Pathology Lesson 10 (Gastro) Flashcards
A person with lactose intolerance presents with what kind of diarrhea?
a) Osmotic
b) Hydrostatic
c) Colloidal
d) Hyperstatic
a) Osmotic
You have a big fight with your boyfriend / girlfriend. Why does your stomach hurt?
a) GI is affected by mood
b) Your stomach muscles are cramped due to excessive crying.
c) Your boyfriend / girlfriend punched you in the stomach.
a) GI is affected by mood
True or false:
There is an anotomical landmark separating the jejunum and ileum.
False
What separates the ilieum and cecum?
a) Ileocecal notch
b) Ileocecal junction
c) Ileocecal valve
d) None of the above
c) Ileocecal valve
What is the innermost layer lining the lumen of the alimentary canal called?
a) Mucosa
b) Submucosa
c) Muscularis externa
d) Serosa
a) Mucosa
What is the mucosa comoposed of?
a) Basal ganglia
b) Surface epithelium
c) Lymph nodes
d) Connective tissue
e) A and C
f) B and D
f) B and D
(Surface epithelium and connective tissue)
What is the mucosa surrounded by?
a) Smooth muscle
b) Mucus
c) Digestive enzymes
d) A and B
d) A and B
(Thin layer of smooth muscle and mucus… digestive enzymes are secreted.)
What cells in the mucosa secrete mucus for lubrication?
a) Chalice cells
b) Mucocrine cells
c) Goblet cells
d) None of the above
c) Goblet cells
Which of the following is/are true for mucosal folds?
a) Increase surface area for reabsorption
b) Allow for expansion after Thanksgiving meal
c) Both of these are true
d) Neither of these are true
b) Allow for expansion after Thanksgiving meal
(It is not “c” because it increases surface area for absorption not reabsorption)
What is the submucosa composed of?
a) Soft connective tissue
b) Epithelial cells
c) Smooth muscle
d) Visceral peritoneum
a) Soft connective tissue
Which of these are not part of the submucosa?
a) blood vessels
b) nerve endings
c) goblet cells
d) lymph vessels
e) lymph nodes
c) goblet cells
(These are in the mucosa)
What is the muscularis externa composed of?
a) two layers of smooth muscle in alimentary canal
b) three layers of smooth muscle in alimentary canal
c) three layers of smooth muscle in stomach
d) A & C
d) A & C
The outer layer of muscularis externa of alimentary canal runs?
a) longitudinally
b) transversely
c) vertically
d) obliquelly
a) longitudinally (in the direction of the canal)
The inner layer of muscularis externa is?
a) longitudinal
b) transverse
c) vertical
d) oblique
d) oblique
What is the coordinated unit of the muscularis externa known as?
a) Sarcolemma
b) Syncytium
c) Peyer’s Patches
b) Syncytium
What is the outermost layer of the wall of the alimentary canal?
a) Mucosa
b) Submucosa
c) Muscularis externa
d) Serosa
d) Serosa
The serosa makes up _________ __________ for most of the alimentary canal.
a) parietal peritoneum
b) parietal pericardium
c) visceral peritoneum
d) parietal pleura
c) visceral peritoneum
The following are all features of the serosa except:
a) produces and secretes serous fluid
b) composed of layer of connective tissue
c) outermost layer of wall
d) makes up parietal peritoneum
d) makes up parietal peritoneum
(it is visceral peritoneum)
The submucosal plexus controls which of the following:
a) gastrointestinal secretions
b) alimentary contraction (repulsion)
c) local blood flow
d) A and C
e) All of the above
d) A and C
(GI movements are controlled by Myenteric plexus)
If you see a bear, ____________ stimulation will occur and ________________ will be shut down.
