GIT Physio MCQ Flashcards
Enterokinase directly activates which of the following zymogens? A. Trypsinogen B. Chymotrypsinogen C. Procarboxypeptidase D. Proelastase E. Propeptidase
A. Trypsinogen
Pancreatic secretions are maximally stimulated by:
A. sight and smell of food
B. gastric distention of food
C. intestinal distention of food
D. presence of fats and proteins in the duodenum
E. vagal stimulation
D. presence of fats and proteins in the duodenum
A. sight and smell of food (only a small percentatge during cephalic phase)
B. gastric distention of food (not as significant as the intestinal phase)
Secretion of saliva increases when: A. mechanoreceptors in the mouth are blocked B. mouth is flushed with water C. vomiting is imminent D. parasympathetic supply is blocked
C. vomiting is imminent
Sectioning of vagal nerve supply to stomach will cause all of the following EXCEPT: A. Decreased gastric mucus secretion B. Decreased gastric acid secretion C. Decreased gastric emptying D. Decreased distension of the stomach E. Decreased mucosal growth
C. Decreased gastric emptying
Stimulation of leptin receptors in the hypothalamus leads to all the following EXCEPT: A. Increased appetite B. Increased basal metabolic rate C. Increased sympathetic activity D. Increased heat production E. Increased subconscious activity level
A. Increased appetite
A lipase inhibitor can cause the following symptoms except: A. Weight loss B. Diarrhea C. Vitamin D deficiency D. Loss of bile salts E. Foul smelling stools
D. Loss of bile salts
In the absorption of lipids by the small intestine:
A. Long Chain FAs are absorbed by an active process into the intestinal epithelium
B. Fatty Acids absorbed are re-esterified in the intestinal epithelium
C. Re-esterified lipids are transported by facilitated transport into the portal blood
D. Short Chain FAs are absorbed directly by intestinal epithelial cells
B. Fatty Acids absorbed are re-esterified in the intestinal epithelium
Absorption of proteins in intestines is:
A: maximal at terminal ileum
B. dependant on proteases in intestinal lumen
C. aided by brush border enterokinases digesting short chain peptides
D. aided by long chain peptide transporters
E. facilitated by potassium
B. dependant on proteases in intestinal lumen
Complete obstruction of the common bile duct leads to all of the following EXCEPT: A. Jaundice B. Raised conjugated bilirubinaemia C. Pale stools D. Bilirubin in the urine E. Urobilirubin the urine
E. Urobilirubin the urine
Total gastrectomy can result in all the following EXCEPT: A. Bacterial overgrowth B. Loss of weight C. Vitamin B12 deficiency D. Diarrhea E. Carbohydrate malabsorption
E. Carbohydrate malabsorption
With reference to gastric function,
a. The average meal has moved from the stomach after ½ hour
b. Contractility is augmented by sympathetic stimulation
c. When the quantity of ingested material increases, the intragastric pressure increases
d. The longitudinal muscle coat has a basic electrical rhythm
e. Histamine inhibits the production of gastric acid
d. The longitudinal muscle coat has a basic electrical rhythm
Which one of the following statements regarding gastric motility and emptying is TRUE?
A) Fatty meals empty faster than carbohydrate meals
B) Liquids empty slower than solid foods
C) A drop in pH of the duodenum increases gastric emptying
D) Vagal stimulation enhances gastric accommodation
E) Gastrin release inhibits gastric motility
D) Vagal stimulation enhances gastric accommodation
Sodium taurocholate
a. is synthesised in the liver after ileal resection
b. is insoluble at pH6
c. is absorbed by Na+ - coupled secondary active transport mechanism in the ileal mucosa
d. is a secondary bile salt
e. forms micelles only at a concentration lower than the critical micellar concentration
c. is absorbed by Na+ - coupled secondary active transport mechanism in the ileal mucosa
The ileum is the principal site for the absorption of
a. glucose
b. products of fat digestion
c. bile
d. vitamin K
e. iron
c. bile
Which following hormone stimulates pancreatic HCO3- secretion in the presence of decreased secretion?
