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Physiology Qs Flashcards

1
Q

What best describes the secondary peristalsis? 2017, 2014, 2013

  1. Starts at the site where food is stuck in the esophagus after a wave of primary peristalsis
  2. initiated after swallowing
A
  1. Starts at the site where food is stuck in the esophagus after a wave of primary peristalsis
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2
Q

What is the difference between the primary salivary secretion and oral saliva? 2017, 2014

  1. The primary secretion is hypotonic and saliva is hypertonic
  2. The primary secretion contains more Na+
  3. Saliva has less HCO3
  4. Both have the same composition of electrolytes
A
  1. The primary secretion contains more Na+
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3
Q

Which of the following factors is responsible for the copious secretions of the salivary gland? 2016, 2015

  1. NE and NO by sympathetic
  2. NE and Ach by ANS
  3. Ach and VIP by parasympathetic
  4. Ach and NE by sympathetic
A
  1. Ach and VIP by parasympathetic
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4
Q

What factor increases blood flow to salivary glands? 2014

  1. Vagal cholinergic
  2. Glossopharyngeal cholinergic
  3. Bradykinin
A
  1. Bradykinin
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5
Q

What increases blood supply to the salivary glands? 2013, Final 2010

  1. VIP & bradykinin
  2. VIP & Ach
A
  1. VIP & bradykinin
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6
Q

What causes movement of water in the salivary glands? 2013

  1. Active transport of Na and isotonic fluid secretion
  2. Paracellular Na transport and isotonic fluid secretion
A
  1. Paracellular Na transport and isotonic fluid secretion
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7
Q

What is the difference between the primary salivary secretion and oral saliva? Final 2013, 2010, 2008

  1. Saliva has less HCO3
  2. Both have the same composition of electrolytes
  3. The primary secretion contains more K+
  4. The primary secretion is hypotonic and saliva is hypertonic
A
  1. The primary secretion contains more K+
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8
Q

If primary peristalsis fails to clear the bolus, a wave of secondary peristalsis is initiated at the site of the bolus. Where does that take place? Final 2011

A

Esophagus

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9
Q

Which of the following is true regarding the effect of parasympathetic fibers on blood vessels of the salivary glands? 2011

A

VIP and bradykinin are vasodilators

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10
Q

What are intercalated duct cells responsible for? 2010, 2009

  1. HCO3- absorption
  2. Cl- secretion
  3. K+ absorption
  4. K+ secretion
  5. HCO3- secretion
A
  1. HCO3- secretion
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11
Q

What is the difference between primary secretion of saliva gland and the modified secretion? Final 2009

A

Tonicity

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12
Q

If a person swallowed repeatedly every 1-2 seconds. What will happen? Final 2009, 2009

A

Esophagus will only contract after the last swallow

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13
Q

What does the intercalated duct secrete? 2008

  1. Na and HCO3-
  2. Cl and K
A
  1. Na and HCO3-
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14
Q

Which of the following causes receptive relaxation of the stomach? Final 2017, 2011, 2009

  1. Somatostatin
  2. Gastrin
  3. Norepinephrine
  4. VIP
A
  1. VIP
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15
Q

What increases both the duration and amplitude of the stomach AP? Final 2017, 2016, 2015

  1. Adrenaline
  2. Sympathetic
  3. Acetylcholine
  4. Secretin
A
  1. Acetylcholine
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16
Q

High activity of fibers that secrete VIP on LES smooth muscle but vagal cholinergic fibers show no action potential. What does it indicate? 2016

  1. LES maintaining resting tone
  2. Over tightening of LES
  3. LES relaxation
  4. Absence of ANS control
A
  1. LES relaxation
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17
Q

A manometer is inserted into a patient’s mouth passing through the pharynx, UES, esophageal body, and LES. What are the pressure readings? 2016, Final 2015, Final 2012, 2012, 2011, 2008

  1. 0 → 50 → 0 → 30
  2. 50 → 30 → 0 → 0
  3. 0 → 30→ 0 → 50
A
  1. 0 → 50 → 0 → 30
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18
Q

Which recording of vagal inhibitory fibers (VIF) and vagal excitatory fibers (VEF) will be seen with receptive opening of the lower esophageal sphincter? Final 2015, 2012, 2011

  1. Both VIF and VEF action potentials are increased
  2. Both VIF and VEF action potentials are decreased
  3. Increased firing of VIF but absent firing of VEF
A
  1. Increased firing of VIF but absent firing of VEF
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19
Q

