Practice Questions

Question 1

Vertebral levels:
Subcostal
Transpyloric
Transtubercular
Transumbilical

Answer 1

L3
L1
L5
L3-4

Question 2

2 ligaments important for femoral hernias?

Answer 2

Lacunar and pectineal

Question 3

Main landmark for inguinal hernia repair?

Answer 3

Conjoint tendon

Question 4

Main sensory
Xiphoid
Umbilicus
Inguinal fold

Answer 4

T7
T10
L1

Question 5

2 recesses with clinical significance in relation to liver?

Answer 5

Subphrenic and hepatorenal

Question 6

Borders of omental foramen?

Answer 6

Ant - hepatoduodenal l
Post - IVC, R crus of diaphragm
Sup - liver
Inf - 1st part of duodenum

Question 7

What does cremaster m come from

Answer 7

Internal oblique

Question 8

Round l is remnant of

Answer 8

Gubernaculum

Question 9

Male structure that is remnant of paramesonephric duct?

Answer 9

Appendix of testes

Question 10

Cremaster reflex

Answer 10

Stroke inner thigh, scrotum up

L1

Question 11

Vertebral levels of unpaired
Celiac
SMA
IMA
Median sacral

Answer 11

T12-L1
L1
L3
L4

Question 12

Para associated with visceral_____

Answer 12

Stretch

Question 13

Symp are associated with visceral _______

Answer 13

Pain

Question 14

What makes up portal v

Answer 14

Splenic and sup mes vein

Valveless

Question 15

Blood drains away from portal system if liver blocked in alcoholic

Answer 15

Esophageal varices - bleed out

Can see kaput medusa on belly

Question 16

Side of testes varices more common?

Answer 16

L

90 degree angle

Question 17

Venous drainage of GI goes to?

Answer 17

Portal v

Question 18

Main ways for blood to bypass the liver?

Answer 18

L or R gastric to esphageal branches - esophageal varices
Sup and inf/middle rectal v - hemorrhoids
Paraumbilical v - caput medusae
Colic v to V. of Retzius

Question 19

Major site of lipid digestion?

Answer 19

Intestine

Question 20

What can occur w/o enough bile salts(micelles)

Answer 20

Streatorrhea - tx give medium chain FA that don’t need micelles to get through lumen

Question 21

Makes up a micelle

Answer 21

Bile salts, FA and 2-MG

Question 22

What condition from protein malnutrition?

Answer 22

Kwashiorkor - adequate calorie

Marasmus - deficient calorie

Question 23

Sucrose

Answer 23

Glucose + fructose

Question 24

Lactose

Answer 24

Glu + galactose

Question 25

Maltose

Answer 25

2 glucoses

Question 26

What breaks down carbs to monosaccharides?

Answer 26

Disacharides - alpha-glucosidase Sucrase In small intestine

Question 27

What moves glucose and galactose?

Answer 27

GLUT2

Question 28

What moves fructose

Answer 28

GLUT 5 in | GLUT 2 out of cell

Question 29

What stimulates glucose transport into m and adipose tissue?

Answer 29

Insulin | Through GLUT4

Question 30

Without this have fructose intolerance?

Answer 30

Aldolase B

Question 31

What pancreatic enzyme activates all others?

Answer 31

Trypsin

Question 32

Paneth

Answer 32

Secrete lysozyme

Question 33

Duodenum

Answer 33

Brunner's glands

Question 34

Jejunum

Answer 34

No glands | Plicae circulares

Question 35

Ileum

Answer 35

Peyer's patches

Question 36

What allows hepatocytes to take up nutrients, O2, toxins and release endocrine?

Answer 36

Sinusoids

Question 37

Hepatic v drainage

Answer 37

Hepatic sinusoid --> central v --> sublobular v --> hepatic v --> IVC

Question 38

Main stimulus for HCL production?