a. gastrin
b. VIP
c. GIP
d. CCK
e. Somatostatin
b. VIP
Which of the following is true:
a. 95% of bile pigments secreted by the liver is absorbed in the gut
b. most of the water absorbed in GIT is derived from dietary intake
c. CCK neutralizes the small intestine of acid from the stomach
d. Cl- is secreted into the bile in the gall bladder
e. malabsorption of lipids will lead to failure of pancreatic secretion
a. 95% of bile pigments secreted by the liver is absorbed in the gut
not sure abt option b
Parasympathetic blockade of the GIT leads to which of the following A. abdominal pain B. increase intestinal transit time C. increase bile secretions D. increase fecal water loss E. increase mucous secretion
B. increase intestinal transit time
Exercise will help which of the following? A. cholesterol B. triglycerides C. vldl D. chylomicrons E. phospholipids
A. cholesterol
In pernicious anaemia, an autoimmune process destroys the “proton pump” and the parietal cells. Which one of the following observations is TRUE:
a. Acid secretion is normal
b. Absorption of intrinsic factor is affected
c. Blood gastrin level is raised
d. Blood histamine level is raised
e. Blood H+ is raised
c. Blood gastrin level is raised
In the case before, a logical treatment for anaemia
a. Proton pump blocker
b. Histamine receptor blocker
c. Vitamin B12 injections
d. Oral folate supplementation
e. Iron injections
c. Vitamin B12 injections
Pancreatic exocrine secretion include all of the following except:
a. Amylase
b. Lipase
c. Enterokinase
d. Trypsinogen
e. Chymotrypsinogen
c. Enterokinase
In the regulation of pancreatic secretion:
a. Low duodenal pH stimulates alkaline secretion
b. Secretin stimulates enzyme secretion
c. CCK stimulates HCO3 secretion
d. Gastrin stimulates acid secretion
e. Enterokinase stimulates protease secretion
a. Low duodenal pH stimulates alkaline secretion
A pregnant woman complains of retrosternal burning pain. The likely cause:
a. Irregular meals
b. Oesophageal spasm
c. Poor chewing
d. Oesophagitis at the UES
e. Acid damage at the lower oesophagus
e. Acid damage at the lower oesophagus
Irritation of GIT commonly leads to
a. Increase GIT mobility and pain
b. Abdominal distention
c. Decreased intestinal secretions
d. Oesophageal reflux
e. Malabsorption
a. Increase GIT mobility and pain
Commonly treated with a drug, that is anti-cholinergic [e.g. atropine], blocking of parasympathetic receptors will lead to all of the following except:
a. Reduction of colicky pain
b. Constipation
c. Decreased intestinal secretion
d. Reduced salivary secretion
e. Incontinence
e. Incontinence
The following regarding the flow of saliva are true except
a. Saliva from the parotid gland exits the parotid duct opening opposite the upper second molar
b. Flow is increased with parasympathetic stimulation
c. Diminished flow is associated with dental caries
d. Swallowing may be affected with diminished flow
e. Sour foods will diminish flow.
e. Sour foods will diminish flow.
Gastric secretion:
(a) is increased by vagal stimulation
(b) contains trypsinogen
(c) cleaves R factor
(d) contains pepsin inhibitor
(e) is stimulated by somatostatin
(a) is increased by vagal stimulation
In the small intestine:
a) absorption of H20 is active
b) Digestion of amylose to form maltose requires brush border enzymes
c) absorption of fatty acid is coupled to Na+ dependent transporters
d) Absorption of most potassium is active
e) Digestion of protein by luminal protease
e) Digestion of protein by luminal protease
Entry of acidic chyme into the duodenum causes all the following except
a. Release of secretin
b. Contraction of sphincter of oddi
c. Contraction of gall bladder
d. Increased pancreatic secretion
e. Inhibition of gastric emptying
b. Contraction of sphincter of oddi
Which of the following is true about nitrogen (protein) balance?
