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  • Question 1 - There is normally an inverse relationship between the hepatic artery and portal venous...

    Correct

    • There is normally an inverse relationship between the hepatic artery and portal venous blood flow. This is maintained by:

      Your Answer: All of the options are correct

      Explanation:

      There is an inverse relationship between the blood flow of the hepatic artery and portal vein. It is maintained by several factors such as chemicals like adenosine, neurohumoral substances, the morphology of the hepatic portal system (especially the ability of hepatic sinusoids to collapse) and myogenic control which causes vasoconstriction or vasodilation.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      12.1
      Seconds
  • Question 2 - During the gastric phase, the acid secretion process is stimulated in the G...

    Correct

    • During the gastric phase, the acid secretion process is stimulated in the G cells by?

      Your Answer: Vagal stimulation, distention of the stomach wall, oligopeptides in the stomach

      Explanation:

      Before the meal enters into the stomach, the amount of secretion is limited. Swallowing of a food bolus triggers the release of gastrin. Once in the stomach, the meal physically distends the stomach activating the stretch receptors and initiating the vago vagal reflex amplifying the secretion during the gastric phase.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      8.2
      Seconds
  • Question 3 - The parasympathetic innervation of the parotid salivary gland arrives from the salivary nuclei:...

    Incorrect

    • The parasympathetic innervation of the parotid salivary gland arrives from the salivary nuclei:

      Your Answer: CN XI

      Correct Answer: CN IX

      Explanation:

      Parasympathetic presynaptic nerve fibers from the glossopharyngeal nerve (CN IX) synapse in the otic ganglion and the postsynaptic parasympathetic nerve fibers pass to the parotid gland via the auriculotemporal nerve.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      6.6
      Seconds
  • Question 4 - The ATPase of parietal cells moves: ...

    Incorrect

    • The ATPase of parietal cells moves:

      Your Answer: H+ from the gastric lumen in exchange for a K+

      Correct Answer: H+ into the gastric lumen in exchange for a k+

      Explanation:

      ATPase of the parietal cell is also known as the proton pump, which moves H+ ions into the gastric lumen in exchange for K+ ions into the cell.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      12.1
      Seconds
  • Question 5 - Which enzyme facilitates the function of pancreatic lipase by increasing exposure of its...

    Correct

    • Which enzyme facilitates the function of pancreatic lipase by increasing exposure of its active site?

      Your Answer: Colipase

      Explanation:

      Colipase is a co enzyme that optimize the activity of lipase by facilitating the exposure of its active sites.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      11.2
      Seconds
  • Question 6 - The pressure in the sinusoids is normally: ...

    Correct

    • The pressure in the sinusoids is normally:

      Your Answer: Lower than portal venous pressure

      Explanation:

      The direction of transport of nutrients in the portal vein occurs from the portal vein to the hepatic sinusoids. Thus, he pressure of sinusoids should be lower than the pressure of he portal vein.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      3.9
      Seconds
  • Question 7 - HCL is secreted by which cells in the stomach ...

    Correct

    • HCL is secreted by which cells in the stomach

      Your Answer: Parietal cells

      Explanation:

      Parietal cells are the epithelial cells that secrete hydrochloric acid (HCl) and intrinsic factor. These cells are located in the gastric glands found in the lining of the fundus and in the body of the stomach.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      2.8
      Seconds
  • Question 8 - In addition to its role in digestion and absorption of fats, bile: ...

    Correct

    • In addition to its role in digestion and absorption of fats, bile:

      Your Answer: Is the major excretory route for lipid-soluble waste products

      Explanation:

      The end product of haem metabolism is bilirubin and jaundice is caused by increased bilirubin levels in the blood. Gallstones are mainly caused by cholesterol and bile pigments. Bile is the main route of excretion for lipid soluble waste products whereas urine is the main route of excretion of water soluble waste products.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      12.1
      Seconds
  • Question 9 - Two types of gallstones are: ...

    Correct

    • Two types of gallstones are:

      Your Answer: Calcium and cholesterol

      Explanation:

      Cholesterol stones are the most common gallstones followed by calcium carbonate and bilirubinate.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      1.7
      Seconds
  • Question 10 - The enzyme located on the brush border of the small intestine activating the...

    Correct

    • The enzyme located on the brush border of the small intestine activating the proteolytic enzymes for further digestion of proteins is called?

