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Question 1
Correct
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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.
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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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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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 3
Incorrect
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H+ ions used in the production of acid by parietal cells is produced with the help of which enzyme?
Your Answer: Gastrin
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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 4
Incorrect
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Which intestinal cells play a major role in secretory immunity?
Your Answer: Mucous cells
Correct 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 5
Incorrect
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Where does secretin work in the pancreas?
Your Answer: Acinar cells
Correct 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 6
Correct
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G cells release which of the following substances
Your Answer: Gastrin
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.
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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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Which of the following enzymes is mainly responsible for the hydrolysis of polysaccharide 1:6a linkages?
Your Answer: Trehalase
Correct Answer: Isomaltase
Explanation:Isomaltase is mainly responsible for hydrolysis of 1:6α linkages. Along with maltase and sucrase, it also breaks down maltotriose and maltose.
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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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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 9
Incorrect
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The parasympathetic innervation of the parotid salivary gland arrives from the salivary nuclei:
Your Answer: CN VII
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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 10
Incorrect
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Which of the following factors is not completely produced in the liver?
Your Answer: Factor v
Correct Answer: Factor viii
Explanation:Factor VIII is produced in liver sinusoidal cells and endothelial cells outside of the liver throughout the body. This protein circulates in the bloodstream in an inactive form, bound to another molecule called von Willebrand factor, until an injury that damages blood vessels occurs.
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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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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 12
Correct
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Peristalsis is an example of:
Your Answer: Enteric nervous system
Explanation:Peristalsis is a type of contraction where radial symmetrical contraction and relaxation of muscles propagates food in a downward wave through the gut. The enteric nervous system is one of the main divisions of the nervous system and consists of a mesh-like system of neurons that controls the function of the gastrointestinal tract. It has an independent reflex activity. The neurons of this system re collected into two types of ganglia: myenteric (or Auerbach’s) and submucosal (or Meissner’s plexuses). Myenteric plexuses are located between the inner and outer layers of the muscularis externa, while submucosal plexuses are located in the submucosa.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 13
Incorrect
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Which of the following provides the sympathetic nervous supply to the stomach?
Your Answer: Vagus nerve
Correct 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 14
Incorrect
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Absorption of protein antigens i.e. bacterial and viral proteins takes place in the:
Your Answer: Brunner’s glands of the intestine
Correct Answer: Microfold cells (m cells) of the intestine
Explanation:M cells are specialized epithelial cells. They have a high capacity of transcytosis of microorganisms and macromolecules. They rapidly uptake antigens and present them to immune cells associated with the gut. In contrast to absorptive enterocytes, M cells do not exert direct defence mechanisms to antigens and pathogens in the intestinal cavity. Crypts of Lieberkühn are located mainly in the small intestine and large intestine and the main function is to replenish epithelial cells and to secrete intestinal enzymatic juice as well as mucous. Brunner’s glands empty into intestinal glands and their main function is to secrete mucin and to form a protective mucus layer on the duodenal epithelial cells to protect it from acidic chyme coming from the stomach. Islets of Langerhans are located in the pancreas and secrets insulin mainly. Mucosa associated lymphoid tissue plays a role in inducing immune response after presentation of antigens.
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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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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 16
Correct
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The ATPase of parietal cells moves:
Your 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.
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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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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 18
Correct
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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.
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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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Where in the gastrointestinal tract are Brunner glands?
Your 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.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 20
Incorrect
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In paralytic ileus the following are true except:
Your Answer: There is decreased intestinal peristalsis
Correct 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 21
Correct
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A patient with a VIPoma (VIP secreting tumour) is likely to exhibit which of the following?
Your Answer: Severe diarrhoea
Explanation:Vasoactive inhibitory peptide (VIP) is found in the nerves innervating the GIT. It markedly stimulates the secretion of intestinal electrolytes and also with them water. This results in secretary diarrhoea. Along with that it also relaxes intestinal smooth muscle including the sphincters, it also results in dilation of the peripheral blood vessels and along with this its also inhibits gastric acid secretions. A VIPoma will exaggerate all this.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 22
Incorrect
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Sympathetic supply to the stomach is derived from
Your Answer: T8-T12 spinal segments via the coeliac ganglion
Correct Answer: T5-T9 spinal segments via the coeliac ganglion
Explanation:Parasympathetic innervation to the stomach is from the vagus nerve and the sympathetic innervation is from the T5-T9 spinal segments via the coeliac ganglion through the greater splanchnic nerve.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 23
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 24
Incorrect
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Chief cells secrete:
Your Answer: HCO3 and pepsinogen
Correct Answer: Pepsinogen and gastric lipase
Explanation:A gastric chief cell (or peptic cell, or gastric zymogenic cell) is a type of cell in the stomach that releases pepsinogen and gastric lipase.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 25
Incorrect
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Regarding short-chain fatty acids, all the following are true except:
Your Answer: They exert a trophic effect on the colonic epithelial cells
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.
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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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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.
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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 area in the GIT lacks Basic Electrical Rhythm?
Your Answer: Oesophagus
Explanation:The basal or basic electrical rhythm acts to coordinate peristalsis and are initiated in the interstitial cells of Cajal, specialized pacemaker cells located in the wall of the stomach, below the oesophagus.
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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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In the gastric mucosa, which of the following cells is known to secrete gastric lipase?
Your Answer: Chief cell
Explanation:Chief cells produce pepsinogen and gastric lipase. Parietal cells produce stomach acid and intrinsic factor.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 29
Incorrect
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The blood supply to the liver is by
Your Answer: None of the above
Correct Answer: Hepatic artery and hepatic portal vein
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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Question 30
Incorrect
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Cells responsible for completely renewing the epithelium of the intestine are located:
Your Answer: In the muscularis propria
Correct 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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