a. it is positive during trauma or metabolic stress
b. urine nitrogen loss increases during prolonged fast
c. positive during normal childhood
d. negative when taking high protein diet
e. increasing fat metabolism decreases urine nitrogen loss
b. urine nitrogen loss increases during prolonged fast
c. positive during normal childhood
The following are true of bile salts except:
a) Synthesized from cholesterol
b) Converted by intestinal bacteria to secondary bile salts
c) Acts as “detergent” in gut
d) Vast majority absorbed in proximal small intestine
e) Causes itch in skin during obstructive jaundice
d) Vast majority absorbed in proximal small intestine
Chemical digestion of food involves:
A. condensation reactions in the small intestine
B. Enzymatic conversion of monosaccharides to polysaccharides in the small intestine
C. hydrolysis reactions in the large intestine (colon)
D. hydrolysis reactions in the small intestine
E. two of the above.
D. hydrolysis reactions in the small intestine
The gall bladder: A. produces bile B. is attached to the pancreas C. stores bile D. produces gastrin E. two of the preceding.
C. stores bile
Which of the following is not a function of the liver? A. synthesis of blood proteins B. secretion of digestive enzyme C. detoxification of certain substances D. production of urea E. gluconeogenesis.
B. secretion of digestive enzyme
Pancreatic cells: A. produce glucagon B. secrete mucus into the duodenum C. are located in the mediastinum D. secrete insulin into the pancreatic duct E. two of the above
A. produce glucagon
The site of production of cholecystokinin and secretin is the:
a. Stomach
b. Pancreas
c. Small Intestine
d. Large Intestine
c. Small Intestine
The majority of the absorption of digested nutrients occurs in the:
a. Stomach
b. Ileum
c. Jejunum
d. Cecum
c. Jejunum
Which of the following sphincters is under voluntary control?
a. Pyloric
b. Cardiac
c. Sphincter of Oddi
d. Internal anal
e. External anal
e. External anal
High doses of antibiotics can destroy the bacterial flora of the large intestine. This can result in impaired:
a. Absorption of protein
b. Blood coagulation
c. Bone resorption
d. Respiratory control
b. Blood coagulation
The gastric gland cell whose absence could lead to pernicious anemia is the:
a. Chief cell
b. Goblet cell
c. Mucous neck cell
d. Parietal cell
e. Enteroendocrine cell
d. Parietal cell
The following is a major factor in protecting the duodenal mucosa from acid secretions from the stomach A) Alkaline bile secretions B) Gastrin release C) Duodenal bicarbonate secretions D) Pancreatic bicarbonate secretions E) Duodenal mucosal permeability
D) Pancreatic bicarbonate secretions
Which of the following induces contraction of gallbladder smooth muscle?
a. Secretin
b. Cholecystokinin
c. Serotonin
d. Gastrin
e. Somatostatin
b. Cholecystokinin
NOT secretin
Which of the following is a major product of serous salivary gland secretion?
a. Pepsinogen
b. Carboxypeptidase
c. Trypsin
d. Nuclease
e. Lysozyme
e. Lysozyme
Which of the following is not a component of gastric juice?
a. Hydrochloric acid
b. Mucus
c. Pepsin
d. Amylase
e. Water
d. Amylase
Which of the following is true of the liver?
a. Hepatocytes synthesize many of the blood proteins such as albumin and antibodies
b. Hepatocytes synthesize 80% of the bile in the body with the other 20% coming from the pancreas
c. The liver receives more nutrient-rich blood than oxygen-rich blood
d. The liver is the 2nd largest gland in the body
c. The liver receives more nutrient-rich blood than oxygen-rich blood
Pepsinogen is synthesized and released by which of the following?
a. Parietal cells
b. Enteroendrocrine cells
c. Paneth cells
d. Chief cells
e. Pancreatic acinar cells
d. Chief cells
Which of the following pairs of hormones are mainly involved in controlling pancreatic exocrine secretions?
a. Insulin and glucagon
b. Cholecystokinin and secretin
c. Somatostatin and gastrin
d. Motilin and serotonin
e. Glucagon and somatostatin
b. Cholecystokinin and secretin
Which of the following organs does not have both endocrine and exocrine function?