      Your Answer: Enterokinase

      Explanation:

      Enterokinase is a brush border enzyme of the duodenum that activates proteolytic enzymes for further digestion of proteins. Trypsinogen is converted to trypsin by the action of enterokinase. Trypsin and chymotrypsin are secreted by the pancreatic acinar cells and are enzymes that aid in protein digestion. Pepsin is secreted by chief cells of the gastric mucosa. Procarboxydase is the inactive form of carboxypeptidase which is converted to its active form by trypsin and is secreted by pancreatic acinar cells.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      5.1
      Seconds
  • Question 11 - Portal vein receives its blood from all the following except: ...

    Correct

    • Portal vein receives its blood from all the following except:

      Your Answer: Kidney

      Explanation:

      The portal vein receives blood from the intestines via the superior and inferior mesenteric veins, from stomach via the gastric veins and from the spleen and pancreas via splenic vein. The kidney is supplied by the renal artery and drains into the renal vein into the inferior venacava.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      2.9
      Seconds
  • Question 12 - Which of the following prevents auto-digestion of the stomach by gastric secretions: ...

    Correct

    • Which of the following prevents auto-digestion of the stomach by gastric secretions:

      Your Answer: Trefoil peptides and mucus- bicarbonate layer.

      Explanation:

      Pepsinogen is the inactive form of pepsin, a protein digesting enzyme. Bombesin is a peptide which stimulates gastrin secreting cells in the stomach increasing production of gastric acid. Ecl or enterochromaffin cells are neuroendocrine cells that aid in the production of gastric acid via the release of histamine. Oxyntic cells are also known as parietal cells and are the main cells secreting gastric hydrochloric acid (HCl). Gastric acid and pepsin are harmful agents for the gastric mucosa and can result in autodigestion. It is therefore protected by several agents including bicarbonate which neutralizes the acidity of gastric acid while Trefoil peptides are a component of gastric mucosa that form a gel like layer in the gastric epithelium protecting it from harmful agents.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      7.6
      Seconds
  • Question 13 - How are the long chain fatty acids (more than 10 to 12 carbon...

    Correct

    • How are the long chain fatty acids (more than 10 to 12 carbon atoms) absorbed?

      Your Answer: Re-esterified to triglycerides and enter the lymphatics as chylomicrons

      Explanation:

      Short and medium chain fatty acids are absorbed into the blood via intestinal capillaries and travel through the portal vein. Long chain fatty acids are not directly released into the intestinal capillaries. They are re-esterified to triglycerides and are coated with cholesterol and protein, forming chylomicrons. Chylomicrons are released in the lymphatic system.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      24.8
      Seconds
  • Question 14 - What is the primary problem of achalasia ...

    Correct

    • What is the primary problem of achalasia

      Your Answer: Deficiency of myenteric plexus at the lower oesophageal sphincter

      Explanation:

      Oesophageal achalasia is an oesophageal motility disorder involving the smooth muscle layer of the oesophagus is characterized by the failure of the lower oesophageal sphincter (LES) relaxation and aperistalsis, caused primarily by the loss of the inhibitory innervation of the oesophageal myenteric plexus.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      14.3
      Seconds
  • Question 15 - Protein digestion starts in the stomach by which enzyme? ...

    Correct

    • Protein digestion starts in the stomach by which enzyme?

      Your Answer: Pepsin

      Explanation:

      Pepsinogen is the inactive form of pepsin which is secreted by gastric chief cells and is converted to pepsin, in the presence of gastric HCL. Pepsin is a peptidase that breaks down proteins into smaller peptides.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      19.7
      Seconds
  • Question 16 - At rest, proton pumps are sequestered within the parietal cell in a series...

    Correct

    • At rest, proton pumps are sequestered within the parietal cell in a series of membrane compartments known as:

      Your Answer: Tubulovesicles

      Explanation:

      The gastric H, K-ATPase pump, which pumps gastric acid (HCl), in the resting state is found in cytoplasmic tubular membranes. In the stimulated state this pump moves from the tubulovesicles to the apical membrane.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      10.2
      Seconds
  • Question 17 - Gastrin activates all of the following cells except: ...

    Incorrect

    • Gastrin activates all of the following cells except:

      Your Answer: Enterochromaffin- like cells

      Correct Answer: Mucus neck cells

      Explanation:

      The G cell is a type of cell in the stomach and duodenum that secretes gastrin. It works in conjunction with gastric chief cells and parietal cells. G cells are found deep within the pyloric glands of the stomach antrum, and occasionally in the pancreas and duodenum. Gastrin-releasing peptide, as well as the presence of amino acids in the stomach, stimulates the release of gastrin from the G cells. Gastrin stimulates enterochromaffin-like cells to secrete histamine. Gastrin also targets parietal cells by increasing the amount of histamine and the direct stimulation by gastrin, causing the parietal cells to increase HCl secretion in the stomach.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      12.7
      Seconds
  • Question 18 - Di and tri peptides are absorbed via a different mechanism as amino acids,...