a) Sympathetic; parasympathetic
b) Parasympathetic; sympathetic
a) Sympathetic and parasympathetic
All of the following are part of the digestive proccess except:
a) Chemical digestion
b) Propulsion
c) Storage
d) Eating
e) None of the above
e) None of the above
All of the following take place in the stomach except:
a) Mixing and propulsion primarily by segmentation
b) Secretion of HCl
c) Digestion of proteins and fats
d) Absorption of lipid-soluble substances
a) Mixing and propulsion primarily by segmentation
(Stomach only has mixing and propulsion –> segmentation happens in small intestines)
ECL cells secrete:
a) HCl
b) Mucous and HCO3-
c) Gastrin
d) Histamine
e) Both A and B
d) Histamine
(ECL are the neuroendocrine cells in the gut)
What stimulates secretion of saliva?
a) Parasympathetic
b) Alpha Adrenergic
c) Beta Adrenergic
d) Sympathetic
e) A and C
f) None of the above
e) A and C
(Parasympathetic and Beta adrenergic)
All of the following are true about saliva except:
a) Carbohydrate digestion (amylase)
b) Has Immunoglobulins
c) Absorbs food chemicals
d) Assists in swallowing
c) Absorbs food chemicals
(Does not absorb, it dissolves food chemicals - taste)
Deglutination is:
a) the act of chewing
b) the act of swallowing
c) the act of breaking down
d) both A and C
b) The act of swallowing
How much saliva do we make in one day?
a) 1 mL
b) 1 L
c) 2 L
d) 10 L
b) 1 L
Which of the following is not a gland in the mouth?
a) Submaxillary gland
b) Sublingual gland
c) Parotid gland
d) Submandibular gland
e) All of them are glands in the mouth.
a) Submaxillary gland
Which of the following is not a human permanent tooth?
a) Premolars (bicuspids)
b) Canine (eyetooth)
c) Fourth molar
d) Incisors
c) Fourth molar
(There are only three)
Which of the following is/are true of lower esophageal sphincter (LES)?
a) AKA cardiac sphincter
b) Muscular ring at the top of the esophagus
c) When closed, prevents acid content reflux
d) A and C
e) All of the above
d) A and C
Muscular ring at the top of the esophagus is the upper esophageal sphincter (UES)
Which of the following allows bolus to enter the stomach?
a) Gastroesophageal sphincter
b) Cardiac sphincter
c) Lower esophageal sphincter (LES)
d) A and C
e) All of the above
e) All of the above
Which of the following is/are not roles of the stomach?
a) Absorption of fat soluble substances
b) Break-down of carbohydrates
c) Chemical digestion
d) Enteroendocrine function
e) They are all correct
b) Break-down of carbohydrates
(That happens in the mouth)
How much food can the stomach hold?
a) 1 L
b) 2 L
c) 4 L
d) There is not limit
c) 4 L
Parietal cells secrete which of the following?
a) HCl
b) Gastrin
c) Intrinsic factor
d) Somatostatin
e) A and C
f) B and D
e) A and C
(HCl and Intrinsic factor)
Chief cells secrete which of the following?
a) HCl
b) Gastrin
c) Intrinsic factor
d) Somatostatin
e) Pepsinogen
f) A and C
e) Pepsinogen
Enteroendocrine cells secrete which of the following?
a) HCl
b) Gastrin
c) Intrinsic factor
d) Somatostatin
e) A and C
f) B and D
f) B and D
(Gastrin and Somatostatin)
Gastrin stimulates all of the following except what?
a) Absorption of lipids
b) Stomach secretory activity
c) Gastric emptying
d) Contraction of intestine
a) Absorption of lipids
Which of the following is/are true of somatostatin?
a) Inhibits gastric emptying
b) Stimulates stomach secretion
c) Secreted by stomach and jejunum
d) All of the above
a) Inhibits gastric emptying
- It inhibits stomach secretion
- It is secreted by stomach and duodenum
A patient was diagnosed with pancreatic cancer. The doctor was hopeful because they caught it early. Where in the pancreas did they find the cancer?
a) Head
b) Neck
c) Body
d) Tail
a) Head
Which of the following is/are duodenal hormones?
