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Question 1
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 2
Correct
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The cells that secrete pepsinogen and gastric lipase are found in which part of the stomach?
Your Answer: Body and fundus
Explanation:Stomach can be divided in to different regions. Cardia, fundus, body, antrum and pylorus from proximal end to distal end respectively. Cells that secret the inactive form of pepsin or pepsinogen are chief cells and are abundant in the body (corpus) and the fundus region of the stomach.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 3
Correct
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Which of the following proteins are NOT synthesized in the liver?
Your Answer: Steroid
Explanation:Human steroidogenesis occurs in a number of locations:- Corticosteroids are produced in the adrenal cortex.- Oestrogen and progesterone are made primarily in the ovary and the placenta during pregnancy, and testosterone in the testes.- Testosterone is also converted to oestrogen to regulate the supply of each in females and males.- Some neurons and glia in the central nervous system (CNS) express the enzymes required for the local synthesis of pregnant neurosteroids, de novo or from peripheral sources.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 4
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 5
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 6
Correct
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Which substance is produced by anterograde neurons?
Your 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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 7
Incorrect
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Absorption of fructose is via:
Your Answer: Secondary active transport
Correct Answer: Facilitated diffusion
Explanation:Dietary fructose may be ingested as a monosaccharide or as a disaccharide. Sucrose is hydrolysed by sucrase to produce equal amounts of glucose and fructose and in this form, is usually completely absorbed. Fructose is mostly absorbed in the small intestine through GLUT-5 transporter mediated facilitative diffusion. This is an energy independent process.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 8
Correct
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Which hormone results in the production of pancreatic juice rich in enzymes but low in volume?
Your Answer: Cholecystokinin
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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 9
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 10
Correct
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Emulsification of dietary lipids is brought about by
Your Answer: Bile salts
Explanation:Digestion of fats can begin in the mouth where lingual lipase breaks down some short chain lipids into diglycerides. However fats are mainly digested in the small intestine. The presence of fat in the small intestine produces hormones that stimulate the release of pancreatic lipase from the pancreas and bile from the liver which helps in the emulsification of fats for absorption of fatty acids.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 11
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 12
Correct
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Which of the following can trigger parietal cell secretion?
Your Answer: 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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 13
Correct
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Almost all of the protein that appears in the stool is:
Your Answer: Comes from bacteria and cellular debris
Explanation:75% of faecal weight is water. By dry weight 30% of faeces is bacteria,10-20% is fat and 2-3% proteins. Almost all proteins ingested are absorbed in the gut.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 14
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 15
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 16
Correct
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Where does secretin work in the pancreas?
Your Answer: Pancreatic ducts
Explanation:Secretin, a hormone produced by the duodenal S cells in response to the stomach chyme containing high hydrogen atom concentration (high acidity), is released into the blood stream; upon return to the digestive tract, secretion decreases gastric emptying, increases secretion of the pancreatic ductal cells, as well as stimulating pancreatic acinar cells to release their zymogenic juice.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 17
Correct
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Which of the following is responsible for transporting both glucose and fructose into the interstitium?
Your Answer: GLUT 2
Explanation:Absorption of glucose involves transport from the intestinal lumen, across the epithelium and into blood. The transporter that carries glucose and galactose into the enterocyte is the sodium-dependent hexose transporter, known as SGLT1. As the name indicates, this molecule transports both glucose and sodium ions into the cell. Once absorbed into the enterocyte, glucose must be exported from the cell into blood. Sodium is rapidly shuttled out in exchange for potassium by Na+/K+ ATPase pumps on the basolateral membrane, and that process maintains the electrochemical gradient across the epithelium. Glucose, galactose and fructose are transported out of the enterocyte into the interstitium and in turn into the blood through another hexose transporter (called GLUT-2) in the basolateral membrane. These monosaccharides then diffuse down a concentration gradient into capillary blood.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 18
Correct
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Which two ducts form the ampulla of Vater?
