OS 206 Compre Flashcards
- Which of the following principal control mechanisms involved in GI function regulation is represented by serotonin (syn. 5-hydroxy-trptamine)?
a. Endocrine
b. Paracrine
c. Neural
d. Combination
D
- Which of the following combination is incorrect?
a. Gastrin-endocrine
b. Histamine-paracrine
c. Acetylcholine-neural
d. Cholecystokinin-paracrine
D
- Which of the following cells in the liver protects against infections secondary to translocation of intestinal bacteria?
a. Hepatic stellate cell
b. Hepatocyte
c. Kupffer cell
d. Gallbladder epithelial cell
C
- In which of the following do Cytochrome P450 enzymes play an important role?
a. Bile acid formation
b. Glycogen synthesis
c. Steroid hormone formation
d. Detoxification of drugs
D
- Xerostamia, or dry mouth, is caused by impaired salivary secretion. Which of the following is not an expected complication of this clinical correlation?
a. Tooth decay
b. Esophageal erosions
c. Difficulty swallowing
d. Gastric ulceration
D
- After complete hepatectomy, a rise of which of the following substances would be expected?
a. Glucose
b. Fibrinogen
c. Conjugated bilirubin
d. Estrogen
D
- Which of the following neurotransmitters act mainly by elevating the Ca++ concentration in the cytosol?
a. Acetylcholine
b. Cholecystokinin
c. Substance P
d. Vasoactive intestinal polypeptide (VIP)
A
- In a patient with acute liver failure, which of the following laboratory finding is expected to be low?
a. Blood glucose
b. Ammonia
c. Vitamin B12
d. Cholesterol
A
- The following are true statements on the regulation of gastric secretion, except:
a. Parietal cell is regulated by a combination of pathways
b. Ach directly activates parietal cells
c. Enterochromaffin cells release histamine
d. Gastrin acts via the paracrine pathway to stimulate the parietal cell.
D
- Which of the following hormone is released to inhibit a meal-stimulated gastrin secretion?
a. Secretin
b. Gastrin
c. Gluco-insulinotropic peptide (GIP)
d. Somatostatin
D
- Which of the following proteins facilitates entry of free bilirubin into the liver cells?
a. Peptide transporter 1 (PepT1)
b. Multidrug resistance protein-2 (MRP-2)
c. Hormone binding proteins
d. Organic anion transporting polypeptides (OATP)
D
- Which of the following enzymes catalyzes the conjugation of bilirubin in the cytoplasm of the hepatocyte?
a. Bilirubin reductase
b. Glucoronyl transferase
c. Heme-oxygenase
d. Glutamyltranspeptidase
B
- Which of the following transmembrane proteins actively secretes conjugated bilirubin into the bile canalliculus
a. Organic anion transporting polypeptides (OATP)
b. Multidrug resistance protein-2 (MRP-2)
c. Gamma Glutamyltranspeptidase
d. Bilirubin reductase
B
- Jaundice (yellowing of the skin and sclerae) is initially manifested at which of the following levels of total plasma bilirubin?
a. >5 mg/dl
b. >4 mg/dl
c. >3 mg/dl
d. >2 mg/dl
D
- What are the primary drugs used in the management of hyperacidity is expected to be more potent?
a. Histamine 2 blockers
b. Proton pump inhibitors
c. Calcium blockers
d. Beta-blockers
B
- Which of the following will not result in an increase in plasma unconjugated bilirubin?
a. Severe infection
b. Abnormal transmembrane protein
c. Decreased albumin binding
d. Stone in the biliary tree
D
- Which of the following will result in an increase in plasma conjugated bilirubin?
a. Abnormality og the OATP
b. Bile canaliculus stasis
c. ABO incompatibility
d. Deficiency of glucoronic acid
B
- Which of the following plasma proteins is quantitatively the most significant protein synthesized by the liver?
a. C3
b. C-reactive protein
c. Albumin
d. Globulin
C
- Which of the following components comprise 65% of the dry weight of bile?
a. Lipids
b. Proteins
c. Bile acids
d. Bilirubin
C
- Which of the following are considered primary bile acids
a. Cholic acid and deoxycholic acid
b. Cholic acid and lithocholic acid
c. Cholic acid and chenodeoxycholic acid
d. Chenodeoxycholic acid and deoxycholic acid
D
- Which of the following processes accounts for ta concentrated bile?