Retropulsion and grinding is the main movement of which organ? 2015, 2014, 2009

  1. Esophagus
  2. Stomach
  3. Small Intestines
  4. Cecum
  5. Ascending Colon
A
  1. Stomach
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20
Q

A movement that occurs in both esophagus and stomach during swallowing? Final 2014, 2011

  1. Peristalsis
  2. Receptive relaxation
A
  1. Receptive relaxation
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21
Q

The stomach efficiently mixes food by contracting the antrum against a closed pyloric sphincter. What is this process called? Final 2014, 2011

A

Retropulsion

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22
Q

What is responsible for receptive relaxation of both lower esophageal sphincter and stomach? 2014, 2012

  1. VIP
  2. NE
  3. Secretin
  4. Gastrin
  5. CCK
  6. Histamine
A
  1. VIP
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23
Q

Which of the following factors acts to decrease the amplitude and duration of slow waves of the stomach? 2014

  1. Secretin
  2. Gastrin
  3. Distension of the stomach
  4. Cholinergic fibers
A
  1. Secretin
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24
Q

Which point confers the first and maximal resistance during insertion of a nasogastric tube? Final 2013, Final 2011, 2010

A

Pharyngoesophageal junction

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25
Which of the following happens during the receptive relaxation of the LES? Final 2013, Final 2010 1. Increase in VIP and decrease in Ach 2. Increase in VIP and decrease in NE
1. Increase in VIP and decrease in Ach
26
What activates gastric secretions? 2013
Gastric distension
27
What keeps intragastric pressure constant during eating? Final 2012 1. Increased tension and radius in the stomach 2. Increased radius with constant tension
-
28
Where does retropulsion take place? Final 2012, Final 2011, 2009
Stomach
29
Which of the following factors promote gastric emptying? Final 2011, Final 2010
Gastric distension
30
What will constrict lower esophageal sphincter? 2010
Vagus Ach
31
What is responsible for the relaxation of the pyloric sphincter? 2009
VIP
32
Which neurotransmitter is most responsible for relaxation of the lower esophageal sphincter? 2009
Nitric Oxide
33
What best describes the slow waves of the intestinal smooth muscle cells? 2017 1. Tonic contractions 2. Action potentials 3. Originate from interstitial cells of cajal 4. Same frequency in all the gut
3. Originate from interstitial cells of cajal
34
What is the main plexus for coordinated contraction of the gastrointestinal smooth muscle? Final 2014 1. Submucous 2. Myenteric 3. Celiac
2. Myenteric
35
A gastrointestinal smooth muscle showed 12 slow waves per minute. Which part of GIT does this muscle represent? 2014 1. Small intestine 2. Colon 3. Stomach
1. Small Intestines
36
Which of the following is a characteristic feature of smooth muscles in the gastrointestinal tract? 2013 1. Depolarize by stretch 2. Hyperpolarize by Ach 3. Depolarize by norepinephrine
1. Depolarize by stretch
37
Which of the following is a characteristic feature of smooth muscles in the gastrointestinal tract? 2013
Changing membrane potential
38
What is the correct sequence of contraction of smooth muscles? 2013
Ca-Calmodulin → MLCK → myosin-p → cross-bridges
39
Which of the following is present in the muscularis externa? 2011
Auerbach plexus
40
Decreased stomach Ph stimulates the secretion of which of the following? 2017, 2015 1. Gastrin 2. Secretin 3. Somatostatin 4. Histamine
3. Somatostatin
41
Parietal cells secrete H+ ions in exchange of what? Final 2015
K+
42
After eating, the stomach pH increases even though acid secretion increases. What is the reason behind this? 2015
Buffering effect of food
43
Which of the following hormones acts as a paracrine to increase the gastric secretion? 2014, 2010 1. Gastrin 2. Histamine 3. CCK 4. Secretin
2. Histamine
44
A hormone that inhibits both G cells and parietal cells? 2014
Somatostatin
45
After a meal, the active acid secretion by the parietal cells in the stomach results in changing the composition of blood leaving the stomach. What does that blood contain? 2014, 2011 1. High levels of bicarbonate 2. High levels of Potassium 3. High levels of Chloride 4. Low levels of Sodium
1. High levels of bicarbonate
46
What enzyme is degraded in the alkaline medium? Final 2013, 2009 1. Trypsin 2. Chymase 3. Pepsin 4. Pancreatic lipase
1. Trypsin
47
What stimulates secretion of secretin? 2013, 2008
Low duodenal pH
48