a) Secretin
b) Pepsin
c) Cholecystokinin (CCK)
d) All of the above
e) A and C
e) A and C
(Pepsin is in the stomach)
All of the following are true about secretin except:
a) Inhibits gastric gland secretion
b) Inhibits gastric motility
c) Increases output of pancreatic juice
d) Increases bile output
e) They are all true
e) They are all true
All of following are true of Cholecystokinin (CCK) except:
a) Stimulates gallbladder to expel bile
b) Increases production of pancreatic juices
c) Stimulated by acidic chyme
d) They are all true
c) Stimulated by acidic chyme
(This is true of secretin)
Which of the following is/are true?
a) Liver stores bile
b) Bile is a fat emulsifier
c) Gallbladder produces bile
d) A and C
b) Bile is fat emulsifier
- Liver produces bile
- Gallbladder stores bile
What is the breakdown product of bile?
a) Salts
b) Pigments
c) Bilirubin
d) Cholesterol
e) Fats
c) Bilirubin
(All of the other choices are components of bile)
What is recycled during enterohepatic circulation?
a) Bile Salts
b) Pigments
c) Bilirubin
d) Cholesterol
e) Fats
f) A and C
a) Bile salts
Which one of these transports amino acids, glucose, and fructose?
a) Active transport
b) Secondary active transport
c) Simple diffusion
d) Osmosis
b) Secondary active transport
(Slide 17)
Which part of the alimentary canal is involved with secondary active transport of amino acids, glucose, and fructose?
a) Mouth
b) Esophagus
c) Stomach
d) Small intestines
d) Small intestines
(Slide 17)
What are the functions of the liver?
a) Metabolizes nutrients and bilirubin
b) Stores minerals and vitamins
c) Vascular
d) Hematologic
e) All of the above
e) All of the above
True of False:
If a patient presents liver problems, the brain should also be monitored.
True
What stomach condition will allow bacteria to come in contact with the blood stream?
a) Colitis
b) Tumor
c) Ulcer
d) None of the above
c) Ulcer
Pancreatic juice contains all of the following except:
a) Glucagon
b) Pancreatic proteases
c) Amylase
d) Lipases
a) Glucagon
The pancreas is responsible for the stimulation of what?
a) Cholecystokinin
b) Prostaglandin
c) Secretin
d) All of the above
e) A and C
e) A and C
(Cholecystokinin and secretin)
The majority of water, salt, and nutrient absorption occurs where?
a) Esophagus
b) Stomach
c) Small intestine
d) Large intestine
c) Small intestine
Where does segmentation of chyme take place?
a) Esophagus
b) Stomach
c) Small intestine
d) Large intestine
c) Small intestine
During cephalic and gastric phases, stimulation by _________ verve fibers causes release fibers causes release of pancreatic juice.
a) Vagal
b) Trigeminal
c) Abducens
d) None of the above
a) Vagal
Acidic chyme entering duodenum causes the enteroendocrine cells to release what?
a) Secretin
b) Cholecystokinin
c) Enzyme rich pancreatic juice
d) Bicarbonate-rich pancreatic juice
a) Secretin
Fatty, protein-rich chyme entering duodenum cause the enteroendocrine cells to release what?
a) Secretin
b) Cholecystokinin
c) Enzyme rich pancreatic juice
d) Bicarbonate-rich pancreatic juice
b) Cholecystokinin
Upon reaching the pancreas, cholecystokinin induces the secretion of what?
a) Secretin
b) Cholecystokinin
c) Enzyme rich pancreatic juice
d) Bicarbonate-rich pancreatic juice
c) Enzyme rich pancreatic juice
Upon reaching the pancreas, secretin causes copious secretion of what?
a) Secretin
b) Cholecystokinin
c) Enzyme rich pancreatic juice
d) Bicarbonate-rich pancreatic juice
d) Bicardbonate-rich pancreatic juice
When secretin and cholecystokinin are secreted by the enteroendocrine cells, where do they immediately go before making their way to the pancreas?
a) Bile duct
b) Pancreatic duct
c) Blood stream
d) Heart
c) Blood stream
There are structural modifications of the small intestines in order for what to happen?
