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Betamax > Physiology 4th LE 2017 (w/o laboratory) > Flashcards

Physiology 4th LE 2017 (w/o laboratory) Flashcards

1
Q

What is TRUE regarding the neural control of gastrointestinal tract (GIT)?
A. the submucosal plexus is controlled directly by the autonomic nervous system
B. Fecal continence is facilitated by the somatic nervous system.
C. The intrinsic primary efferent neurons send impulses to the PNS
D. chemo and mechanoreceptor stimulation is only the short reflex pathways

A

B. Fecal continence is facilitated by the somatic nervous system. - The puborectalis and anal sphincter and other muscles included in fecal continence are skeletal so they are controlled by the somatic NS
**
A. the submucosal plexus is controlled directly by the autonomic nervous system (not directly but the submucosal plexus as part of the ENS has partial autonomy)
C. The intrinsic primary efferent neurons send impulses to the PNS- ENS first.
D. chemo and mechanoreceptor stimulation is only the short reflex pathways- also for long reflexes

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2
Q

Slow waves are:
A. generated only by the interstitial cells of cajal
B. Enhanced by sympathetic stimulation
C. Constant in pace and rhythm throughout the GIT
D. always immediately followed by smooth muscle contraction

A

A. generated only by the interstitial cells of cajal - (no other source)
**
B. Enhanced by sympathetic stimulation - actually inhibited
C. Constant in pace and rhythm throughout the GIT- different in each segment
D. always immediately followed by smooth muscle contraction- not always

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3
Q 
The superior mesenteric ganglion send efferent neurons to the
A. esophagus
B. Gallbladder
C. Distal colon
D. rectum
A

C. Distal colon - the rest are controlled by celiac.

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4
Q 
Which of the following processes is purely due to reflexes and has NO voluntary control?
A. Mastication
B. Salivation
C. Deglutition
D. None of the above
A

B. Salivation - (CORRECT ANSWER) all the rest have voluntary component with skeletal muscles involved

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5
Q

Saliva:
A has a lower potassium content than ECF
B. Is secreted in response to sympathetic stimulation
C. Has an acidic pH because there’s no bicarb
D. does not contain any microbrial component

A

B. Is secreted in response to sympathetic stimulation - (CORRECT ANSWER) even if scantier still secretion occurs
**
A has a lower potassium content than ECF ( K is secreted in the saliva)
C. Has an acidic pH because there’s no bicarb - pH is basic coz bicarb
D. does not contain any microbrial component – contains IgA and IgM

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6
Q

During swallowing:
A the soft palate remains quiescent and is not moved
B. Breathing stops when the epiglottis covers the larynx
C. Primary peristalsis guides food until just before the LES
D. secondary peristalsis ensure food entry of food into the stomach

A

B. Breathing stops when the epiglottis covers the larynx
**
A the soft palate remains quiescent and is not moved (moves upwards)
C. Primary peristalsis guides food until just before the LES – beyond

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7
Q

The Lower Esophageal Sphincter (LES)
A. relaxes together with the antrum of the stomach during receptive relax
B. Is contracted by the vagus nerve to prevent acid reflux from the stomach
C. Will relax when much ethanol and chocolate is ingested
D. all of the above is true of the LES

A

C. Will relax when much ethanol and chocolate is ingested

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8
Q

Peristalsis and retropulsion in the stomach:
A. Are able to push ingested particels > 2cm into the duodenum
B. Occur throughout the whole stomach right after a meal
C. are most intense at the cardia and body
D. Will result in impaction of slow moving particles at the pyloric sphincter

A

D. Will result in impaction of slow moving particles at the pyloric sphincter = closes when chyme is brought by retropulsion and peristalsis and antrum
**
A. Are able to push ingested particels > 2cm into the duodenum (No. Only those

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9
Q 
Gastric emptying of contents into the duodenum is slowed by:
A. Antral stretching
B. Gastrin
C. Cholecystokinin
D. ingesting a lot of fluid
A

C. Cholecystokinin - the rest speed up emptying

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10
Q 
Gastric secretion of mucus and bicarbonate is increased by:
A. ingesting aspirin
B. Chronic sympathetic stimulation
C. smoking cigarettes
D. voluntary fasting
A

D. voluntary fasting - more mucus secreted when

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11
Q 
Secretion of gastric acid is decreased by:
A. Vagovagal reflexes
B. Distention of the duodenum
C. Histamine secretion
D. voluntary fasting
A