a. Stomach
b. Small Intestine
c. Gallbladder
d. Liver
e. Pancreas
c. Gallbladder
Peristaltic waves are:
a. Segmental regions of the GI tract
b. Churning movements of the GI tract
c. Pendular movements of the GI tract
d. Waves of muscular contractions that propel contents from one point to another
e. Circular contractions of the GI tract muscularis mucosae
d. Waves of muscular contractions that propel contents from one point to another
If you eat a meal of french fries, buttered toast, ice cream, and whole milk, which of the following glands would secrete the most enzymes that would be involved in digesting all this food?
a. Liver
b. Exocrine pancreas
c. Endocrine pancreas
d. Ileum
e. Buccal Glands
b. Exocrine pancreas
Protein molecule will be hydrolyzed by enzymes secreted from the:
a. Mouth, stomach, small intesine, liver
b. Stomach, pancreas, small intestine
c. Stomach, small intestine, liver
d. Mouth, pancreas, colon
b. Stomach, pancreas, small intestine
Carbohydrates are acted on by:
a. Trypsin, chymotrypsin, and enterokinase
b. Amylase, maltase, and sucrase
c. Lipase
d. Hexokinase, pepsin, and amylase
b. Amylase, maltase, and sucrase
Which of the following is true of electrolyte absorption?
a. Sodium ion absorption is coupled to glucose and amino acid uptake
b. Potassium can diffuse through the intestinal epithelium
c. Vitamin D is necessary for calcium absorption
d. All of the above
d. All of the above
Secretin from the duodenum causes the pancreas to produce secretions rich in \_\_\_\_\_. A. proteolytic enzymes B. amylase C. lipase D. bicarbonate
D. bicarbonate
Digestive processes in the large intestine include:
a. Mass peristalsis
b. Absorption of some vitamins and electrolytes
c. Elimination of cellulose-based material
d. All of the above
e. 2 of the above
d. All of the above
A patient had the terminal portion of the ileum and cecum surgically removed due to a tumour in the region. The following physiologic consequences are expected except: A) Decreased folate absorption B) Decreased Vitamin B12 absorption C) Impaired fat absorption D) Increased water content in faeces E) Increased intestinal flow into colon
A) Decreased folate absorption
A 52y/o man admitted for abdominal pain and found to have chronic pancreatitis (long-standing destruction of pancreas), the following are expected findings except: A) Significant weight loss B) Increased amount of stood bulk mass C) Increased blood glucose levels D) Decreased luminal amylase activity E) Decreased bile secretion
E) Decreased bile secretion
A perimenopausal woman was seen in the clinic because of excessive menstrual bleeding. Investigations revealed that she had a hypochromic microcytic anaemia. She was treated orally with iron supplements and her condition improved with resolution of the anaemia. Which of the following statements is TRUE?
A) Iron is almost completely absorbed in the small intestines
B) Iron is absorbed via the ferroportin transporter on the intestinal epithelial cells
C) Iron is absorbed in its ferric form in the small intestine
D) Iron is bound in ferric form as ferritin in storage tissue
E) Iron is transported in the blood as haptoglobulin
D) Iron is bound in ferric form as ferritin in storage tissue
If the whole colon is removed, what physiological function of the colon would be lost as well?
A) Net absorption of K+
B) Net absorption of HCO3-
C) Net secretion of H+
D) Bile acid stimulated water absorption
E) Short chain fatty acid stimulated water absorption
E) Short chain fatty acid stimulated water absorption
In absorption of nutrients from the small intestine
A) Brush border lipases enhances digestion of fats for absorption
B) Fructose absorption is dependent on Na+ absorption
C) Short peptides are absorbed via transporters
D) Amino acids are absorbed by passive diffusion
E) Calcium absorption is dependent on chloride absorption
C) Short peptides are absorbed via transporters
An old man had pylorus and antrum of his stomach removed because of a tumour. Which of the following would happen?
