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  • Question 1 - 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
      18.7
      Seconds

  • Question 2 - Which enzyme is responsible for the formation of the active endopeptidases from their...

    Incorrect

    • Which enzyme is responsible for the formation of the active endopeptidases from their inactive precursors?

      Your Answer: Trypsin

      Correct 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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      20.6
      Seconds

  • Question 3 - The lower oesophageal sphincter is under neural control. Which of the following causes...

    Correct

    • The lower oesophageal sphincter is under neural control. Which of the following causes contraction of the intrinsic sphincter?

      Your Answer: Acetylcholine

      Explanation:

      The lower oesophageal sphincter (LOS) is a specific region of the oesophageal circular smooth muscle. It allows the passage of a food bolus to the stomach and prevents the reflux of gastric contents into the oesophagus. The tone of the LOS is myogenic in origin and depends on smooth muscle properties that lead to the opening of Ca2+ channels but can also be modulated by enteric motor neurons, the parasympathetic and sympathetic extrinsic nervous system and several neurohumoral substances. Nitric oxide causes LOS relaxation. Acetylcholine and tachykinins are involved in the LOS contraction.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      27.2
      Seconds

  • Question 4 - Which of the following prevents auto-digestion of the stomach by gastric secretions: ...

    Incorrect

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

      Your Answer: Ecl cells product

      Correct 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
      10.9
      Seconds

  • Question 5 - A patient with a VIPoma (VIP secreting tumour) is likely to exhibit which...

    Incorrect

    • A patient with a VIPoma (VIP secreting tumour) is likely to exhibit which of the following?

      Your Answer: Increased gastrointestinal motility.

      Correct 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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      18.7
      Seconds

  • Question 6 - The enzyme located on the brush border of the small intestine activating the...

    Incorrect

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

      Your Answer: Pepsin

      Correct 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
      30.5
      Seconds

  • Question 7 - Histamine, acetylcholine and gastrin act by way of which second messengers in the...

    Incorrect

    • Histamine, acetylcholine and gastrin act by way of which second messengers in the release of acid by parietal cells:

      Your Answer: G proteins

      Correct Answer: A and D

      Explanation:

      Acetylcholine, Histamine and Gastrin receptors are located on the basolateral membrane of the parietal cell and control its activity. Stimulation of these receptors modulates the levels of protein kinases in the cell and brings about the changes from a resting to stimulated structure. Protein kinase catalyses conversion of ATP to cyclic AMP which activates the proton pump. Calcium ions increase gastric acid secretion elicited by gastrin released through a vagal mechanism, and also by a direct effect on parietal cells.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      15.3
      Seconds

  • Question 8 - Where does most fat digestion begin? ...

    Incorrect

    • Where does most fat digestion begin?

      Your Answer: Mouth

      Correct 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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      8.1
      Seconds

  • Question 9 - Concerning protein digestion: ...

    Incorrect

    • Concerning protein digestion:

      Your Answer: Pepsin functions optimally in an acidic ph of 3.2 to 5.6

      Correct Answer: Most protein digestion occurs in the duodenum

      Explanation:

      Human pepsinogens can be divided into two immunochemically distinct groups: Pepsinogen I (PG I) and Pepsinogen II (PGII). PG I is secreted mainly by chief cells in the fundic mucosa whereas PGII is secreted by the pyloric glands and the proximal duodenal mucosa. Maximal acid secretion correlates with PG I. Most protein digestion occurs in the duodenum/jejunum. Pepsin functions best in an acidic environment and specifically at a pH of 1.5 to 3.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      22.2
      Seconds

  • Question 10 - Interruption of the entero-hepatic circulation causes: ...

    Incorrect

    • Interruption of the entero-hepatic circulation causes:

      Your Answer: General malabsorption

      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
      38.6
      Seconds

  • Question 11 - Vagotomy leads to the following: ...

    Incorrect

    • Vagotomy leads to the following:

      Your Answer: Slowed propulsion of food bolus

      Correct 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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      15.7
      Seconds

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

    Correct

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

      Your 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
      23.1
      Seconds

  • Question 13 - The first enzyme carbohydrates encounter in the digestive tract is? ...

    Incorrect

    • The first enzyme carbohydrates encounter in the digestive tract is?