B. Distention of the duodenum - the rest increase HCl secretion

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12
Q

The Migrating Myoelectric Complex (MMC)
A. can start from the esophagus
B. Occurs in 3 phases within the same degree of activity
C. has a phase 3 that is synchronized with GIT secretion
D. continues until the middle of a meal

A

C. has a phase 3 that is synchronized with GIT secretion
**
A. can start from the esophagus (No. starts at stomach, distally only)
B. Occurs in 3 phases within the same degree of activity (No. increasing degree of activity)
D. continues until the middle of a meal (no, MMC stops at the start of meal ingestion)

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13
Q 
Motility of the colon:
A. Is not affected by the ingestion of food 
B. Can be inhibited by the MMC 
C. Is always propulsive and peristaltic 
D. may include weak retrograde movements
A

D. may include weak retrograde movements
**
A. Is not affected by the ingestion of food – gastrocolic reflex
B. Can be inhibited by the MMC - not affected by MMC
C. Is always propulsive and peristaltic - there are retrograde movements

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14
Q 
What is not secreted by the pancreas?
A. Colipase
B. Ribonuclease
C. Trypsin inhibitor
D. enterokinase
A

D. enterokinase - secreted by intestinal mucosa

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15
Q

Bile
A. is mostly composed of bile salts
B. Contains bilirubin from RBC degradation
C. is always a mix of primary and secondary bile acids
D. all are true

A

D. all are true

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16
Q 
The longest transit time of ingested food is in the
A. mouth
B. Stomach
C. Small intestine
D. large intestine
A

D. large intestine - 24-48 intestine

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17
Q 
A non-carbohydrate fiber:
A. gum
B. Cellulose
C. lignin
D. pectin
A

C. lignin - the rest are hard to digest CHO

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18
Q 
Digested only by bacteria in the colon:
A. trehalose
B. Raffinose
C. Alpha limit dextrins
D. lactose
A

B. Raffinose - the rest can be digested by our pancreatic hormones

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19
Q

Protein:
A. once ingested, almost totally absorbed by GIT
B. Stimulates relaxation of the LES
C. have some RDA for all sexes and ages
D. is totally digested by pepsin in the stomach

A

A. once ingested, almost totally absorbed by GIT
**
B. Stimulates relaxation of the LES - actually contracts it
C. have some RDA for all sexes and ages – different for sex and age
D. is totally digested by pepsin in the stomach –pancreatic proteases have a major role in digestion

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20
Q

For Lipid Digestion:
A.cell membrane transport proteins are used for absorption
B. Lipases begin digestion in the mouth
C. Micelles are absorbed into enterocytes
D. glycerol in chylomicrons are absorbed into lacteals

A

B. Lipases begin digestion in the mouth - there are lingual lipases
**
A.cell membrane transport proteins are used for absorption – simple diffusion is used
C. Micelles are absorbed into enterocytes - they break up and only fatty digestion products are absorbed while the bile is absorbed in ileum.
D. glycerol in chylomicrons are absorbed into lacteals – they go straight through to the venules in the villi

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21
Q 
Absorbed in the cecum
A. vitamin B12
B. Bile salts
C. Iodine
D. short chain fatty acids
A

D. short chain fatty acids - products of probiotic metabolism, the rest are absorbed in the small intestines

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22
Q 
Major mineral required for normal cell function:
A. Iron
B. Selenium
C. Phosphorus
D. chromium
A

D. chromium - also sodium, potassium, calcium, and magnesium

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23
Q 
Non-renal function of the nephron
A. Nutrient reabsorption
B. EPO secretion 
C. Secretion of K+
D. Production of new HC03
A

B. EPO secretion

24
Q 
Which substance will decrease GFR?
A. prostaglandin
B. Dopamine
C. Angiotensin II 
D. Nitric Oxide
A

C. Angiotensin II

25
Q 
Renal clearance of which of the following substances approximates renal plasma flow?
A. tridated water
B. Insulin
C. Inulin
D. para amino hippuric acid
A

D. para amino hippuric acid - only substance that is filtered and secreted, thus approximates renal plasma flow; inulin approximates gfr and tritaded water goes into both ecf and icf. Insurlin is a hormone

26
Q 
Which of the following factors regulating GFR will be affected by contraction of the mesanglial cells?
A. a coefficient of reflection
B. Coefficient of filtration
C. tubular hydrostatic pressure
D. capillary hydrostatic pressure
A