Your Answer: The common bile duct and the pancreatic duct of Wirsung
Explanation:The ampulla of Vater, also known as the hepatopancreatic ampulla or the hepatopancreatic duct, is formed by the union of the pancreatic duct and the common bile duct. The ampulla is specifically located at the major duodenal papilla.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 19
Correct
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Vagotomy leads to the following:
Your Answer: Irregular and chaotic peristalsis
Explanation:The Vagus nerve is primarily responsible for autonomic regulation involved in heart, lung and gastrointestinal function. The gastric branches supply the stomach. The right branch joins the celiac plexus and supplies the intestines. Vagotomy involves cutting of the vagus nerve or its branches which is a now-obsolete therapy that was performed for peptic ulcer disease. Vagotomy causes a decrease in peristalsis and a change in the emptying patterns of the stomach.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 20
Correct
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Where does most fat digestion begin?
Your Answer: Duodenum
Explanation:Digestion of some fats can begin in the mouth where lingual lipase breaks down some short chain lipids into diglycerides. However fats are mainly digested in the small intestine (in the duodenum). The presence of fat in the small intestine produces hormones that stimulate the release of pancreatic lipase from the pancreas and bile from the liver which helps in the emulsification of fats for absorption of fatty acids.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 21
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 22
Correct
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Question 23
Correct
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Which of the following is NOT a pancreatic enzyme?
Your Answer: Pepsinogen 1
Explanation:Pancreatic juice, composed of the secretions of both ductal and acinar cells, is made up of the following digestive enzymes:Trypsinogen, which is an inactive(zymogenic) protease that, once activated in the duodenum into trypsin, breaks down proteins at the basic amino acids. Trypsinogen is activated via the duodenal enzyme enterokinase into its active form trypsin.Colipase is a protein co-enzyme required for optimal enzyme activity of pancreatic lipase. It is secreted by the pancreas in an inactive form, procolipase, which is activated in the intestinal lumen by trypsin.Chymotrypsinogen, which is an inactive (zymogenic) protease that, once activated by duodenal enterokinase, breaks down proteins at their aromatic amino acids. Chymotrypsinogen can also be activated by trypsin.Carboxypeptidase, which is a protease that takes off the terminal amino acid group from a proteinSeveral elastases that degrade the protein elastin and some other proteins.Pancreatic lipase that degrades triglycerides into fatty acids and glycerol.Sterol esterasePhospholipaseSeveral nucleases that degrade nucleic acids, like DNase and RNase.Pancreatic amylase that breaks down starch and glycogen which are alpha-linked glucose polymers.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 24
Correct
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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).
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 25
Correct
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Colipase is secreted in an inactive form. Its activation in the intestinal lumen is by
Your 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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 26
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 27
Correct
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Which of the following initiates migrating motor complex
Your Answer: Motilin
Explanation:Migrating motor complexes (MMC) are thought to be partially regulated by motilin, which is initiated in the stomach as a response to vagal stimulation, and does not directly depend on extrinsic nerves.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 28
Correct
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The haustral pattern seen in the normal colon is produced by
Your Answer: Taenia coli
Explanation:The haustra (singular haustrum) of the colon are the small pouches caused by sacculation (sac formation), which give the colon its segmented appearance. The teniae coli run the length of the large intestine. Because the taeniae coli are shorter than the intestine, the colon becomes sacculated between the taeniae coli, forming the haustra.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 29
Correct
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The oligosaccharidases responsible for further digestion of starch after breakdown by the above mentioned enzymes is located where?
Your 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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 30
Correct
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Which of the following substances inhibits pancreatic secretion?
Your 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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 31
Correct
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Cells responsible for completely renewing the epithelium of the intestine are located:
Your Answer: At the base of the crypts
Explanation:Epithelial cells are renewed every 4-5 days through a process of renewal and migration. Renewal relies on proliferative cells or stem cells that reside at the crypt base of the intestinal glands. Crypts are epithelial invasions into the underlying connective tissue.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 32
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 33
Correct
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The pyloric sphincter is largely made up of thickening of
Your Answer: The circular muscle layer
Explanation:The pyloric sphincter, or valve, is a strong ring of smooth muscle (circular muscle layer) at the end of the pyloric canal which lets food pass from the stomach to the duodenum. It controls the outflow of gastric contents into the duodenum. It receives sympathetic innervation from the celiac ganglion.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 34
Correct
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One function of the liver is synthesis and storage of protein. Which of the following will result in hypoalbuminemia?
