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  • Question 1 - 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
      15.8
      Seconds

  • Question 2 - Interruption of the entero-hepatic circulation causes: ...

    Incorrect

    • Interruption of the entero-hepatic circulation causes:

      Your Answer: Formation of gallstones due to stasis

      Correct Answer: The amount of fat in the stool to be increased

      Explanation:

      Enterohepatic circulation refers to the circulation of biliary acids, bilirubin, drugs, or other substances from the liver to the bile, followed by entry into the small intestine, absorption by the enterocyte and transport back to the liver. One of the causes of the interruption of enterohepatic circulation is the resection of the ileum where fat is mainly absorbed. Fat malabsorption results in increased fat in stools. Pale stools and dark urine is caused by obstruction of the biliary ductal system especially the common bile duct where urobilin and stercobilin are formed.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      23.7
      Seconds

  • Question 3 - Where in the gastrointestinal tract are Brunner glands? ...

    Incorrect

    • Where in the gastrointestinal tract are Brunner glands?

      Your Answer: Jejunum

      Correct Answer: Duodenum

      Explanation:

      Brunner’s glands (or duodenal glands) are compound tubular submucosal glands found in that portion of the duodenum which is above the hepatopancreatic sphincter (aka sphincter of Oddi). The main function of these glands is to produce a mucus-rich alkaline secretion (containing bicarbonate) in order to:- protect the duodenum from the acidic content of chyme (which is introduced into the duodenum from the stomach);- provide an alkaline condition for the intestinal enzymes to be active, thus enabling absorption to take place; lubricate the intestinal walls.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      10.5
      Seconds

  • Question 4 - A patient with achalasia ...

    Incorrect

    • A patient with achalasia

      Your Answer: Has failure of the lower oesophageal sphincter to contract.

      Correct 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
      60.7
      Seconds

  • Question 5 - The infoldings or spaces between the bases of the villi are known as...

    Incorrect

    • The infoldings or spaces between the bases of the villi are known as

      Your Answer: Intestinal pits

      Correct Answer: Crypts of Lieberkühn

      Explanation:

      An intestinal gland (also crypt of Lieberkühn and intestinal crypt) is a gland found in the intestinal epithelium lining of the small intestine and large intestine (colon) between the villi.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      21.1
      Seconds

  • Question 6 - Where does protein digestion begin? ...

    Incorrect

    • Where does protein digestion begin?

      Your Answer: Duodenum

      Correct Answer: Stomach

      Explanation:

      Digestion typically begins in the stomach when pepsinogen is converted to pepsin by the action of hydrochloric acid, and continued by trypsin and chymotrypsin in the small intestine.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      6.1
      Seconds

  • Question 7 - The oligosaccharidases responsible for further digestion of starch after breakdown by the above...

    Incorrect

    • The oligosaccharidases responsible for further digestion of starch after breakdown by the above mentioned enzymes is located where?

      Your Answer: Gastric folds and secretions

      Correct Answer: Brush border of small intestine

      Explanation:

      The final step in digestion of carbohydrates, which is conversion of disaccharides to absorbable monosaccharides occurs on the small intestinal epithelial cells. The enzymes responsible for this final stage of digestion are not freely found in the intestinal lumen, but they are found as integral membrane proteins in the plasma membrane of the epithelial cell. The apical plasma membrane of the intestinal epithelial cell has numerous microvilli known as the brush border. Thus, the enzymes embedded in those microvilli are referred to as brush border enzymes.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      22.3
      Seconds

  • Question 8 - VIP, GIP and somatostatin play an inhibitory role in gastric acid secretion by...

    Incorrect

    • VIP, GIP and somatostatin play an inhibitory role in gastric acid secretion by inactivating?

      Your Answer: Chief cells

      Correct Answer: G cells

      Explanation:

      Gastrin is secreted from the G cells. VIP, GIP and somatostatin all inhibit acid production by inhibiting the G cells.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      6.2
      Seconds

  • Question 9 - 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
      11.3
      Seconds

  • Question 10 - The transport of the di- and tri-peptides into enterocytes is by: ...

    Correct

    • The transport of the di- and tri-peptides into enterocytes is by:

      Your Answer: H+ dependent peptide transporter 1

      Explanation:

      Peptides 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 cell of the small intestine via a transporter called Peptide Transporter 1 by co transport with H+ ions.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      9.3
      Seconds

  • Question 11 - Pepsinogens are inactive pepsin precursors which are activated by ...