B. Coefficient of filtration - because the contraction of mesangial cells will decrease surface area of the filter

27
Q 
Substance with the greatest clearance in the kidney:
A. creatinine
B. Cl
C. Amino Acid
D. Na+
A

A. creatinine – becasuse it is secreted to a certain degree, the others are reabsorbed 100% (amino acid) while Na+Cl- is reabsorbed mostly

28
Q 
A normal individual who is a meat eater may have an increased K excretion in the urine due to an increase in:
A. aldosterone secretion
B. GFR
C. Secretin of K+ in the distal tubule
D. K reabsorbtion in proximal
A

D. K reabsorbtion in proximal tubule - meat eaters form a lot of metabolic acids that are non volatile and excess h+ needs to be excreted in exchange for k+

29
Q 
When the macula densa detects decreased sodium tubular load, which of the following is released?
A. Renin
B. Erythropoietin
C. Angiotensin II			
D. Aldosterone
A

A. Renin - macula densa stimulates the JG cells to secrete renin when it detects that the tubular load of Na is decreased

30
Q 
Given that all other factors are constant, a decrease in which factor will result in increased filtration fraction?
A. Afferent arteriolar resistance 	
B. Plasma protein concentration
C. Filtration area
D. Glomerular capillary
A

B. Plasma protein concentration - because when plasma protein concentration is low then net filtration pressure is increased, and will cause increased GFR; the numerator increases –> filtration fraction is higher
**C. Filtration area - decrease area for filtration, decrease filtration rate –> lower filtration fraction
D. Glomerular capillary pressure - will lower GFR and filtration fraction is smaller

31
Q

The rate of water reabsorption from the proximal convoluted tubule is determined primarily by the:
A. Passive filtration due to high hydrostatic pressure in the proximal tubule
B. Concentration of ADH in the blood
C. Osmotic pressure developed by plasma CHONs in PCT
D. Active transport of water molecule by proximal tubule cells
E. Rate of dissolved particle (solute) reabsorption from the proximal tubule

A

E. Rate of dissolved particle (solute) reabsorption from the proximal tubule

32
Q 
A patient with aldosterone secreting tumor is likely to manifest the following signs EXCEPT:
A. Edema
B. Hypertension 	
C. Hyperkalemia 
D. alkalosis
A

C. Hyperkalemia - inc. aldosterone means inc. Na+ re absorption in exchange for K+. Thus, there can be no hyperkalemia.
**
A. Edema - due to Na in blood and increased filtration at arteriole end
B. Hypertension – increased blood volume will increase cardiac output – HPN
D. alkalosis - happens because you also lose H+ in exchange for Na+ reabsorbed in tubulues

33
Q

A decrease in the effective circulating blood volume leads to an increase in the following EXCEPT:
A. Fraction reabsorption of Na in renal tubules
B. ADH secretion
C. Secretion of ANP
D. Secretion of aldosterone

A

C. Secretion of ANP - secreted when Na+ is high and blood volume is high, not when Blood vol is low
**A. Fraction reabsorption of Na in renal tubules – increased reabsorption when decreased blood volume is present because of the effect of aldosterone

34
Q 
Regulates the facultative reabsorption of water:
A. ADH					
B. aldosterone
C. ANP						
D. Na+ reabsorption at PCT
A

A. ADH

**B. aldosterone - obligatory reabsorption

35
Q 
Which of the following is NOT a fixed acid?
A. Sulfuric acid						
B. Phosphoric acid	
C. Carbonic acid
D. All of the above
A

C. Carbonic acid: volatile acid

36
Q 
A decrease in plasma pH is seen in persons with:
A. Fruit and vegetable diet
B. Kidney failure		
C. Peristent vomiting
D. Hyperventilation
A

B. Kidney failure

37
Q 
Renal compensation for acid-base balance involves:
A. Reabsorption of HCO3
B. Excretion of carbon dioxide		
C. Tubular H+ secretion
D. All of the above are true
E. Only A and C are true
A

E. Only A and C are true

38
Q 
The daily maintenance of normal H+ balance involves the excretion of H+ and an equivalent 
A. Filtered HCO3 load
B. NH4 production 		
C. Titratable acid excretion
D. Production of fixed acids
A

D. Production of fixed acids

39
Q 
1 year old patient with persistent vomiting,  dehydrated, ABG showed pH= 7.55, pCO2= 40mmHg, HCO3= 29. 
The patient has:
A. Metabolic acidosis
B. Metabolic alkalosis		
C. Respiratory acidosis
D. Respiratory alkalosis
A