a) Increase surface area for digestion
b) Movement of chyme
c) Increase surface area for absorption
d) A and C
d) A and C
(Increase surface area for digestion and absorption… the smooth muscles of the alimentary canal aid in propulsion)
Which of the following is/are not part of our intestinal flora?
a) E. coli
b) Clostridium
c) C. diff
d) Coliforms
e) They are all part of our intestinal flora
c) C. diff
Which of the following do our intestinal flora not metabolize?
a) Bile salts
b) Drugs
c) Nitrogenous substances
d) They are all metabolized
d) They are all metabolized
True or False:
Our stomach is sterile.
True
Which of the following are true?
a) Anaerobes proximal to ileocecal valve: 2/3 of bulk of feces
b) Anaerobes distal to ileocecal valve: 1/3 of bulk of feces
c) Anaerobes distal to ileocecal valve: 2/3 of bulk of feces
d) None of these are true
b) Anaerobes distal to ileocecal valve: 1/3 of bulk of feces
True or False:
Our stomachs are sterile because of the high amounts of bicarbonate.
False
(Our stomach is sterile because of the high acidity.)
Which of the following is/are role(s) of the large intestine?
a) Stores fecal material
b) Moves fecal material
c) Absorbs vitamins
d) Absorbs water
e) All of the above
f) A and C
e) All of the above
Starch and disaccharides are broken down where?
a) Mouth
b) Stomach
c) Small intestines
d) A and C
d) A and C
(Mouth and small intestines)
The monosaccharides glucose and galactose are absorbed via cotransport with what ions?
a) Calcium
b) Potassium
c) Sodium
d) Phosphate
c) Sodium
(The same is true with amino acids)
While in the small intestines, sucrose is broken down into what?
a) Fructose
b) Glucose
c) Galactose
d) A and B
f) B and D
d) A and B
(Fructose and glucose)
While in the small intestines, lactose is broken down into what?
a) Fructose
b) Glucose
c) Galactose
d) A and B
f) B and D
f) B and D
(Glucose and fructose)
What breaks protein down into large polypeptides?
a) Pepsin
b) Pancreatic enzymes
c) Brush border enzymes
d) A and C
a) Pepsin
(This happens in the stomach)
What breaks large polypeptides into small polypeptides and small peptides?
a) Pepsin
b) Pancreatic enzymes
c) Brush border enzymes
d) A and C
d) Pancreatic enzymes
(This happens in the small intestines)
What breaks down small polypeptides and small peptides into amino acids?
a) Pepsin
b) Pancreatic enzymes
c) Brush border enzymes
d) A and C
c) Brush border enzymes
(This happens in the small intestines)
How are unemulsified fats emulsified in the small intestines?
a) Detergent action of bile salts from the liver
b) Ciliary action of bile salts from the liver
c) Detergent action of bile salts from the gallbladder
d) Ciliary action of bile salts from the gallbladder
a) Detergent action of bile salts from the liver
In the small intestines, unemulsified fats are emulsified into what?
a) Monoglycerides
b) Glycerol
c) Fatty acids
d) A and C
e) All of the above
e) All of the above
In the small intestines, nucleic acids are broken down to the following except?
a) Calcium ions
b) Pentose sugars
c) N-containing bases
d) Phosphat ions
a) Calcium ions
All of following break down nucleic acids in the small intestines except:
a) Deoxyribonuclease
b) Pancreatic lipase
c) Pancreatic ribonuclease
d) Brush border enzymes
b) Pancreatic lipase
Which of the following should glucose not be associated with?
a) Brain metabolism
b) Metabolism in most tissues
c) Urine
d) All are ok to be associated with.
c) Urine
Carbohydrates are to glucose as ___________ are to ____________.
a) Proteins; amino acids
b) Excess glucose; body proteins
d) Fats; amino acids
a) Proteins; amino acids
- Carbohydrates break down into glucose
- Fats break down into free fatty acids + glycerol
There is an epidemic of diabetes because the old food pyramid promoted
a) Candy
b) Carbs
c) Proteins
d) Fats
b) Carbs
What is anorexioa?