What describes the postprandial effect? Final 2012
Alkaline blood leaving the stomach after increased acid secretion
49
Which substance has receptors on oxyntic cells and inhibits their activity? 2012
Somatostatin
50
A patient who underwent vagotomy goes out with his friends to eat in a restaurant. In which phase will gastrin secretion be inhibited? 2012 1. When he thinks about the food 2. When the bolus of food reaches his stomach
1. When he thinks about the food
51
What causes decreased secretion from gastric glands? 2012
Acidic pH in the antrum
52
What is secreted by enterochromaffin like cells? 2012, Final 2009
Histamine
53
What has maximum activity at pH 3? 2012
Pepsin
54
What is the main secretion of the glands in the body of the stomach? 2011 1. Intrinsic factor 2. Pepsin 3. Mucus 4. Gastrin
1. Intrinsic factor This is a trick question; the glands in the body produce pepsinogen not pepsin so intrinsic factor would be the correct answer
55
After meals, the patient's serum is alkaline (↑ HCO3). Why? Final 2010
Postprandial alkalosis
56
What will cause inhibition of acid secretion? 2010, 2009
Low pH in antrum
57
Which paracrine hormone is produced from the ECM? 2008 1. Pepsinogen 2. Gastrin 3. Somatostatin 4. Histamine
4. Histamine
58
What is the mechanism by which bile acid is secreted to bile canaliculi? 2017, 2016, 2015, 2014, 2013, 2011, 2010, 2008 1. Primary active transport 2. Secondary active transport 3. Tertiary active transport 4. Facilitated diffusion
1. Primary active transport
59
What increases blood flow in the hepatic artery? 2016, 2014 1. Low CO2 in portal vein 2. Low O2 in portal vein 3. High pH in portal vein 4. Increased blood flow of portal vein
2. Low O2 in portal vein
60
A patient with liver disease develops peripheral edema. What is the underlying mechanism? 2016, Final 2013, 2012, 2011 1. Decreased plasma colloid osmotic pressure 2. Increased plasma colloid osmotic pressure 3. Decreased tissue colloid osmotic pressure 4. Increased tissue colloid osmotic pressure
1. Decreased plasma colloid osmotic pressure
61
What is actively removed from the gallbladder to concentrate its contents? Final 2015
Na
62
What increases blood flow in the hepatic artery? 2015 1. Low CO2 2. Increased O2 3. Increased postprandial Hyperosmolarity
3. Increased postprandial Hyperosmolarity
63
What happens during hepatic blood flow regulation in hepatic arterial buffer response HABR, when portal blood flow increases? Final 2014 1. Hepatic blood flow remains constant 2. Buffers vasoconstrict to reduce blood flow 3. Hepatic arterial blood flow increase 4. Autoregulation reduces portal blood flow
2. Buffers vasoconstrict to reduce blood flow
64
Which ion binds with unconjugated bilirubin and forms stones? 2010
Ca+
65
What causes relaxation of the sphincter of oddi? Final 2009
VIP
66
What is excluded out of the gallbladder? Final 2009
NaCl
67
Uptake of xenobiotics to the liver is done by? 2009
OATP
68
Contraction of what will cause filling of gallbladder? 2009
Common Bile duct
69
The presence of which structure necessitates active transport of electrolytes? 2008 1. Tight junction 2. Gap junction
1. Tight junction
70
What prevents bile from leaking? 2008
Tight Junctions
71
Which of the following enzymes is responsible for converting trypsinogen to trypsin? Final 2017, 2017 1. Enterokinase 2. Carboxypeptidase 3. Chymotrypsin 4. Trypsin inhibitor
1. Enterokinase
72
What occurs when exocrine secretion of the Pancreas increases? 2017 1. The secretion becomes hypertonic with more HCO3 than in plasma 2. The secretion becomes hypertonic with less HCO3 than in plasma 3. The secretion becomes isotonic with more Cl than in plasma 4. The secretion becomes isotonic with less Cl than in plasma
1. The secretion becomes hypertonic with more HCO3 than in plasma
73
Pancreatic enzymes are first secreted as proenzymes to prevent destruction of the pancreatic tissue; they then get activated in the small intestine. What is the first step of pancreatic enzyme activation? 2016, Final 2015, 2014, Final 2012, 2011 1. Activation of trypsin by the brush border enterokinase in the small intestine 2. Activation of enterokinase by trypsin
1. Activation of trypsin by the brush border enterokinase in the small intestine
74
What is the mechanism by which the ions above are regulated in pancreatic secretions? 2016, 2015
An exchanger transporter
75
The pancreatic fluid is released into the small intestine during which phase of digestion? 2016, 2013 1. Basal 2. Intestinal 3. Gastric 4. Cephalic
Intestinal
76