    Correct

    • Pepsinogens are inactive pepsin precursors which are activated by

      Your Answer: Gastric acid

      Explanation:

      Pepsinogen is converted to pepsin by the action of hydrochloric acid i.e. gastric acid

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      11.8
      Seconds

  • Question 12 - All of the following constitute small intestinal brush border enzymes except: ...

    Incorrect

    • All of the following constitute small intestinal brush border enzymes except:

      Your Answer: Maltase

      Correct Answer: Alpha-amylase

      Explanation:

      The final step in digestion of carbohydrates, which is conversion of disaccharides to absorbable monosaccharides occurs on the small intestinal epithelial cells. The enzymes responsible for this final stage of digestion are not freely found in the intestinal lumen, but they are found as integral membrane proteins in the plasma membrane of the epithelial cell. The apical plasma membrane of the intestinal epithelial cell has numerous microvilli which extend from the cell known as the brush border. Thus, the enzymes embedded in those microvilli are referred to as brush border enzymes. All these enzymes except alfa amylase are brush border enzymes. Alfa amylase is secreted by pancreatic acinar cells.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      33.7
      Seconds

  • Question 13 - The central veins in the liver: ...

    Incorrect

    • The central veins in the liver:

      Your Answer: None of the options are correct

      Correct Answer: Coalesce to form the hepatic vein

      Explanation:

      The central veins coalesce to form the hepatic vein which in turn drains into the inferior vena cava. The portal vein mainly carries blood from different parts of the GIT and is not drained to the inferior vena cava.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      19.3
      Seconds

  • Question 14 - In paralytic ileus the following are true except: ...

    Correct

    • In paralytic ileus the following are true except:

      Your Answer: Opioid blocking drugs will exacerbate the symptoms

      Explanation:

      Paralytic ileus causes adynamic intestinal obstruction or decreased peristalsis and the most common reason being postoperative ileus. Opioid drugs like morphine are given for pain management and cause decreased peristalsis in the gut resulting in constipation. Theoretically opioid blocking drugs or opioid antagonists can increase peristalsis and can alleviate paralytic ileus symptoms.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      14.6
      Seconds

  • Question 15 - Gastrin activates all of the following cells except: ...

    Incorrect

    • Gastrin activates all of the following cells except:

      Your Answer: Stomach smooth muscle

      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
      11.7
      Seconds

  • Question 16 - What percentage of blood to the liver is supplied by hepatic artery? ...

    Incorrect

    • What percentage of blood to the liver is supplied by hepatic artery?

      Your Answer: 50%

      Correct Answer: 25%

      Explanation:

      The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries. The hepatic portal vein delivers approximately 75% of the liver’s blood supply, and carries venous blood drained from the spleen, gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remaining quarter of its blood flow.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      6.8
      Seconds

  • Question 17 - Which substance is produced by anterograde neurons? ...

    Incorrect

    • Which substance is produced by anterograde neurons?

      Your Answer: Serotonin

      Correct Answer: Nitric oxide

      Explanation:

      Nitric oxide is thought to act as an anterograde neurotransmitter. Classically in the peripheral nervous system, it diffuses from a presynaptic nerve ending to the post synaptic effecter cell which is mainly smooth muscle cells in the gastrointestinal, respiratory and urogenital tracts.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      13.4
      Seconds

  • Question 18 - The channel that coalesces the small pancreatic duct radicles before joining the common...

    Incorrect

    • The channel that coalesces the small pancreatic duct radicles before joining the common bile duct is known as the:

      Your Answer: Duct of Vater

      Correct Answer: Duct of Wirsung

      Explanation:

      The small ducts from the pancreas coalesce into a single duct known as the pancreatic duct or the duct of Wirsung. It usually joins the bile duct at the ampulla of Vater before entering the duodenum.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      9.9
      Seconds

  • Question 19 - The parietal cells of the stomach secrete which of the following? ...

    Incorrect

    • The parietal cells of the stomach secrete which of the following?

      Your Answer: Acetylcholine

      Correct Answer: Hydrochloric acid

      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
      8.3
      Seconds

  • Question 20 - 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
      14.3
      Seconds

  • Question 21 - H+ ions used in the production of acid by parietal cells is produced...

    Incorrect

    • H+ ions used in the production of acid by parietal cells is produced with the help of which enzyme?

      Your Answer: Pepsinogen

      Correct Answer: Carbonic anhydrase ii

      Explanation:

      Carbonic anhydrase enzyme catalyses the rapid interconversion of carbon dioxide and water to bicarbonate and protons (or vice versa). This is a reversible reaction that takes place in the gastric parietal cells.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      8
      Seconds

  • Question 22 - Which of the following is not secreted by cells in the antrum of...

