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Formative questions > GI > Flashcards

GI Flashcards

1
Q

What is the function of Intrinsic Factor produced in the stomach?
A. Stimulates secretion of Vitamin B12 into the bowel lumen
B. Protects Vitamin B12 from degradation by stomach acid
C. Cleaves Vitamin B6 to form Vitamin B12
D. Allows absorption of Vitamin B12 in the terminal ileum
E. Blocks absorption of Vitamin B12 to prevent B12 overdose

A

D. Allows absorption of Vitamin B12 in the terminal ileum
(Gastric) Intrinsic Factor is a glycoprotein produced by the parietal cells of the stomach and is essential for the absorption of Vit B12.
It binds with Vit B12 and forms a complex that resists digestion by gastric enzymes.
The Vit B12 complex then passes through the stomach where it absorbed in the terminal ileum, transported to the liver and stored.

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2
Q

How do non steroidal anti inflammatory drugs (NSAIDs) irritate the stomach?
A. By stimulating the vagus nerve to secrete more acetylcholine
B. By increasing acid secretion through stimulation of the proton pump
C. By decreasing chloride secretion through inhibition of the K/Cl exchange pump
D. By inhibition of gastrointestinal mucosal cyclo-oxygenase (COX) activity
E. By increasing secretion of pepsinogen

A

D. By inhibition of gastrointestinal mucosal cyclo-oxygenase (COX) activity
NSAIDs inhibit COX-1 and COX-2 (COX = cyclo-oxygenase).
COX-2 is the target enzyme and blockade of this will inhibit production of inflammatory and nociceptive-enhancing prostaglandins.
Inhibition of COX-1 will prevent production of gastro-protective prostaglandins.

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3
Q 
Which of these substances is secreted by Enterochromaffin like (ECL) Cells    
A. Amylase
B. Acetylcholine
C. Pepsinogen
D. Somatostatin
E. Histamine
A

E. Histamine

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4
Q

Which of the following statements is correct regarding the function of the Vagus nerve and its action on parietal cells?
A. Vagus nerve is part of the parasympathetic system and releases histamine onto parietal cells
B. Vagus nerve is part of the sympathetic system and releases adrenaline onto parietal cells
C. Vagus nerve is part of the parasympathetic system and releases acetylcholine onto parietal cells
D. Vagus nerve is part of the parasympathetic system and releases noradrenaline onto parietal cells
E. Vagus nerve is part of the sympathetic system and releases acetylcholine onto parietal cells

A

C. Vagus nerve is part of the parasympathetic system and releases acetylcholine onto parietal cells

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5
Q

You are trying to design a drug to act on histamine receptors on parietal cells to help patients with reflux disease. What would be the mechanism of this drug?
A. Inhibits Histamine 1 receptors to reduce acid secretion
B. Stimulates Histamine 2 receptors to reduce acid secretion
C. Stimulates Histamine 1 receptors to stimulate acid secretion
D. Inhibits Histamine 2 receptors to reduce acid secretion
E. Inhibits both Histamine 1 and Histamine 2 receptors to reduce acid secretion

A

D. Inhibits Histamine 2 receptors to reduce acid secretion

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6
Q 
What is the change in cell-type (‘metaplasia’) seen in the lower oesophagus after prolonged reflux of acid?   
A. Pseudostratified columnar to columnar
B. Stratified squamous to columnar
C. Columnar to stratified squamous
D. Columnar to pseudostratified columnar
E. Cuboidal to columnar
A

B. Stratified squamous to columnar

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7
Q 
Which of these substances is secreted by Chief cells?      
A. Somatostatin
B. Pepsinogen
C. Chymotrypsinogen
D. CCK
E. Saliva
A

B. Pepsinogen

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8
Q 
Where does the Common Bile Duct drain into?
A. Caecum
B. Duodenum
C. Lesser sac
D. Gallbladder
E. Stomach
A

B. Duodenum

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9
Q

What is the action of the proton pump in the parietal cells of the stomach?
A. Chloride in, HCO3- out of cell
B. K+ into cell, H+ out of cell
C. H+ into cell, Chloride out of cell
D. HCO3- into cell , Chloride out of cell
E. H+ into cell, K+ out of cell

A

B. K+ into cell, H+ out of cell

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10
Q

What is the function of the drug ‘Omeprazole’ on the GI tract?
A. Stimulation of CCK receptors to increase bile secretion
B. Direct neutralisation of stomach acid
C. Inhibition of Proton Pump to reduce acid secretion
D. Inhibit pancreatic proteases to protect lining of the duodenum
E. Blockade of Vagus nerve activity on the stomach

A

C. Inhibition of Proton Pump to reduce acid secretion

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11
Q 
Which of the following structures is NOT present in the Porta Hepatis?
A. Left and Right Hepatic Ducts
B. Hepatic vein
C. Portal vein
D. Hepatic branch of Vagus Nerve
E. Left and Right Hepatic Arteries
A

B. Hepatic vein
The Porta hepatis is a fissure on the underside of the liver. It has several structures running through it, the hepatic artery proper, portal vein, hepatic bile duct, Vagus nerve branches, Sympathetics and lymphatics.