    Correct

    • Di and tri peptides are absorbed via a different mechanism as amino acids, this is due to the working of which transporter?

      Your Answer: PEPT 1

      Explanation:

      GLUT and SGLT are glucose transporters. Peptides which are longer that four amino acids are not absorbed. There is abundant absorption of di and tri peptidases in the small intestine. They are absorbed into the epithelial cells of the small intestine via a transporter called PepT1 by co-transport with H+ ions.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      15.3
      Seconds
  • Question 19 - Which of the following is the most common route of hepatitis B transmission...

    Correct

    • Which of the following is the most common route of hepatitis B transmission worldwide?

      Your Answer: Perinatal transmission

      Explanation:

      The virus is transmitted by exposure to infectious blood or body fluids. Infection around the time of birth or from contact with other people’s blood during childhood is the most frequent method by which hepatitis B is acquired in areas where the disease is common. In areas where the disease is rare, intravenous drug use and sexual intercourse are the most frequent routes of infection. Perinatal transmission is the most common and without intervention, a mother who is positive for HBsAg has a 20% risk of passing the infection to her offspring at the time of birth. This risk is as high as 90% if the mother is also positive for HBeAg.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      5.2
      Seconds
  • Question 20 - Normally the portal venous pressure is about: ...

    Incorrect

    • Normally the portal venous pressure is about:

      Your Answer: 15mmhg

      Correct Answer: 5mmhg

      Explanation:

      Under normal physiological conditions, the pressure in the portal vein, which carries blood from the gastrointestinal tract and spleen to the liver, typically ranges around 5-10 mmHg. Pressures significantly higher than this range can indicate portal hypertension, which can be associated with liver diseases such as cirrhosis.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      3.8
      Seconds
  • Question 21 - Which of the following provides the sympathetic nervous supply to the stomach? ...

    Correct

    • Which of the following provides the sympathetic nervous supply to the stomach?

      Your Answer: Coeliac plexus

      Explanation:

      Parasympathetic innervation to the stomach is from the vagus nerve and the sympathetic innervation is from the coeliac plexus.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      3.6
      Seconds
  • Question 22 - The lamina propria contains all of the following except: ...

    Correct

    • The lamina propria contains all of the following except:

      Your Answer: Neutrophils

      Explanation:

      The connective tissue of the lamina propria is very loose, allowing it to be very cell rich. The cell population of the lamina propria is variable and can include, for example, fibroblasts, lymphocytes, plasma cells, macrophages, eosinophilic leukocytes, and mast cells. It provides support and nutrition to the epithelium, as well as the means to bind to the underlying tissue.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      3.6
      Seconds
  • Question 23 - Which of the following is NOT a component of bile? ...

    Incorrect

    • Which of the following is NOT a component of bile?

      Your Answer: Cholesterol

      Correct Answer: Unconjugated bilirubin

      Explanation:

      The composition of gallbladder bile is 97% water, 0.7% bile salts, 0.2% bilirubin, 0.51% fats (cholesterol, fatty acids and lecithin), and 200 meq/l inorganic salts (electrolytes).

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      10
      Seconds
  • Question 24 - Where is Basic Electrical rhythm initiated ...

    Correct

    • Where is Basic Electrical rhythm initiated

      Your Answer: Interstitial cells of cajal

      Explanation:

      The interstitial cells of Cajal are specialized pacemaker cells located in the wall of the stomach, small intestine, and large intestine. These cells are connected to the smooth muscle via gap junctions and the myenteric plexus. The cell membranes of the pacemaker cells undergo a rhythmic depolarization and repolarization from -65mV to -45mV. This rhythm of depolarization-repolarization of the cell membrane creates a slow wave known as a basic electrical rhythm (BER), and it is transmitted to the smooth muscle cells.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      14.2
      Seconds
  • Question 25 - What is the function of migrating motor complex ...