a. Passive transport of Na+
b. Facilitated diffusion of Na+
c. Active transport Na+
d. Endocytosis of bile acids
C
- What is the most potent stimulus for gallbladder emptying
a. Cholecystokinin (CCK)
b. Vasoactive Intestinal polypeptide (VIP)
c. Bombesin
d. Gastrin
A
- Of the 12-36 grams daily secretion of bile acids, how much goes through the enterohepatic circulation?
a. Around 97%
b. Around 85%
c. Less than 75%
d. Less than 50%
A
- Which of the following enzymes would specifically test liver cell injury?
a. ALT
b. AST
c. AP
d. GGT
A
- Which of the following may be normally elevated in a 7-year old, active well-nourished boy?
a. ALT
b. AST
c. AP
d. GGT
C
- In a 2-month old exclusively breastfed infant brought to the clinic for jaundice but otherwise very well baby, which of the following would you expect to be likely increased?
a. Unconjugated bilirubin
b. Conjugated bilirubin
c. AST
d. GGT
A
- Which of the following ratio of conjugated to unconjugated bilirubin would you consider as cholestatic?
a. >10
b. 20
d. <20
C
- Which of the following will likely be increased in a patient who has been taking alcohol regularly for almost 15 years?
a. GGT
b. AP
c. Prothrombin time
d. Albumin
A
- Which of the following laboratory tests are considered synthetic functions of the liver?
a. GGT and glucose
b. Glucose and albumin
c. Prothrombin and Albumin
d. ALT and prothrombin time
C
- Which vitamin B requires intrinsic factor for absorption
a. B
b. B2
c. B6
d. B12
D
- A 10-year old boy complains of recurrent abdominal pain. He recalled being “kicked” in the stomach during his taekwondo about 2 weeks ago. The ER resident is considering pancreatitis. Which of the following tests is expected to be elevated?
a. Bilirubin
b. Lipase
c. ALT
d. Amylase
B
- Liver function tests were obtained from a 3-year old well-nourished boy taking anti-tuberculosis drugs (known to be toxic to the liver). If there is hepatocyte injury, which of the following will be elevated?
a. ALT
b. AP
c. Indirect bilirubin
d. Cholesterol
A
- A medical student complains of bloating and flatulence after eating specific foods such as cheese and cereals with milk. If a breath hydrogen test is performed, what will be the “cut-off value” that is considered positive result?
a. >10 ppm above baseline
b. >20 ppm above baseline
c. >50 ppm above baseline
d.
B
- Which of the following is responsible for our experiencing the “coolness of menthol” or the “sting of ammonia”
a. Olfactory cells
b. Gustatory cells
c. Common chemical sense
d. Mucus cells of the tongue
C
- Which of the following is not a response in the cephalic phase of digestion?
a. Hypothermia (decreased temp)
b. Increased flow of saliva
c. Increased HR
d. Change in urine osmolarity
A
- Which of the following hormones stimulates an enzyme-rich pancreatic secretion?
a. Secretin
b. CCK
c. Somatostatin
d. VIP
B
- Which of the following is the enzyme responsible for secretion of HCL by the parietal cell?
a. Na-K-ATPase
b. H-K-ATPase
c. Carbonic anhydrase
d. Adenylate cyclase
B
- Which of the following hormones stimulates a HCO3-rich pancreatic secretion?
a. Secretin
b. CCK
c. Samatosatin
d. VIP
A
- Which is the primary physiologic control for salivary secretion?
a. Sympathetic
b. Parasympathetic
c. Hormonal
d. Paracrine
B
- Which of the following agonists of pancreatic acinar secretion is not mediated by an increased intracellular calcium?
a. Acetycholine
b. CCK
c. Gastrin
d. Secretin
D
hat is the main stimulant of primary peristalsis of the esophagus?
a. Retained food
b. Gastric acid
c. Swallowing
d. Burping
C
- The ability of the stomach to accommodate food and fluid without significant increase in gastric pressure is known as
a. Emptying
b. Retropulsion
c. Transit
d. Receptive relaxation
D
- Slow wave rate from highest to lowest is seen in:
a. Stomach, Duodenum, Jejunum, Ileum
b. Duodenum, Jejunum, Ileum, Stomach
c. Jejunum, Ileum, Stomach, Duodenum
d. Ileum, Stomach, Duodenum, Jejunum
C
- What phase of fast Migratory Motor Complex (MMC) moves undigested food over long distances in the intestines?
a. I
b. II
c. III
d. IV
C
- Which sphincter prevents reflux of chime from the duodenum to stomach?