    Correct

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

      Your 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
      17.6
      Seconds

  • Question 23 - Somatostatin is responsible for? ...

    Incorrect

    • Somatostatin is responsible for?

      Your Answer: Decreased fluid reabsorption

      Correct 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
      3.1
      Seconds

  • Question 24 - Which of the following happens when anterograde neurons are stimulated? ...

    Correct

    • Which of the following happens when anterograde neurons are stimulated?

      Your Answer: Smooth muscle relaxation ahead of the stimulus

      Explanation:

      Nitric oxide is thought to act as an anterograde neurotransmitter. Nitric oxide causes relaxation of smooth muscles ahead of the stimulus. Clinically it is used as a potent vasodilator.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      7.2
      Seconds

  • Question 25 - Where in the course of the gastrointestinal tract does the first significant digestion...

    Correct

    • Where in the course of the gastrointestinal tract does the first significant digestion of fat begin in a normal human being?

      Your Answer: Duodenum

      Explanation:

      The enzyme lipase which is responsible for digestion of fat is secreted by the exocrine pancreas in the 2nd part of the duodenum at the point where the pancreatic duct opens. It opens together with the common bile duct which contains bile that emulsify fat aiding in digestion. The oesophagus, stomach and mouth do not contain enzymes related to fat digestion.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      8.3
      Seconds

  • Question 26 - In Hirschsprung disease which one is incorrect ...

    Incorrect

    • In Hirschsprung disease which one is incorrect

      Your Answer:

      Correct Answer: Due to congenital absence of myenteric and submucosal plexuses

      Explanation:

      During normal prenatal development, cells from the neural crest migrate into the large intestine (colon) to form the networks of nerves called the myenteric plexus (Auerbach plexus) (between the smooth muscle layers of the gastrointestinal tract wall) and the submucosal plexus (Meissner plexus) (within the submucosa of the gastrointestinal tract wall). In Hirschsprung’s disease, the migration is not complete and part of the colon lacks these nerve bodies that regulate the activity of the colon. The affected segment of the colon cannot relax and pass stool through the colon, creating an obstruction.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 27 - Pancreatic juice is usually? ...

    Incorrect

    • Pancreatic juice is usually?

      Your Answer:

      Correct Answer: Alkaline

      Explanation:

      Pancreatic juice is alkaline in nature and has a high amount of bicarbonate ions. About 1500 ml is secreted every day. It also contains a large quantity of enzymes in the inactive form.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 28 - Which of the following is true with regard to the acini? ...

    Incorrect

    • Which of the following is true with regard to the acini?

      Your Answer:

      Correct Answer: The central zone (Zone III) is the least oxygenated

      Explanation:

      The acini are divided into zone I (periportal), zone II (transition zone), and zone III (pericentral). Cells located close to the portal triad or peripheral zone which consist of an arteriole from the hepatic artery are the most oxygenated cells. Cells in the central zone (III) are least oxygenated and mainly receive blood supply from the central vein which is a branch of hepatic vein.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 29 - Which of the following substances inhibits pancreatic secretion? ...

    Incorrect

    • Which of the following substances inhibits pancreatic secretion?

      Your Answer:

      Correct Answer: Pancreatic polypeptide

      Explanation:

      Number of hormones and neurotransmitters can stimulate and inhibit pancreatic exocrine secretion. Cholecystokinin, secretin, vasoactive intestinal peptide and substance P stimulate pancreatic secretion. Pancreatic polypeptide, somatostatin inhibit pancreatic secretion.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 30 - The following are synthesized in the liver EXCEPT? ...

    Incorrect

    • The following are synthesized in the liver EXCEPT?

      Your Answer:

      Correct Answer: Cholecystokinin

      Explanation:

      The liver is responsible for the mainstay of protein metabolism, synthesis as well as degradation. It is also responsible for a large part of amino acid synthesis. The liver plays a role in the production of clotting factors as well as red blood cell production. Some of the proteins synthesized by the liver include coagulation factors I (fibrinogen), II (prothrombin), V, VII, VIII, IX, X, XI, XIII, as well as protein C, protein S and antithrombin. The liver is a major site of production for thrombopoietin, a glycoprotein hormone that regulates the production of platelets by the bone marrow. The liver also produces albumin, the most abundant protein in blood serum and angiotensinogen. Cholecystokinin, previously called pancreozymin, is synthesized and secreted by enteroendocrine cells in the duodenum

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Gastrointestinal (7/25) 28%
Medicine (7/25) 28%
Passmed
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