    Correct

    • What is the function of migrating motor complex

      Your Answer: Clears the gut of luminal contents in preparation of the next meal

      Explanation:

      Migrating motor complexes (MMC) are waves of electrical activity that sweep through the intestines in a regular cycle during fasting. These motor complexes trigger peristaltic waves, which facilitate transportation of indigestible substances such as bone, fiber, and foreign bodies from the stomach, through the small intestine, past the ileocecal sphincter, and into the colon. The MMC occurs every 90–120 minutes during the interdigestive phase (between meals), and is responsible for the rumbling experienced when hungry. It also serves to transport bacteria from the small intestine to the large intestine, and to inhibit the migration of colonic bacteria into the terminal ileum.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      3.7
      Seconds
  • Question 26 - The end product of trehalase action on oligosaccharides is ...

    Correct

    • The end product of trehalase action on oligosaccharides is

      Your Answer: Two glucose molecules

      Explanation:

      Disaccharides are glycoside hydrolases, enzymes that break down certain types of sugars called disaccharides into simpler sugars called monosaccharides.Examples of disaccharides:Lactase (breaks down lactose into glucose and galactose)Maltase (breaks down maltose into 2 glucoses)Sucrase (breaks down sucrose into glucose and fructose)Trehalase (breaks down trehalose into 2 glucoses)

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      4.5
      Seconds
  • Question 27 - Colipase is secreted in an inactive form. Its activation in the intestinal lumen...

    Incorrect

    • Colipase is secreted in an inactive form. Its activation in the intestinal lumen is by

      Your Answer: Bile salt-activated lipase

      Correct Answer: Trypsin

      Explanation:

      The enzyme trypsin exists in pancreatic juice in the inactive form trypsinogen, it is activated by the intestinal enterokinase in intestinal juice. Trypsin can then activate other protease enzymes and catalyse the reaction pro-colipase → colipase. Colipase is necessary, along with bile salts, to enable lipase function.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      25.1
      Seconds
  • Question 28 - Which of the following is a product of D cells ...

    Correct

    • Which of the following is a product of D cells

      Your Answer: Somatostatin

      Explanation:

      Somatostatin is secreted by D cells, HCL and intrinsic factor secreted by parietal cells. Trefoil peptides are secreted by mucus secreting goblet cells and gastrin releasing peptide (grp) by post-ganglionic fibers of the vagus nerve (which innervate the G cells of the stomach).

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      2.1
      Seconds
  • Question 29 - Regarding short-chain fatty acids, all the following are true except: ...

    Incorrect

    • Regarding short-chain fatty acids, all the following are true except:

      Your Answer: They are two-to five-carbon weak acids

      Correct Answer: They are produced in the small intestine but their absorption occurs in the colon

      Explanation:

      Short chain fatty acids (SCFAs) have carbon chains of 2-5 carbon atoms. They are produced in the large intestine and are also absorbed there. They exert a trophic effect on the colonic epithelial layer in absorption of sodium. In the absence of short chain fatty acids there is a loss of sodium and water. Transport of SCFA is coupled with sodium thus absorption leads to the accumulation in the lumen of HCO3, a rise in pH, fall in pCO2 and stimulation of Na+ and water transport. The effect on Na+ transport is thought to indicate the presence of a Na+/H+ exchange in the cell membrane.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      31.1
      Seconds
  • Question 30 - Which three parietal cell agonists bind at the basolateral membrane at specific receptors...

    Incorrect

    • Which three parietal cell agonists bind at the basolateral membrane at specific receptors respectively: M3 , H2 , CCK-B, to stimulate acid secretion?

      Your Answer: Histamine, acetylcholine, gastrin

      Correct Answer: Acetylcholine, histamine , gastrin

      Explanation:

      The three agonists of parietal cell secretion are gastrin, acetylcholine and histamine. Parietal cells are responsible for the secretion of HCl and intrinsic factor.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      30.7
      Seconds
  • Question 31 - The oesophagus is lined by ...

    Correct

    • The oesophagus is lined by

      Your Answer: Stratified squamous epithelium

      Explanation:

      The wall of the oesophagus from the lumen outwards consists of mucosa, submucosa (connective tissue), layers of muscle fibers between layers of fibrous tissue, and an outer layer of connective tissue. The mucosa is a stratified squamous epithelium of around three layers of squamous cells, which contrasts to the single layer of columnar cells of the stomach. The transition between these two types of epithelium is visible as a zig-zag line. Most of the muscle is smooth muscle although striated muscle predominates in its upper two thirds.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      5
      Seconds
  • Question 32 - Which of the following is not secreted by cells in the antrum of...

    Incorrect

    • Which of the following is not secreted by cells in the antrum of the stomach?

