/ CCK = (++), Secretin = (+), Glucagon- like Intestinal Peptide = (++)
37
Q

A 6-day old breast fed boy is brought to the emergency department by his mother because of poor weight gain and irritability since delivery, and a 2- hour history of vomiting. Physical examination shows jaundice and hepatomegaly. A reducing substance test result of the urine is positive, and a glucose oxidase test is negative.

A deficiency of which of the following liver enzyme activities is most likely in this patient?

A

Galactose - 1- phosphate uridyltranferase

38
Q

A 24yrs-old woman is brought to the emergency department by her friend because of a 6 hour history of vomiting and difficulty breathing. she has a 10-yrs history of type 1 diabetes mellitus. she has not had an insulin injection for 24hrs. her pulse is 100/min, and respiration is 30/min. Physical examination shows lethargy, deep respiration, and dehydration. laboratory studies shows hyperglycemia and metabolic acidosis.

which of the following best describes the activity of the biochemical pathways in this patient’s liver

A
  • Gluconeogenesis ( Increased)
  • Glycogen synthesis (decreased)
  • Fatty Acid oxidation ( Increased)
  • Glycolysis (Decreased)
39
Q

A 9-months old boy is brought to the physician because of a 4-hr history of vomiting and irritability. He was exclusively breastfed for 8 months and has been introduced to cereal, apple juice and prepared baby foods during the past month. His mother says that he drank six ounces of apple juice before the onset of symptoms. Physical examination shows lethargy and hepatomegaly. laboratory studies shows hypoglycemia and hyperuricemia. When fruit and added sucrose are removed from his diets, the symptoms resolve. the physician suspects that the patients lacks the activity of a specific enzymes.

the enzyme normally function at which of the area labelled in the schematic diagram of a hepatocyte

A

F ( ER)

40
Q

LDLs serve predominantly to transport which of the following

A
  • From liver to the peripheral tissues
  • HDL = transport cholesterol from the peripheral tissues to the liver
  • Chylomicrons = Dietary cholesterol from the intestine to the liver
41
Q

which of the following best describe the response of the circular muscle layer to distention of the jejunum to a volume slightly less than that which causes pain

A

Contraction above and relaxation below the point of distention

42
Q

After fasting for 8 to 12hrs, the amount of glucose in the hepatic portal vein is markedly lower than the amount after a meal but the amount in the systemic circulation remains near the normal level. Hepatocytes are able to maintain systemic glucose homeostasis in this situation primarily by gluconeogenesis and which of the following biochemical mechanisms?

a) Activation of lactase
b) Glycogenolysis
c) Glycolysis
d) Pentose Phosphate shunt

A

Glycogenolysis

43
Q

A full term male newborn has a portion of small intestine and omentum visible in a hernia sac. the sac Is covered by peritoneum and amnion and protrudes into the base of the umbilical cord. The pregnancy and delivery were uneventful.

which of the following development defects is most likely responsible for this findings

A

Failure of the intestine to return to the abdominal cavity during fetal development

44
Q

A 54yr-old man undergoes successful rubber band ligation of a prolapsing hemorrhoid. four weeks later, he returns to have another hemorrhoid ligated. After being informed that the first hemorrhoid was successfully removed, he says that he experienced no pain.

which of the following is the most likely explanation for the absence of pain

A

The ligation was done superior to the pectinate (mucocutaneous) line

45
Q

Which of the following is a product of heme degradation?

A

Urobilinogen

46
Q

Which of the following compounds in erythrocytes is decreased in patients with a deficiency of glucose-6- phosphate dehydrogenase

A

Ribose

47
Q

A 55yrs old man is receiving treatment with lovastatin to control hypercholesterolemia is found to have underglycosylated proteins on the erythrocytes membrane.

the most likely cause is a decrease in which of the following

A

Cholesterol

48
Q

A 9-month-old girl is brought to the physician because of poor feeding, failure to thrive, and developmental delay since birth. she has been exclusively breastfed. she is at the 5th percentile for length and weight. Physical examination shows hypotonia, poor head control and inability to sit unassisted. serum studies shows increased concentrations of alanine, pyruvate, and lactate. A restricted carbohydrate diet is prescribed.

The restricted diet in this patient is most likely to cause which of the following effects?

A

Increased hepatic acetyl- CoA concentration

49
Q

A fasting adult is receiving a continuous infusion of secretin. Which of the following changes in pancreatic secretion will occur if he begins to chew, but does not swallow, but does not swallow, a piece of meat ?

Sham feeding is what this is called.

A

Decreased bicarbonate concentration ( Acinar cells stimulated)

50
Q

In a healthy person consuming a high carbohydrate diets, which of the following plays a vital role in triacylglycerol deposition in adipocytes

A

Formation of VLDLs by hepatocytes

51
Q

Under which of the following condition will lactic acidosis occur

A

Increase NADH-NAD+ and decrease ATP-ADP

52
Q

Lymph absorbed via lymphatics from the jejunum is most likely to pass first to which of the following group of regional lymph nodes

A

Celiac

53
Q

A diet rich in carbohydrates result in storage of muscle glycogen mediated by increased insulin.

which of the following processes is responsible for increased storage of glycogen ?

A

Dephosphorylation of glycogen synthase ( glucokinase)

54
Q

An investigator produces a strain of transgenic mice in which the gene for the enzymes phosphofructokinase 1 has been knocked out. only heterozygotic offspring in this line are viable.

which of the following pathways would be most affected by this genetics change

A

Glucose to pyruvate

55
Q

A 54yrs-old woman undergoes laparoscopic correction of a hiatal hernia. During the procedure, the left gastric artery is damaged when the stomach is pulled down, and it requires ligation at its origin.

As a result, which of the following arteries is most likely to provide blood supply to the cardia of the stomach compromised by this situation?

A

Right gastric

56
Q

A male newborn has anemia and jaundice. A peripheral blood smear shows variable erythrocytes morphology and an increase reticulocytes count.Addition of glucose to the erythrocytes exacerbated the hemolysis. The erythrocytes shows a decreased affinity for oxygen.

Defects in which of the following enzymes is most likely

A

Glyceraldehyde- 3 phosphate dehydrogenase

57
Q

Digestion of starch occurs in the absence of pancreatic secretions because of the action of which of the following enzymes

A

Salivary amylase

CAS 3 (1 decks)

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