a. UES
b. LES
c. Pyloric Sphincter
d. Sphincter of Oddi
C
- Which of the following neurotransmitter plays a major role in the receptive relaxation of the stomach?
a. VIP
b. Motilin
c. Enkephalin
d. Gastrin
A
- The major factor responsible for vomiting is:
a. Reflex relaxation of the LES
b. Decreased interthoracic pressure
c. Contractor of abdominal muscles
d. Diaphragmatic contraction
C
- Migarting motor complex is most probably mediated by:
a. Motilin
b. Gastrin
c. Secretin
d. Nitric oxide
A
- Which of the following isocaloric meals will stay in the stomach in the lest amount of time?
a. Meal with rice and boiled fish
b. Meal with 2 oz beef tenderloin
c. Light meal of clear soup gelatin and sugar
d. Meal with pizza and French fries
D
- Which functional layer of the GIT is concerned with propulsion?
a. Mucosa
b. Submucosa
c. Muscularis
d. Serosa
C
- The storage function of the stomach is performed mainly by:
a. Fundus
b. Distal body
c. Antrum
d. Pylorus
A
- Normally, the movement of the contents of the GIT is fastest along this segment:
a. Esophagus
b. Stomach
c. Small intestines
d. Colon
A
- Which phase of swallowing is voluntary
a. Oral
b. Pharyngeal
c. Esophageal
d. Gastric
A
- Swallowing is associated with esophageal peristalsis:
a. Tone
b. Retropulsion
c. Receptive relaxation
d. Enterogastric reflex
C
- Which of the following is the most potent inhibitor of gastric emptying
a. Secretin
b. CCK
c. GIP
d. Motilin
B
- Which of the following will make the GI smooth muscle is resting membrane potential more negative?
a. Sympathetic stimulation
b. Acetylcholine
c. Parasympathetic agents
d. Distension
A
- The GI contents stay approx. 4 hours in the:
a. Esophagous
b. Stomach
c. Small intestines
d. Colon
C
- Which of the following is true of fructose absorption in the apical membrane
a. It is inhabited by the absorption of glucose of galactose
b. It is facilitated by SGLT1
c. It is independent of sodium concentration
d. It requires a passive diffusion transport mechanism
C
- Transport of galactose in the apical membrane is an example of:
a. Primary active transport
b. Secondary active transport
c. Facilitated transport
d. Passive diffusion
B
- The digestion of the major foodstuff in the GIT is a process of:
a. Sulfation
b. Decarboxylation
c. Hydrolysis
d. Amidation
C
- Parasympathetic innervation to the small intestines is provided by the
a. Celiac plexus
b. Vagus nerve
c. Sacral plexus
d. Pelvic nerve
B
- What is the most potent stimulus for relaxation of Sphincter of Oddi and gal bladder contraction?
a. VIP
b. Bombesin
c. CCK
d. Gastrin
C
- Procarboxypeptidase is directly activated by
a. Chymotrypsin
b. Trypsin
c. Pepsin
d. Enterokinase
B
- Phospholipids are digested into:
a. Monoglyceride and cholesterol
b. Cholesterol and lysolecithin
c. Fatty acids and lysolecithin
d. Lysilecithin and monoglyceride
C
- Which of the following is responsible for apical transport of fructose in enterocytes?
a. SGLT1
b. GLUT 2
c. GLUT 4
d. GLUT 5
D
- Reesterification of monoglyceride and fatty acids occur in the enterocyte:
a. Cytosol
b. Smooth ER
c. Golgi apparatus
d. nucleus
B
- What digestive enzyme is necessary for the hydrolysis of phospholipids?
a. Cholesterol easter hydrolase
b. Phospholipiase A2
c. Pancreatic lipase
d. Lingual lipase
B
- Extensive injury of the ileum will gratly affect the absorption of:
a. Vitamin C
b. Fructose
c. Cyanocobalamin
d. Amino acids
C
- Which of the following monosaccharides will be absorbed first?
a. Pentose
b. Arabinose
c. Galactose
d. Glucose
C
- Intrinsic factor is necessary for the absorption of Vitamin:
a. B1
b. B2
c. B6
d. B12
D
- Which of the following fats will you recommend for a healthy life?
a. Palm Oil
b. Trans fat
c. Canola Oil
d. Coconut Oil
C
- How much sodium will a 55-year old hypertensive diabetic female be advised to take daily (mg)?
a. 500
b. 1500
c. 2400
d. 3400
B
- If an overweight Medical Student wishes to lose 1lb/week, how much less kilocalories of her daily energy allowance must be take per day?