Your Answer: All of the above
Explanation:Both trauma and sepsis cause an acute inflammatory response causing plasma leakage of albumin. Nephropathy causes leakage of albumin from glomeruli and excretion of albumin in urine known as albuminuria. A hypercatabolic state is characterized by increased circulating catabolic hormones and increase break down of proteins.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 35
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 36
Incorrect
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The intestine is lined by:
Your Answer: Simple squamous epithelium
Correct Answer: Simple columnar epithelium
Explanation:In the small intestine, epithelium is simple columnar and specialised for absorption. The epithelium is arranged into villi, creating a brush border and increasing the area for absorption. The epithelium is simple columnar with microvilli.In the colon, epithelium is simple columnar and without villi. Goblet cells, which secrete mucous, are also present.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 37
Correct
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What is the function of basic electrical rhythm
Your Answer: To coordinate peristalsis and other motor activity
Explanation:The basal or basic electrical rhythm (BER) or electrical control activity (ECA) determines the frequency of the contractions in the gastrointestinal (GI) tract, thus acting to coordinate peristalsis.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 38
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 39
Correct
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Select the correct statement regarding cholecystokinin (CCK):
Your Answer: It causes gallbladder contraction and pancreatic enzyme secretion.
Explanation:CCK has a primary action of increasing the motility of the gallbladder by contracting the muscles in the mucosa of the gall bladder. Apart from this, it augments the action of secretin, resulting in the production of an alkaline pancreatic juice. It increases the synthesis of enterokinase, inhibits gastric emptying and may also enhance the motility of the small intestine and colon. It is released (secreted) by your small intestine during the digestive process. It’s sometimes called pancreozymin.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 40
Correct
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The pressure in the portal circulation is normally adjusted in the:
Your Answer: Sinusoids
Explanation:The pressure in the portal circulation depends on the pressure of the hepatic sinusoids mainly because the direction of transport of nutrients in the portal vein occurs from the portal vein to the hepatic sinusoids.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 41
Correct
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Which of the following statements correctly describes a function of the parasympathetic innervation of the GI tract.
Your Answer: Parasympathetic cholinergic activity increases the activity of intestinal smooth muscle
Explanation:The parasympathetic nerves stimulate peristalsis and relax the sphincters; they also stimulate secretion. Acetylcholine is the neurotransmitter of the parasympathetic system.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 42
Correct
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The cells that secrete HCL are found in which part of the stomach?
Your Answer: Body
Explanation:The stomach can be divided in to different regions. Cardia, fundus, body, antrum and pylorus from proximal end to distal end respectively. Different cell types are distributed accordingly among the regions of the stomach. Cells that secret HCl in the gastric mucosa are known as parietal cells and are abundant in the gastric body region. They have receptors for acetylcholine stimulated via the vagus nerve, histamine receptors and gastrin receptors which stimulate gastric acid secretion. G cells that secret gastrin are abundant in the antrum.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 43
Correct
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Which enzyme is responsible for the formation of the active endopeptidases from their inactive precursors?
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 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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 44
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 45
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 46
Correct
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The blood supply to the greater curvature of the stomach is via the:
Your Answer: Right and left gastro-epiploic arteries
Explanation:The blood supply to the greater curvature of the stomach is via the left and the right gastro-epiploic arteries branching from the splenic artery near the hilum.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 47
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 48
Correct
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Regarding carbohydrates absorption;
Your Answer: Intestinal absorption of sugars is inhibited by the drug phlorizin
Explanation:The main role of insulin is in the uptake of glucose from blood to tissues where it is metabolised. Glycose transporters in the intestines do not depend on the action of insulin. Phlorizin is a competitive inhibitor of SGLT1 and SGLT2 because it competes with glucose for the binding site, reducing intestinal and renal glucose transport.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 49
Correct
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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 50
Correct
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What percentage of blood to the liver is supplied by hepatic artery?
Your 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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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