      Your Answer: Somatostatin

      Correct Answer: Hydrochloric acid

      Explanation:

      Cells in the body of the stomach secrete mucus, HCl and pepsinogen. Cells in the antrum secrete pepsinogen, gastrin and mucus.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      19.9
      Seconds
  • Question 33 - Cholecystokinin causes the pancreas to ...

    Correct

    • Cholecystokinin causes the pancreas to

      Your Answer: Produce pancreatic juice rich in enzymes

      Explanation:

      Cholecystokinin (CCK) mediates digestion in the small intestine by inhibiting gastric emptying and decreasing gastric acid secretion. It stimulates the acinar cells of the pancreas to release a juice rich in pancreatic digestive enzymes, hence the old name pancreozymin. Together these enzymes catalyse the digestion of fat, protein, and carbohydrates.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      9.9
      Seconds
  • Question 34 - Intrinsic Factor is released by, ...

    Incorrect

    • Intrinsic Factor is released by,

      Your Answer: Mucus neck cells

      Correct Answer: Parietal cell

      Explanation:

      Intrinsic factor (IF), also known as gastric intrinsic factor (GIF), is a glycoprotein produced by the parietal cells of the stomach. It is necessary for the absorption of vitamin B12 (cobalamin) later on in the small intestine.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      9
      Seconds
  • Question 35 - Which intestinal cells play a major role in secretory immunity? ...

    Correct

    • Which intestinal cells play a major role in secretory immunity?

      Your Answer: M cells

      Explanation:

      M cells are specialized epithelial cells of the MALT or mucosa-associated lymphoid tissues. They transport antigens from the intestinal lumen to cells of the immune system, thereby initiating an immune response. T and B cells are lymphocytes found in blood. Mucous cells secrete mucous and can be considered as a part of innate immunity. Chief cells in the gastric mucosa secret pepsin.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      9.8
      Seconds
  • Question 36 - Carbohydrates digestion starts in the ...

    Correct

    • Carbohydrates digestion starts in the

      Your Answer: Mouth

      Explanation:

      Digestion begins in the mouth with the secretion of saliva and its digestive enzymes. Food is formed into a bolus by the mechanical mastication and swallowed into the oesophagus from where it enters the stomach through the action of peristalsis.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      7.1
      Seconds
  • Question 37 - Anti-gastroesophageal reflux mechanisms include the following except: ...

    Correct

    • Anti-gastroesophageal reflux mechanisms include the following except:

      Your Answer: Peristaltic movements of the oesophagus

      Explanation:

      The lower oesophageal sphincter contracts preventing reflux of acid into the oesophagus. The sling muscles of the stomach, the crura of the diaphragm and the phreno-oesophageal ligament all play an important role in constricting the lower portion of the oesophagus and preventing reflux. Peristaltic movements do not stop the acid reflux.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      20.6
      Seconds
  • Question 38 - Somatostatin is responsible for? ...

    Correct

    • Somatostatin is responsible for?

      Your Answer: Decreased gastrin release

      Explanation:

      Somatostatin is an inhibitory hormone secreted from the D cells of the Pancreatic Islets. It causes the inhibition of gastrin (decreasing stomach acid production), CCK (decreasing gallbladder motility), gastrin inhibitory peptide and secretin. Gastrin production is also inhibited by secretin, GIP, VIP, glucagon and calcitonin.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      8.1
      Seconds
  • Question 39 - Which inhibitor of gastric enzyme secretion is released by the presence of fat...

    Correct

    • Which inhibitor of gastric enzyme secretion is released by the presence of fat in the jejunum?

      Your Answer: Peptide yy

      Explanation:

      Peptide yy is secreted from the jejunum due to the presence of fat. It inhibits gastric acid secretion and motility.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      11.8
      Seconds
  • Question 40 - A patient with achalasia ...

    Correct

    • A patient with achalasia

      Your Answer: Has decreased production of vasoactive intestinal polypeptide (VIP)

      Explanation:

      Oesophageal achalasia is an oesophageal motility disorder involving the smooth muscle layer of the oesophagus and the lower oesophageal sphincter (LES). It is characterized by incomplete LES relaxation, increased LES tone, and lack of peristalsis of the oesophagus (inability of smooth muscle to move food down the oesophagus) in the absence of other explanations like cancer or fibrosis. In achalasia, there is loss of nitric oxide (NO) and vasoactive intestinal polypeptide (VIP) releasing inhibitory neurons.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      7.9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Gastrointestinal (30/40) 75%
Medicine (30/40) 75%
Passmed