a) Binge eating and purging
b) A relentless pursuit of thinness
c) A lack of desire to eat
d) A desire to eat even when full
c) A lack of desire to eat
(Full definition: A lack of desire to eat despite physiologic stimuli that would normally produce hunger)
What is the forceful emptying of the stomach and inestinal contents through the mouth?
a) Vomiting
b) Nausea
c) Retching
d) A and C
a) Vomiting
(It does not include retching because retching is nonproductive)
What are common symptoms of nausea?
a) Hypersalivation
b) Headache
c) Tachycardia
d) A and C
e) All of the above
d) A and C
(Hypersalivation and tachycardia)
Projectile vomiting is spontaneous vomiting that does not follow
a) Nausea
b) Coughing
c) Retching
d) A and C
e) All of the above
d) A and C
(Nausea and retching)
When is vomiting good for you?
a) You want to lose weight
b) You drank too much
c) You are pregnant
d) All of the above
b) You drank too much
(It is good to vomit when you have ingested poisons. An excessive amount of alcohol is poisonous.)
Which of the followin is not part of the pathophysiology of constipation?
a) Neurogenic disorders
b) Changes in bowel habits
c) Excessive use of antacids
d) High-residue diet
d) High-residue diet
(It’s low-residue diet)
Which of the following is not a major mechanism of diarrhea?
a) Hypertonic
b) Osmotic
c) Secretory
d) Motility
a) Hypertonic
(There is no such thing)
What kind of diarrhea?
Occurs when too much water is drawn into the bowels.
a) Osmotic
b) Secretory
c) Motility
a) Osmotic
What kind of diarrhea?
There is an increase in the active secretion or there is an inhibition of absorption.
a) Osmotic
b) Secretory
c) Motility
b) Secretory
What kind of diarrhea?
Rapid movement of food through the intestines.
a) Osmotic
b) Secretory
c) Motility
c) Motility
Dehydration, electrolyte imbalance, metabolic acidoses, and weight loss are al manifestations of which GI dysfunction?
a) Diarrhea
b) Acute bacterial or viral infection
c) Inflammatory bowel disease
d) Malabsorption syndromes
a) Diarrhea
Fever, with or without cramping pain, is a manifestation of which GI dysfunction?
a) Diarrhea
b) Acute bacterial or viral infection
c) Inflammatory bowel disease
d) Malabsorption syndromes
b) Acute bacterial or viral infection
Fever, cramping pain, and bloody stools are all manifestations of which GI dysfunction?
a) Diarrhea
b) Acute bacterial or viral infection
c) Inflammatory bowel disease
d) Malabsorption syndromes
c) Inflammatory bowel disease
Steatorrhea (fat in stools) and diarrhea are manifestations of which GI dysfunction?
a) Diarrhea
b) Acute bacterial or viral infection
c) Inflammatory bowel disease
d) Malabsorption syndromes
d) Malabsorption syndromes
Which of the following is/are kinds of abdominal pain?
a) Parietal pain
b) Referred pain
c) Visceral pain
d) A and C
e) All of the above
e) All of the above
A patient comes in with abdominal pain. Which biochemical mediators stimulated this pain?
a) Cytokines, prostaglandins, gastrin
b) Bradykinins, secretin, pepsin
c) Histamine, bradykinin, serotonin
d) Serotonin, cytokines, histamine
c) Histamine, bradykinin, serotonin
Which of the following is/are not considered upper GI bleeding?
a) Ileum
b) Esophagus
c) Duodenum
d) Stomach
e) A and C
a) Ileum
Which of the following is/are not considered lower GI bleeding?
a) Duodenum
b) Jejunum
c) Ileum
d) Colon
e) A and C
a) Duodenum
A patient comes in and complains of vomiting blood. What is this called?