A) Absence of gastric accommodation
B) Gastric acid secretion will be absent
C) Fluid efflux into intestinal lumen will be increased
D) Constipation would be frequent
E) Increased intestinal transit time
C) Fluid efflux into intestinal lumen will be increased
A patient was investigated for epigastric discomfort and was found to have reduced gastric acid secretion. Antibodies directed against parietal cells and loss of parietal cells were both detected. The following are features of his disease except: A. Bacteria overgrowth in the stomach B. Raised gastrin levels C. Raised pepsin activity D. Low B12 absorption E. Low Ca2+ absorption
Ans is C
A. Bacteria overgrowth in the stomach since can’t maintain low pH
B. Raised gastrin levels lack of low pH inhibiting gastrin release
C. Raised pepsin activity no reason why this will increase; after all, pepsinogen to pepsin requires high H+ concentration!
D. Low B12 absorption since intrinsic factor secretion by parietal cells is compromised
E. Low Ca2+ absorption because no H+ is released, anions like RCOO- in food are not protonated and will hang on to cations like Ca2+, retarding their uptake
Administration of parasympathetic agonist (cholinergic) effects: A. dry mouth B. difficulty in swallowing C. constipation D. abdominal pain E. tachycardia
D. abdominal pain
Bilateral vagotomy was used for treatment of peptic ulcer. The following will be the physiologic consequences except: A. Decreased gastric secretion B. Decreased gastric volume after food C. Decreased gastric secretion D. Decreased intestinal transit time E. Decreased colonic filling
D. Decreased intestinal transit time
The absorption of major amount of fluid in the small intestine is the result of the activity of which of the following nutrient coupled transport? A. Sodium transport B. Chloride transport C. Potassium transport D. Bicarbonate transport E. Proton transport
A. Sodium transport
What will be observed when there is total obstruction of common bile duct A. Unconjugated hyperbilirubinemia B. Stercobilin in feces C. Secretory diarrhoea D. Unconjugated bilirubin in urine E. Increase bile salts in blood
E. Increase bile salts in blood
In pancreatitis, there will be malabsorption of fat. Apart from lack of pancreatic secretion, what other mechanism leads to inability to digest and absorb fat? A. Decreased lipase activation B. Decreased pancreatic HCO3- secretion C. Decreased bile salt secretion D. Decreased colipase activation E. Decreased enterokinase activity
C. Decreased bile salt secretion
Sight and smell will stimuate which of the following EXCEPT A. appetite B. salivary secretion C. gastric secretion D. pancreatic endocrine secretion E. ileogastric reflex
E. ileogastric reflex
A 40 year old woman has been experiencing abdominal colicky pain, especially after eating a fatty meal. Ultrasound of hepatobiliary system shows gallstones. Which of the following contributes to her symptoms? A. Release of lipase B. Release of motilin C. Release of CCK D. Release of secretin E. Release of gastrin
C. Release of CCK
Total removal of the pancreas will result in all of the following except
A. maldigestion of triglycerides
B. maldigestion of proteins
C. maldigestion of disaccharides
D. raised blood glucose levels
E. reduction in bile salt ionization in duodenum
C. maldigestion of disaccharides
After ingestion of a fatty meal, which of the following physiological changes and process are true?
A brush border lipase digest fats prior to reabsorption
B fatty acids are reesterified with glucose in the intestinal epithelial cells
C the resterified fatty acids are absorbed into the blood by diffusion
D postprandial fatty acids are transported in the blood by chylomicrons
D postprandial fatty acids are transported in the blood by chylomicrons
A doctor suspects a patient of having familial LPL deficiency. Elevation of which of the following particles will confirm his diagnosis?
a. LDL b. Chylomicron Remnants and IDL c. HDL d. VLDL e. Chylomicrons
e. Chylomicrons
Which of the following statements about bile salts and bile acids are true:
a. Liver only secretes primary bile acid b. Excess production of bile salts is a common cause of gall stones c. Excretion of bile salts in faeces is the only way to remove cholesterol from body d. Bacteria in intestines conjugate primary bile salts with taurine or glycine e. Bile acids are synthesized form cholesterol by bacteria in the intestines
c. Excretion of bile salts in faeces is the only way to remove cholesterol from body