a. 125
b. 250
c. 375
d. 500
D
- Which of the following is least associated with increased cardiovascular risk?
a. WHC 23
c. High dietary intake of omega 3 fatty acid
d. Diet with 400 mg of cholesterol per day
A
- Absorption of fat digestion products and fat soluble vitamins is by what transport mechanism?
a. Primary active
b. Secondary active
c. Facilitated diffusion
d. Passive diffusion
D
- Dipeptides and tripeptides are absorbed by the intestines with which ion?
a. Sodium
b. Chloride
c. Hydrogen
d. potassium
C
- Which of the following explains the lack of disinterest of the elderly in food?
a. Increase in bitter receptors in the tongue
b. Over-enhancement of taste sensations
c. Increased esophageal emptying
d. Decreased salivary production
D
- What is the mechanism responsible for early satiety in the elderly?
a. Decreased resistance of the gastric mucosa to damage
b. Increased numbers of parietal cells
c. Decreased salivary production
d. Slower gastric emptying time
D
- Which segment of the GIT is least affected by aging?
a. Esophagous
b. Stomach
c. Small intestines
d. Large intestines
C
- Osteopenia and bone loss in the elderly are related to changes in which segment of the GIT?
a. Esophagus
b. Stomach
c. Small intestines
d. Large intestines
C
- Osteopenia and bone loss in the elderly are related to changes in which segment of the GIT?
a. Esophagus
b. Stomach
c. Small intestines
d. Large intestines
C
- The brown colour of the liver of the elderly is due to the long-term deposition of which molecule?
a. Alcohol dehydrogenase
b. Hepcidin
c. Iron
d. Lipofuscin
D
- Which hepatic phase reactions decrease linearly with age?
a. 1
b. 2
c. 3
d. 4
A
- Which of the following is true regarding significant age-related changes of the life
a. Weight increases
b. Blood flow increases
c. Drug elimination decreased
d. Regeneration is impaired
C
- An increase in the likelihood for gallstones in the elderly may be due to an increase in which of the following?
a. Blood flow
b. Bile acid synthesis
c. Cholesterol secretion
d. Hepatobiliary transport
C
- What may increase the risk of elderly patients who has diarrhea?
a. Non-compliance with medication
b. Avoidance of food
c. Achlorhydria
d. calcium
C
- What is the most common complaint in the elderly?
a. Constipitation
b. Fecal impaction
c. Incontinenece
d. Diarrhea
A
- Which of the following decreases due to age-related changes to the small intestines
a. Absorption
b. Motility
c. Transit time
d. Villus height
D
- Which of the following decreases due to age-related changes in the GIT?
a. Diameter of the pancreatic duct
b. Fat absorption
c. Lipase
d. Fibrosis
D
- Which of the following increases with age in terms of effectiveness?
a. Electrical activity
b. Exercise
c. Enemas
d. Abdominal plain
B
At what level does the esophagus pierces the diaphragm A. T8 B. T10 C. T12 D. L1
B
Which normally does NOT have gas in its lumen? A. Stomach B. Rectum C. Sigmoid D. Gall bladder
D
The posterior area of origin of the diaphragm that forms anterior to the psoas muscle is the:
a. medial arcuate ligament
b. costal part
c. median arcuate ligament
d. lateral arcuate ligament
C
A knife thrusts into your abdomen, piercing your AAL. What layers does it traverse?
