Flash Card
“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”
“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”
“What catalyzes the energy process of sodium absorption?
A. Adenosine triphosphatase
B. SGLT1
C. SGPT
D. SGOT”
“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”
“It is absorbed along with sodium that are mainly passively “dragged” by the positive electrical charges.
A. Water
B. Phosphate
C. Chloride
D. Calcium”
“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”
“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”
“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”
“All carbohydrates in the food are absorbed in the form of?
A. Monosaccharides
B. Starch
C. Sucrose
D. Polysaccharide”
“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”
“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.”
“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”
“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”
“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
“
“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”
“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”
“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”
“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”
“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”
“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”
“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
”
“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)”
“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”
“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)”
“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 "
“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)”
“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 "
“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)”
“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”
“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)”
“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”
“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)”
“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”
“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)”
“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”
“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)”
“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”
“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)”
“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 "
“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)”
“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”
“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) “
“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”
“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)”
“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”
“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)”
“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”
“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)”
“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”
“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)”
“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”
“A. Ptyalin, pancreatic amylase and brush border enzymes
In carbohydrate digestion, the enzymes involved are Ptyalin, pancreatic amylase and brush border enzymes. (Lecture Note)”
“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”
“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)”
“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”
“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)”
“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”
“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)”
“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
“
“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)”
“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.”
“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)”
“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
“
“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)”
“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”
“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)”
“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
“
“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)”
“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”
“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)”
“It is a condition in which the lower esophageal sphincter fails to relax during swallowing?
A. Achalasia
B. Achlorhydria
C. Hypochlorhydria
D. Botulism “
“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)”
“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 “
“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)
”
“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
”
“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)”
“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 "
“C. Hot chocolate
Caffeine containing beverages like coffee, tea and chocolate lower LES (lower esophageal sphincter) pressure and will further cause GERD”
“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”
“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)”
“This nerve innervates parietal cells and stimulates H+ secretion directly
A. Vagus nerve
B. Facial nerve
C. Abducens nerve
D. Trigeminal nerve”
“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”
“It is a gastro intestinal hormone from duodenum (I cells) that inhibits H+ secretion.
A. Cholecystokinin
B. Secretin
C. Peptide YY
D. Glucoinsulinotropic peptide”
“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”
“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”
“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”
“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”
“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”
“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”
“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”
“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”
“D. H+ secretion is increased
This is the action of gastric cells. Textbook of Medical Physiology 11th edition Guyton and Hall”
“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”
“D. A and C
Somatostatin inhibits gastrin release Textbook of Medical Physiology 11th edition Guyton and Hall”
“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”
“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”
“Hormones that stimulate the secretory activity of the pancreas
A. VIP
B. Sequestrin
C. Cholecystokinase
D. A and B”
“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”
“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”
“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”
“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
“
“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.)”
“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
”
“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.)”
“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 "
“b. Duodenal Ulcers
duodenal ulcers gastrin secretion in response to a meal is increased (Guyton 9th ed)”
“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”
“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)”
“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”
“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)”
“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”
“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)”
“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”
“d. Pernicious anemia
gastrectomy results on the loss of gastric parietal cells, which are the source of intrinsic factor. (guyton 9th ed)”
“Frequent use of laxatives can lead to what disorder of the large intestine?
a. Megacolon
b. Enteritis
c. Psychogenic diarrhea
d. Constipation
”
“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)”
“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”
“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)”
“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”
“a. Gastric ulcer
food neutralizes the acidity of the stomach in gastric ulcers. “
“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-“
“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)”
“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”
“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.)”
“Which of the following is the site of secretion of intrinsic factor?
a. Gastric antrum
b. Gastric fundus
c. Duodenum
d. Ileum”
“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”
“Which of the following is the site of Na+ bile acid transport?
a. Gastric antrum
b. Duodenum
c. Ileum
d. Colon”
“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.)
”
“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”
“a.HCl and intrinsic factor
The gastric parietal cells secrete HCl and intrinsic factor. The chie cells secrete pepsinogen. (BRS 4th Ed.)”
“What type of cell ejects saliva into the mouth?
a.Acinar cells
b.Parietal cells
c.Myoepithelial cells
d.Ductal cells
“
“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)”
“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
“
“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)”
“A digestive enzyme responsible for initial triglyceride digestion:
a. Amylase
b. Lingual lipase
c. Pepsin
d. Gastrin”
“b.Lingual lipase
Initial starch digestion by amylase (ptyalin) and initial triglyceride digestion by lingual lipase. (BRS 4th Ed”
“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”
“b.1-1.5 liters
In humans, the daily secretion of saliva is 1-1.5 liters or 1000ml. (Guyton & Hall)”
“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
“
“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)”
“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
“
“a. Facilitated diffusion
Fructose is transported exclusively by facilitated diffusion: therefore it cannot be absorbed against a concentration gradient.(BRS Physiology 5th Edition)”
“An enzyme that breaks down protein by hydrolyzing interior peptide bond?
a. Endopeptidases
b. Exopeptidases
c. Protease
d. Pepin
“
“a. Endopeptidases
Endopeptidases degrades protein by hydrolysing the interior peptide bond. (BRS Physiology 5th Edition)”
“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
“
“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)”
“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”
“a. Vitamin D deficiency
Vitamin D greatly enhances calcium absorption in the duodenum (Guyton and Hall Textbook of Medical Physiology 12th edition)”
“The optimum pH for pepsin is between pH?
a. 1 and 3
b. 4 and 6
c. 5 and 7
d. 6 and 8
“
“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)”
“It increase the surface area for absorption in the small intestine?
a. Brush border
b. Villi
c. Peyer’s patches
d. Stereocilia
“
“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)”
“It has an emulsifying/detergent action on fat particles in the food?
a. Bile salts
b. Pancreatic lipase
c. Lingual lipase
d. Protease”
“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)”
“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”
“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)”
“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”
“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)”
“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”
“a.Malabsorption of lipid
Low duodenal pH inactivates pancreatic lipase. (BRS Physiology 5th edition)”