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12
Q 
Which of the following structures is classified in embryology as part of the ‘foregut’?       
A. Pancreas
B. All of them
C. Lower third of oesophagus
D. Gallbladder
E. Proximal half of the Duodenum
A

B. All of them

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13
Q 
Which of these substances is secreted by G cells?
A. Glycogen
B. Secretin
C. Pepsinogen
D. Somatostatin
E. Gastrin
A

E. Gastrin

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14
Q 
Which of the following vessels supplies arterial blood to the Jejunum?
A. Right Gastro-Epiploic Artery
B. Superior Mesenteric Artery
C. Inferior Mesenteric Artery
D. Splenic Artery
E. Direct branches from Aorta
A

B. Superior Mesenteric Artery

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15
Q 
Which of these substances is secreted by D cells?
A. Stomach acid
B. Gastrin
C. Adrenaline
D. Somatostatin
E. Pepsinogen
A

D. Somatostatin

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16
Q 
What is the first location that Fat is acted upon by Lipase enzymes when passing through the GI tract?             
A. Oral cavity
B. Duodenum
C. Stomach
D. Ileum
E. Oesophagus
A

A. Oral cavity

17
Q 
How many layers of muscle are present in the stomach wall?                     
A. 4
B. 1
C. 3
D. 5
E. 2
A

C. 3

18
Q

Which of the following statements is False?
A. The liver is divided into 8 segments
B. The hepatic blood supply is 35-40% of the cardiac output.
C. The portal vein supplies 75% of hepatic blood flow.
D. The acinus is the functional hepatic unit.
E. The liver lies in the right hypochondrium.

A

B. The hepatic blood supply is 35-40% of the cardiac output.

The hepatic blood supply is 25% of cardiac output.

19
Q 
Which of these is not a cause of Obstructive Jaundice?
A. Hepatitis
B. Gallstones
C. Pancreatic Carcinoma
D. Cirrhosis
E. Gilbert’s Syndrome
A

E. Gilbert’s Syndrome
Gilbert’s syndrome is a genetic disorder.
People with the syndrome have a faulty gene which causes the liver to have problems removing bilirubin from the blood.
There is no obstructive element in Gilbert’s syndrome

20
Q

Concerning the function of the pancreas. Which of the following is False?
A. Pancreatic polypeptide is secreted by the F islet cell.
B. Glucagon is secreted by the alpha (A) islet cells.
C. Somatostatin is secreted by the gamma (G) islet cells
D. Insulin is secreted by the beta (B) islet cells.
E. Glucagon stimulates the breakdown of glycogen

A

C. Somatostatin is secreted by the gamma (G) islet cells
Somatostatin is secreted by the Delta (D) islet cells
Somatostatin is a peptide hormone that includes amongst its actions the inhibition of insulin and glucagon secretion

21
Q

Which of the following statements is True?
A. The gall bladder synthesizes 50 mls of bile per day.
B. The sympathetic nervous system releases Acetylcholine causing the gallbladder to contract.
C. Cholecystokinin is released in response to the presence of carbohydrates in the gut.
D. The entero-pancreatic reflex is mediated by the sympathetic system.
E. Cholecystokinin is released in response to the presence of amino acids in the gut.

A

E. Cholecystokinin is released in response to the presence of amino acids in the gut.
The Vagus nerve (parasympathetic) releases Acetylcholine causing the gallbladder to contract.
Cholecystokinin is released in response to the presence of amino acids in the gut as well as lipids, free fatty acids, peptides but not carbohydrates or HCl.
The gall bladder stores up to 50 mls of bile.
The entero-pancreatic reflex is mediated by the parasympathetic system.

22
Q

Which of these is not a function of the liver?
A. Production of Urobilinogen
B. Storing Vitamins A D E K
C. Production of Cholesterol
D. Conversion of thyroxine (T4) into triiodothyronine (T3)
E. Glycogen storage

A

A. Production of Urobilinogen

23
Q 
Obstructive jaundice is commonly caused by gall stones within what structure?
A. Common bile duct
B. Gall bladder
C. Right hepatic duct
D. Cystic duct
E. Pancreas
A

A. Common bile duct

24
Q 
Which one of these cells is part of the reticuloendothelial system in the liver?
A. Hepatocyte
B. Sinusoidal endothelial cell
C. Fibroblast
D. Ito cell (Hepatic stellate cell)
E. Kupffer cell
A

E. Kupffer cell

25
Q

Which of the following causes an increased serum unconjugated (free) bilirubin and increased faecal urobilinogen?
A. Pre-hepatic cause of jaundice
B. Hepatocellular cause of jaundice
C. Post-hepatic (obstructive) cause of jaundice
D. Mixed picture cause of jaundice

A

A. Pre-hepatic cause of jaundice
Pre hepatic has both raised.
Hepatocellular causes have increased free bilirubin but decreased faecal urobilinogen.
Post hepatic causes have normal free bilirubin and absent faecal urobilinogen.

26
Q 
What structure is situated within the duodenal loop? 
A. Cystic duct
B. Common bile duct
C. Gall bladder
D. Pancreas
E. Right hepatic duct
A

D. Pancreas

27
Q 
Microsomal enzyme uridine diphosphoglucuronosyl transferase (glucuronyl transferase) catalyses the formation of what?
A. Conjugated bilirubin 
B. Unconjugated bilirubin
C. Urobilinogen
D. Stercobilinogen
E. Free bilirubin
A

A. Conjugated bilirubin
Bilirubin is essentially insoluble.
Conjugated bilirubin is soluble and therefore more easily excreted in the urine and bile.

28
Q 
What is the structure in the middle of the hepatic lobule?
A. Portal triad
B. Bile duct
C. Central vein
D. Hepatic artery
E. Portal vein
A

C. Central vein

29
Q

What is the cause of physiological jaundice of the new-born?
A. Excess breakdown of foetal haemoglobin
B. Immaturity of conjugation enzyme mechanisms in the liver
C. Horizontal alignment of the common bile duct as it enters the duodenum
E. Diversion of portal blood flow into the umbilical vein

A

A. Excess breakdown of foetal haemoglobin

30
Q 
Which compound is returned to the liver by the enterohepatic circulation?
A. Unconjugated bilirubin
B. Urobilinogen
C. Conjugated bilirubin
D. Free bilirubin
E. Stercobilinogen
A

B. Urobilinogen

Formative questions (9 decks)

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