Answer 38

Histamine binding to H2 receptor on parietal

Question 39

Inhibitors of HCL

Answer 39

``` Gastrin binding to CCKB receptor D cells (activated by gastrin, CCK) ```

Question 40

Pump in liver and pancreas to get H+ out of cells?

Answer 40

NA+-H+ pump

Question 41

Cephalic phase of pancreatic secretion

Answer 41

Ach | Increase enzyme secretion

Question 42

Gastric phase of pancreatic secretion

Answer 42

Ach + gastrin | Increase enzyme secretion

Question 43

Intestinal phase of pancreatic secretion

Answer 43

CCK and Secretin | Increased bicarb and enzyme secretion

Question 44

Required to cause relaxation of muscles in GI tract?

Answer 44

NO

Question 45

Where gastrin found?

Answer 45

Pyloric glands

Question 46

Gastrin made by?

Answer 46

G cells

Question 47

Gastrin stimulus

Answer 47

Distension - mainly in stomach

Question 48

Gastrin action

Answer 48

Increase acid, pancreatic enzyme secretion and motility

Question 49

What hormone is trophic to the intestines and what is it secreted by?

Answer 49

GLP-2 | L cells

Question 50

What danger during pharyngeal phase? | History of?

Answer 50

Aspiration | Stroke - NTS

Question 51

Why is it imp for LES to remain above atm pressure?

Answer 51

Lets it remain contracted - protects esophageal mucosa

Question 52

What does gastrin cause in SI?

Answer 52

Increased motility

Question 53

What does gastrin cause in LI?

Answer 53

Relaxation of ileocecal valve

Question 54

Damage to ventromedial hypothalamic nuclei results in?

Answer 54

Weight gain | Stops feeling full

Question 55

What causes release of NRY and AGRP?

Answer 55

Ghrelin

Question 56

Release of NRY and AGRP causes

Answer 56

Ghrelin | Feeling of hunger

Question 57

What chemoreceptors used that lead to serotonin release? Cause?

Answer 57

Glucostats | Satiety

Question 58

Role of leptin

Answer 58

Tells body have enough E stores | Causes CART and MSH release --> satiety

Question 59

Why can't signal leptin when have too much adipose?

Answer 59

Transporter protein at arcuate nucleus is down regulated when leptin levels high

Question 60

Where are sympathetic preganglionic cell bodes of each part of gut? Parasymp?

Answer 60

F - T5-9 (Vagus) M - T9-12 (Vagus) H - T12-L2 (Pelvic splanchnic - L2-4)

Question 61

Most common malformation of esophagus?

Answer 61

Esophageal atresia with tracheoesophageal fistula | -TE diverticulum didn't divide correctly

Question 62

At 6 weeks is midgut doing?

Answer 62

Rotating 90 degrees and herniates into umbilical cord | SMA is axis and helps with it

Question 63

Total degrees for rotation?

Answer 63

270

Question 64

Omphalocele

Answer 64

Midgut doesn't come back into cavity

Question 65

Gastroschisis

Answer 65

Failure of abd wall to close

Question 66

Meckel's remnant of?

Answer 66

Vitelline duct

Question 67

Most common malformation in anal canal development?

Answer 67

Anorectal agenesis (below UG diaphragm)

Question 68

Lymphoid follicles in mucosa of stomach?

Answer 68

H pylori present

Question 69

Low serum trypsinogen means?

Answer 69

Chronic pancreatitis

Question 70

How many g of carbs per day needed?

Answer 70

100g

Question 71

Male comes in after blunt trauma to genitals. Suspect urethral tear. Between which layers would you expect to find urine leaking?

Answer 71

Scarpa's (membranous l) and deep fascia of external oblique

Question 72

What position on cholesterol is -OH group?

Answer 72

3C

Question 73

What is rate limiting step in cholesterol synthesis? | Enzyme used?

Answer 73

Acetyl CoA --> mevalonate | HMG CoA Reductase

Question 74

What is cholesterol used for in body?

Answer 74

Bile salts, membranes, steroid hormones

Question 75

Phospholipids mainly used in

Answer 75

Lipid bilayer

Question 76

Where is ammonia detoxified?

Answer 76

Neural tissues | -using glutamate

Question 77

Imp marker for liver/renal function?

Answer 77

BUN - blood urea nitrogen | -kidney dz, liver dz, pregnant, hepatitis

Question 78

Def of what can cause hyperammonemia?

Answer 78

Carbamoyl phosphate or ornithine transcarbomoylase

Question 79

What causes yellow discoloration seen in jaundice?

Answer 79

hyperbilirubinemia (heme breakdown)

Question 80

Type of ALDH in liver cytosol? Mito?

Answer 80

ALDH1 | ALDH2

Question 81

2 main types of pancreatic enzymes?

Answer 81

Endopeptidases | Exopeptidases

Question 82

Endopeptidases

Answer 82

Trypsinogen Chymotrypsinogen Proelastase

Question 83

Exopeptidases

Answer 83

Aminopeptidase | Carboxypeptidase