After truncal vagotomy, how does the stomach continue to secrete gastrin? 2015
Distention of the stomach activates the enteric nervous system
77
What is secreted in response to low acidity in duodenum? 2015, Final 2009, 2009, 2008 1. Secretin 2. CCK
1. Secretin
78
This is a graph of ion concentrations in pancreatic secretion at different rates of secretion. Which of the following is correct? Final 2014
High HCO3- concentration secreted by Cl-HCO3- exchanger at higher rates of secretion
79
Which of the following stimulates exocrine fluid secretion of pancreas? 2014 1. Secretin 2. CCK
1. Secretin
80
Amylase is inactive at a very low pH; however, most of the starch digestion by amylase takes place in the stomach. What would provide a proper explanation for that? 2013, Final 2011, Final 2009
Salivary amylase in the core of the food, so pH will take longer time to inactivate that
81
What is the correct sequence of activation of pancreatic enzymes? 2013
Trypsinogen→ trypsin → activate the inactive enzymes
82
What is secreted from pancreatic duct cells? 2013 1. Cl and K 2. HCO3-and Cl-
2. HCO3-and Cl-
83
What activates all pancreatic enzymes? 2012, 2009, 2008 1. Trypsin 2. Carboxypeptidase 3. Chymotrypsin
1. Trypsin
84
In the intestinal phase of pancreatic secretion, the ducts secrete large amounts of fluid, but the secretion to the intestine contains enzymes. Why? 2010, 2008
The fluid pushes the enzymes that are already there
85
What accurately describes migrating myoelectric complex MMC? Final 2017 1. It happens during digestive period 2. It stops after vagotomy 3. Its is generated by sympathetic nervous system 4. It needs an intact enteric nervous system
4. It needs an intact enteric nervous system
86
What hormone generates MMC ( migrating myoelectric complex )? 2017 1. Motilin 2. Gastrin 3. Secretin 4. CCK
1. Motilin
87
An instrument was inserted into the intestine of a dog to measure the electrical activity of the GI tract. Intense bursts of electrical activity were recorded, which took place every 90 minutes while fasting. What do these waves represent? 2017, 2016, 2011, Final 2010, 2009, 2008
MMC
88
What is a characteristic of peristalsis in the small intestine? 2016 1. it involves the contraction of the inner circular layer and relaxation of outer longitudinal layer in front of the food bolus 2. it involves the contraction of the inner circular layer and relaxation of outer longitudinal layer behind the food bolus 3. mixes the food bolus 4. it is innervated by the central nervous system (CNS)
2. it involves the contraction of the inner circular layer and relaxation of outer longitudinal layer behind the food bolus
89
What needs further processing before being absorbed by the intestinal epithelium? 2016 1. Sucrose 2. Glucose 3. Galactose 4. Tri and di peptides
1. Sucrose
90
What happens to the intestinal motility when autonomic innervation is cut? Final 2014, Final 2013, Final 2011, Final 2009 1. Reverse peristalsis 2. Motility Stops 3. Motility is unaffected 4. Relaxation of all smooth muscles
3. Motility is unaffected
91
What is the main mixing movement in the small intestine? 2014
Segmentation
92
What is migrating myoelectric complex (MMC)? Final 2013
Bursts of intense electrical contractions
93
Which enzyme needs emulsification to optimize its function? Final 2013 1. Trypsin 2. Chymase 3. Pepsin 4. Pancreatic lipase
4. Pancreatic lipase
94
By which mechanism in the intestinal lumen is the glucose absorbed across the brush border? 2017, Final 2012, 2012, 2010 1. Facilitated diffusion 2. Primary active transport 3. Secondary active transport 4. Endocytosis 5. Exchange with hydrogen
3. Secondary active transport
95
An increase in the level of which solute at the microenvironment of the enterocyte surface causes micelles to release digested fat products? 2016, 2015, 2012, 2011 1. H+ ions 2. K+ ions 3. Cl- ions
1. H+ ions
96
What is the process of transport of di and tri peptides along the enterocyte? 2016, Final 2015, 2011, 2010, 2009 1. primary active transport. 2. secondary active transport 3. Tertiary active transport (co-transport with H+)
3. Tertiary active transport (co-transport with H+)
97
When a patient was administered 100g of oral glucose, his blood glucose went up by 20%. However, when he was orally administered 200g of lactose, his blood glucose did not change. What does that suggest? 2016, 2015, 2014, 2013, 2012, Final 2011, 2010, 2008 1. the liver doesn’t utilize lactose 2. lactose does not change the serum glucose level 3. lack of the enzyme lactase in the enterocyte brush border