      Your Answer: Isomaltase

      Correct Answer: Amylase

      Explanation:

      Carbohydrate digesting enzymes are known as amylase. Salivary amylase or ptyalin is the first enzyme to begin carbohydrate digestion in he oral cavity. Amylose is a component of carbohydrates and is not an enzyme. Isomaltase, maltase and sucrase are enzymes found in the small intestines that digest disaccharides like maltose and sucrose to monosaccharides.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      15
      Seconds

  • Question 14 - The pressure in the portal circulation is normally adjusted in the: ...

    Correct

    • 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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      17.8
      Seconds

  • Question 15 - 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
      23.1
      Seconds

  • Question 16 - Regarding the anatomy of the intestine, the muscularis propria contains all of which...

    Correct

    • Regarding the anatomy of the intestine, the muscularis propria contains all of which of the following constituents?

      Your Answer: Circular muscle, myenteric plexus, longitudinal muscle

      Explanation:

      The muscularis mucosa/propria consists of the inner circular muscles and the outer longitudinal muscles. Between these muscles is the myenteric plexus.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      12
      Seconds

  • Question 17 - Which of the following enzymes is mainly responsible for the hydrolysis of polysaccharide...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      21.5
      Seconds

  • Question 18 - Cells responsible for completely renewing the epithelium of the intestine are located: ...

    Incorrect

    • Cells responsible for completely renewing the epithelium of the intestine are located:

      Your Answer: At the base of the microvilli

      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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      18.3
      Seconds

  • Question 19 - What is the primary problem of achalasia ...

    Incorrect

    • What is the primary problem of achalasia

      Your Answer: Chronic inflammation of mucosal cells in the lower oesophageal sphincter

      Correct 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
      10.8
      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
      20.2
      Seconds

  • Question 21 - Which of the following takes place during fasting ...

    Incorrect

    • Which of the following takes place during fasting

      Your Answer: Segmentation and mixing

      Correct Answer: Migrating motor complex

      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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      10.5
      Seconds

  • Question 22 - The oesophagus is lined by ...

    Incorrect

    • The oesophagus is lined by

      Your Answer: Simple squamous epithelium

      Correct 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
      17
      Seconds

  • Question 23 - Dietary starch is mainly: ...

    Incorrect

    • Dietary starch is mainly:

      Your Answer: Lactose

      Correct Answer: Amylopectin

      Explanation:

      Dietary starch consists of two types of molecules: the linear and helical amylose and the branched amylopectin. Starch generally contains 20 to 25% amylose and 75 to 80% amylopectin by weight but depends in the plant. Glycogen, the glucose store of animals, is a more branched version of amylopectin.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      10.7
      Seconds

  • Question 24 - Which of the following would provide relief from nausea and vomiting? ...

    Correct

    • Which of the following would provide relief from nausea and vomiting?

      Your Answer: Cannabinoids

      Explanation:

      Ondansetron, chlorpromazine and haloperidol are effective antiemetic agents. Corticosteroids, cannabinoids, and benzodiazepines, alone or in combination with 5-HT3 and D2 antagonists, are also useful in the treatment of vomiting produced by chemotherapy.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      17.4
      Seconds

  • Question 25 - 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: Gastric lipase

      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
      9.5
      Seconds

  • Question 26 - 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
      8.8
      Seconds

  • Question 27 - Which hormone results in the production of pancreatic juice rich in enzymes but...

    Correct

    • 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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      12.5
      Seconds

  • Question 28 - Which of the following forms an important constituent of the brush border on...

    Correct

    • Which of the following forms an important constituent of the brush border on the microvilli of the intestinal epithelium?

      Your Answer: Hydrolases

      Explanation:

      There are certain enzymes which are part of the brush border cells including hydrolases also known as the brush border hydrolases. They perform the final step in digestion of certain nutrients.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      14.7
      Seconds

  • Question 29 - Where in the course of the gastrointestinal tract does the first significant digestion...

    Incorrect

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

      Your Answer: Jejunum

      Correct 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
      16.8
      Seconds

  • Question 30 - What is the function of basic electrical rhythm ...

    Incorrect

    • What is the function of basic electrical rhythm

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Gastrointestinal (10/29) 34%
Medicine (10/29) 34%
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