Superficial fascia, EO, IO, TA, TF
Outermost covering of spermatic cord as it exits the superficial inguinal ring A. Cremasteric Muscle B.Internal Spermatic Fascia C. External Spermatic Fascia D. Processus Vaginalis
C
In the inguinal trigone, the structure seen medial to the deep inguinal ring A. Inferior Epigastric artery B. Inguinal ligament C. Conjoint Tendon D. Rectus Abdominis
C
What is the normal position of the uterus? A. Anteverted and Anteflexed B. Anteverted only C. retroverted and retroflexed D. retroverted only
A
Case of old woman: Cyst that does not dissolve in 10 weeks A. Physiologic cyst B. hemorrhagic cyst C. corpus luteum cyst D. endometrioma
D
What passageway can be found on the central tendon of the diaphragm? A. Esophageal hiatus B. Caval Opening C. Aortic hiatus D. Sternocostal hiatus
B
Arterial supply of prostate and seminal vesicle
a. superior vesical and middle rectal
b. inferior vesical and inferior rectal
c. inferior vesical and middle rectal
C
Bile and blood from a ruptured segment 2 of the liver will likely gravitate first to
a. Left subhepatic space
b. hepatorenal space
A
Dull sensation and hypoesthesia of penis and scrotum result from an injury of the
a. iliohypogastic nerve
b. ilioinguinal nerve
c. inguinal branch of genitofemoral
d. obturator nerve
e. spermatic nerve
B
. Patient diagnosed to have developed retroperitoneal hemorrhage following blunt trauma. Positive Cullen sign appreciated meaning a discoloration in this area
a. Epigastric area
b. flank
c. umbilical region
d. inguinal region
e. lumbar
C
. A hematoma that originates initially in this zone would immediately be investigated regardless of the cause
a. centromedial
b. anterior
c. lateral
d. posterior
A
. Due to the presence of short gastric and left gastroepiploic arteries in the ______ ligament, these vessels may be destroyed during splenectomy
a. splenorenal
b. phrenicosplenic
c. gastrosplenic
d. hepatoduodenal
C
Acute cholecystitis referred pain in: A. RUQ B. Shoulder C. Hypogastric D. LUQ
A
A 40-year old obese woman with a history of gallstones was brought to the hospital. Gallstones from a ruptured cyst may descend to the
a. ileum
b. colon
c. all of the above
d. none of the above
B
The gall stones ulcerate into A. Colon B. Duodenum C. Both D. Neither
A
Which artery does not supply the pancreas
a. gastroduodenal
b. SMA
c. IMA
d. splenic
C
At the midinguinal level, at a horizontal plane, what covers the rectus abdominis posteriorly? A. External Oblique Aponeurosis B. Internal Oblique Aponeurosis C. Transverse Abdominal Aponeurosis D. Transversalis Fascia
D
Most movable part of duodenum.
first part
[T/F] The duct of Santorini drains the anterosuperior head of the pancreas along with the uncinate process
T
[T/F] The impacted site of the Ampulla of Vater can be approached by an incision in the 4th part of duodenum
F
[T/F] Gastroesophageal junction has a true anatomical landmark
T
In the CT of a hepatic tissue (?), one may find:
a) branch of hepatic artery
(b) hepatic portal vein
(c) bile duct
(d) lymph vessel
(e) all of the above
E
Which of the following features of a female pelvis is not favorable for childbirth?
a. wider sacrosciatic notch
b. wider pubic angle
c. greater iliac flaring
d. shallow pelvic cavity
C
Marker for the pudendal nerve block
a. Ischial tuberosity
b. Pubic symphysis
c. ischial spine
d. sacral promontory
B
Most variable branch of the internal iliac artery
a. obliterated umbilical
b. obturator
c. inferior gluteal
d. superior gluteal
B
By the phrase "bridge over water", what vessel passes over the ureter? A. Something a. B. uterine artery C. Inferior vesicular a. D. Superior vesicular a.
B
What is the most common modality used in pelvic organ imaging? A. CT Scan B. Ultrasonography C. MRI D. HSG
B
To best investigate a case of possible obstruction of the fallopian tube/s , you use:
a. CT
b. Ultrasound
c. MRI
d. Hysterosalpingogram
D
A hysterosalpingogram is…
a. Diagnostic
b. Therapeutic
c. Both
A
This transducer is used for (endocavitary)
a. transvaginal
b. transrectal
c. transabdominal
d. A and B
e. A and C
D
Which part of the duodenum do the common hepatic duct and primary pancreatic duct empty?
2nd part of duodenum
Which of the following methods of GI functional GI functional control is expressed by serotonin?
a. endocrine
b. paracrine
c. neural
d. combination
C
Which of the ff cells in liver protect against infection secondary to translocation bacteria?
a. hepatic stellate cells
b. hepatocyte
c. Kupffer cells
d. gallbladder epithelial cells
C
Xerostomia or dry mouth is caused by impaired salivary reaction. Which of the following is NOT expected complication of this condition? A. Tooth decay B. Esophageal erosion C. Difficulty swallowing D. Gastric ulceration
D
After complete hepatectomy, which is elevated?
a. glucose
b. fibrinogen
c. conjugated bilirubin
d. estrogen
D
What transmembrane protein actively transports conjugated bilirubin to bile canaliculus?
a. OATD
b. MRP-2
c. bile reductase
B
Which of the following is most potent for hyperacidity?
a. H2 blocker
b. proton pump inhibitor
c. Ca channel blocker
d. beta-blocker
B