3. lack of the enzyme lactase in the enterocyte brush border
98
What are glucose and galactose coupled to, to be absorbed? Final 2015, 2010 1. Na 2. K
1. Na
99
What is the process of transport of di and tri peptidases along the enterocyte? Final 2014 1. Primary active transport 2. Cotransport with Na+ 3. Cotransport with H+
3. Cotransport with H+
100
# Choose the correct combination of ions with the digestion products that are cotransported with them in the intestine. 2013
Na+ with glucose; H+ with peptides
101
What induces the mixed micelle to release its contents at the absorbing epithelium? 2013
High H+ concentration near the mucosa
102
What is the source of free fatty acids in a well-fed person? 2012
Chylomicrons
103
Absorption of glucose and amino acids are dependent on the gradient of which ion? 2011
Sodium
104
After removal of intestinal lymph nodes during surgery. Absorption of what will be affected? 2010 1. Water 2. Proteins 3. Carbohydrates 4. Lipids
4. Lipids
105
Which of the following is a brush border enzyme? 2008
Lactase
106
Which of the following segments has the lowest motility? Final 2017, Final 2010, 2008 1. Transverse colon 2. Upper rectum 3. Lower rectum 4. Descending colon
3. Lower rectum
107
What happens if there’s a distention of the cecum? 2016, Final 2015, Final 2014 1. Stimulation of peristalsis in ileum 2. Closure of ileocecal valve 3. Reverse peristalsis in colon
2. Closure of ileocecal valve
108
Structural and functional unit of the colon because of its inner circular muscle thickenings? Final 2015
Haustrations
109
What is the dominant mixing movement in colon? Final 2015, Final 2014, 2011 1. Haustrations 2. Segmentations
1. Haustrations
110
What increases the gastrointestinal transit time? Final 2015 1. Haustrations 2. Segmentation 3. Propulsion 4. Reverse peristalsis
4. Reverse peristalsis
111
The segmental contractions (haustrations) in the descending colon are more intense than those in the ascending colon, while the sigmoid colon showed the weakest segmental contractions of these. What is the reason? 2012, 2011, 2010, Final 2009, 2008
Increased transit time between the ascending and descending colon
112
What ion is maintained at 25 mM in colon by transporters? 2010
K+
113
A healthy person made a BaSO4 GI motility test and showed reverse peristalsis in one section, which part of the GI is this? 2017, 2016, Final 2015, 2011, 2010, Final 2009, 2008 1. Colon 2. Stomach 3. Esophagus 4. Small intestine
1. Colon
114
What part of the gastrointestinal tract has the lowest intensity of segmental contractions in normal colonic and rectal motility? 2016, 2009 1. Transverse colon 2. Descending colon 3. Upper rectum 4. Lower rectum
4. Lower rectum
115
Distension of the rectum by the fecal matter induces contraction of the rectum. This is followed by relaxation of the internal anal sphincter. If defecation is desired, the rectum will relax. What reflex is responsible for that? 2016 1. Clonorectal 2. Anorectal 3. Rectorectal 4. Rectosphinctric
2. Anorectal
116
Distension of the rectum by the fecal matter induces contraction of the rectum. This is followed by relaxation of the internal anal sphincter and contraction of the external anal sphincter. Which of the following happens next to maintain continence? 2015, Final 2013 1. Contraction of the rectum 2. Relaxation of the rectum
2. Relaxation of the rectum
117
After passive and active increase in pressure inside the rectum, the internal anal sphincter relaxes. What happens next if one doesn’t want to defecate and the external anal sphincter remained contracted? 2014
Relaxation of rectum
118
Which part of the GI tract has a functional sphincter preventing fecal matter from passing from the colon? 2014
Rectum
119
As fecal material is being emptied into the rectum, passive pressure of the rectum will increase up to a threshold then the recto-rectal reflex will start. What will happen next? 2013 1. Contraction of rectum 2. Relaxation of rectum 3. Contraction of internal anal sphincter 4. Relaxation of external anal sphincter
1. Contraction of rectum
120
Which part of the gastrointestinal tract is characterized by the presence of a weak functional sphincter and sharp angulation? Final 2012, Final 2011
Rectum
121
Inhibition of which of the following causes contraction of external anal sphincter? 2009
Auerbach’s plexus
122
What would occur if the external rectal sphincter relaxes? 2008 1. Contraction of rectum 2. Rectocolonic reflex 3. Further relaxation of internal anal sphincter
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