B. Metabolic alkalosis

40
Q 
1 year old patient with persistent vomiting,  dehydrated, ABG showed pH= 7.55, pCO2= 40mmHg, HCO3= 29. 
Compensation for the case above?
A. Excretion of HCO3
B. Formation of new HCO3	
C. Hyperventilation
D. Excretion of NH4
A

A. Excretion of HCO3

41
Q

A patient with prolonged and profuse diarrhea will have the following ABGs:
A. pH = 7.55; HCO3 = 42 mEq/L; pCO2 = 45 mm Hg
B. pH 7.5
C. pH=7.4, HCO3=24mq/L, pCO2=40mmHg
D. pH=7.25, HCO3=18meq/L, pCO2=30mmHG

A

D. pH=7.25, HCO3=18meq/L, pCO2=30mmHG

42
Q 
Respiratory acidosis directly stimulates the central chemoreceptors by:
A. decreased H ions					
B. increased pCO2 
C. decreased CO2
D. all are true
A

C. decreased CO2

43
Q 
A. gastrin
B. secretin
C. CCK
D. glucose-dependent insulinotropic polypeptide (GIP)
E. glucagon-like peptide
  1. Increases triglyceride storage in adipose tissues:
  2. Promotes growth of the gastric mucosa:
  3. Secreted by cells in the ileum and colon:
  4. Decreases gastric acid secretion:
  5. Increases enterokinase:
  6. Stimulates gallbladder contraction:
  7. Requires sodium coupled transporters for absorption
A
  1. D
  2. A
  3. E
  4. B
  5. C
  6. C
  7. A and B
44
Q

A. Carbohydrate digestion and absorption
B. Protein digestion and absorption
C. Lipid digestion and absorption
D. All of the above

  1. Final steps in the process of sucrase-isomaltase complex
  2. Complete digestion always occurs in the intestinal microvilli
  3. May require SER of enterocyte for processing
A
  1. A
  2. B
  3. C
45
Q

A. Loop of Henle
B. Proximal convoluted tubule
C. Distal convoluted tubule
D. Vasa recta

  1. Countercurrent exchanger
  2. Countercurrent multiplier
  3. Greatest water
A
  1. D
  2. A
  3. B
46
Q

A if X is directly related to Y
B if X is indirectly related to Y
C if X has no relation to Y

X = bile acids in the portal circulation
Y = synthesis of bile in the liver
A

B

47
Q

A if X is directly related to Y
B if X is indirectly related to Y
C if X has no relation to Y

X = gastrin secretion			
Y = histamine secretion
A

A

48
Q

A if X is directly related to Y
B if X is indirectly related to Y
C if X has no relation to Y

X = stretching of the stomach		
Y = ileal motility
A

A

49
Q

A if X is directly related to Y
B if X is indirectly related to Y
C if X has no relation to Y

X = fiber ingestion			
Y = gastric emptying time
A

A

50
Q

A if X is directly related to Y
B if X is indirectly related to Y
C if X has no relation to Y

X = gastric pH			
Y = somatostatin secretion
A

B

51
Q

A if the word or statement is associated with X only
B if the word or statement is associated with Y only
C if the word or statement is associated with BOTH X and Y
D if the word or statement is associated with NEITHER X and Y

Continuous with a swallow
X = primary peristalsis
Y = secondary peristalsis

A

A

52
Q

A if the word or statement is associated with X only
B if the word or statement is associated with Y only
C if the word or statement is associated with BOTH X and Y
D if the word or statement is associated with NEITHER X and Y

Aboral direction
X = peristaltic reflex
Y = vomiting

A

A

53
Q

A if the word or statement is associated with X only
B if the word or statement is associated with Y only
C if the word or statement is associated with BOTH X and Y
D if the word or statement is associated with NEITHER X and Y

Products of bacterial deconjugation/dehydroxylation of bile
X = lithocolic acid
Y = chenodeoxycolic acid

A

A

54
Q

A if the word or statement is associated with X only
B if the word or statement is associated with Y only
C if the word or statement is associated with BOTH X and Y
D if the word or statement is associated with NEITHER X and Y

Secretin
X = bicarbonate secretion of pancreatic ducts
Y = delayed gastric emptying

A

C

55
Q

A if the word or statement is associated with X only
B if the word or statement is associated with Y only
C if the word or statement is associated with BOTH X and Y
D if the word or statement is associated with NEITHER X and Y

Fecal incontinence
X = puborectalis muscle
Y = internal anal sphincter

A

A

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