a) Hematemesis
b) Hematochezia
c) Melena
d) Occult bleeding
a) Hematemesis
A patient comes in and complains of bright red blood in his stool. What is this called?
a) Hematemesis
b) Hematochezia
c) Melena
d) Occult bleeding
b) Hematochezia
A patient comes in and complains of black, tarry stool. What is this called?
a) Hematemesis
b) Hematochezia
c) Melena
d) Occult bleeding
c) Melena
A patient comes in and complains of weakness and fatigue. She is pale and her hands are cold. You have a CBC done and see that she has an iron deficiecy anemia. What could this indicate?
a) Hematemesis
b) Hematochezia
c) Melena
d) Occult bleeding
d) Occult bleeding
A patient comes in complains of bright red blood in stool. What could this indicate?
a) Hemorrhoids
b) Colorectal cancer
c) Inflammatory bowel disease
d) A and C
e) All of the above
e) All of the above
(Hemorrhoids and diverticulosis are mostly benign. Colorectal cancer is potentially fatal.)
A patient complains of dark, tarry stool. What could this indicate?
a) Peptic ulcer disease
b) Hemorrhoids
c) Esophageal varices
d) A and C
e) All of the above
d) A and C
(Also Mallory-Weiss Tear)
Concerning GI bleeding, a loss of 1000 ml or more of blood will cause the heart rate to be ________ and the systolic BP to be _______.
a) > 100 BPM; > 100 mm Hg
b) < 100 BPM; > 100 mm Hg
c) < 100 BPM; < 100 mm Hh
d) > 100 BPM; < 100 mm Hg
d) > 100 BPM; < 100 mm Hg
Which of the following is/are types of dysphagia?
a) Mechanical
b) Achalasia
c) Functional
d) A and C
d) A and C
(Achalasia is a denervation of smooth muscle in the esophagus and lower esophageal sphincter relaxation… it is a disorder of motility, not swallowing)
32 y/o woman c/o persisten burning sensation in chest and upper abdomen, worse at night when she is lying down and after meals. Sour taste in mouth in AM, P/E is normal.
What is the diagnosis?
a) Achalsia
b) Hiatal Hernia
c) Intestinal obstruction of ileus
d) GERD (Gastroesophageal reflux disease)
d) GERD (Gastroesophageal reflux disease)
If GERD causes inflammation of esophagus, what is it called?
a) Barrett Esophagus
b) Reflux esophagitis
c) Esophagitis
d) None of the above
b) Reflux esophaitis
True or False:
A normal functioning lower esophageal sphincter maintains a zone of low pressure to prevent chyme reflux.
False
(It is a zone of HIGH pressure)
Which of the following can contribute to GERD?
a) Chest pain
b) Heart burn
c) Increased abdominal pressure
d) Barrett esophagus
c) Increased abdominal pressure
Which of the following is / are manifestations of GERD?
a) Regurgitation of chyme
b) Lower abdominal pain within 1 hour of eating
c) Barrett Esophagus (premalignant change)
d) A and C
e) All of the above
d) A and C
(It causes UPPER abdominal pain)
Which of the following hiatal hernias can cause tissue necrosis?
a) Sliding hiatal hernia
b) Paraesophageal hiatal hernia
c) They both cause tissue necrosis
b) Paraesophageal hiatal hernia
(Sliding is better because it can move up and down… If it is not sliding, there will be loss of blood flow and death of tissue)
All of the following are manifestations of intestinal obstruction and ilues except?
a) Colicky pain
b) Vomiting
c) Diarrhea
d) Metabolic acidosis
c) Diarrhea
(You cannot pass anything because of the blockage)
All of the following are causes of mechanical bowel obstruction except
a) Volvulus
b) Adhesions
c) Intussusception
d) Ileus
e) Incarcerated inguinal hernia
d) Ileus
If the intestines are obstructed, what will happen at the site obstruction?
a) Ishemia (necrosis)
b) Gas and fluid accumulation
c) Distension (pain)
d) A and C
e) All of the above
e) All of the above
