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- 1.In a laboratory experiment, a segment of esophagus is placed in a tissue bath. The circular muscle in this segment contracts tonically but relaxes upon stimulation of the extrinsic nerves supplying it. From which part of the esophagus is this segment most likely to come?
- A.
Distal region of the esophagus
- B.
Lower esophageal sphincter
- C.
Middle region of the esophagus
- D.
Proximal region of the esophagus
- E.
Upper esophageal sphincter
- 2.You are given an esophageal manometery recording obtained from a patient with Achalasia. What would be the distinctive feature in these recordings that you might see at either the upper or lower esophageal sphincters at rest and during swallowing?
- A.
Higher than normal pressure at the lower esophageal sphincter
- B.
Lower than normal pressure at the lower esophageal sphincter
- C.
Higher than normal pressure at the upper esophageal sphincter
- D.
Lower than normal pressure at the upper esophageal sphincter
- 3.A pressure recording was made at an unknown site in the esophagus of a normal healthy male volunteer. At rest, the pressure recorded was stable and high (40 mmHg) in comparison to atmospheric pressure. Upon a single voluntary swallow, the pressure recorded fell immediately to below atmospheric and then increased rapidly to a peak of 55 mmHg before returning to 40 mmHg. Where was the pressure sensor likely to have been located?
- A.
Upper esophageal sphincter
- B.
The body of the esophagus in the thorax
- C.
The body of the esophagus below the diaphragm
- D.
The lower esophageal sphincter
- E.
The fundus of the stomach
- 4.Which of the following is higher in saliva compared with blood plasma?
- A.
Chloride concentration
- B.
Sodium concentration
- C.
Potassium concentration
- D.
Osmolarity
- 5.An 80-year-old male suffers a stroke, that eliminates vagal nerve input to the gastrointestinal tract and also severely reduces the functions of the glossopharyngeal nerve. Of the following motility functions of the esophagus which would remain largely intact?
- A.
Pharyngeal phase of swallowing
- B.
Primary peristalsis in the thoracic esophagus
- C.
Receptive relaxation of the lower esophageal sphincter
- D.
Secondary peristalsis in the smooth muscle portion of the esophagus
- 6.Which of the following characteristics is a characteristic of salivary secretion?
- A.
It has a low concentration of potassium in comparison with plasma
- B.
The volume of secretion is low relative to the total weight of the glands
- C.
Parasympathetic nerves reduce, but sympathetic nerves increase the rate of secretion
- D.
The secreted saliva has an osmotic pressure lower than that of plasma
- E.
It is primarily regulated by hormones
- 7.A 45-year-old woman has been referred to a gastroenterology clinic for evaluation of chronic heartburn. Endoscopic evaluation of her lower esophagus reveals erosion and scarring of the distal esophagus in the region adjacent to the lower esophageal sphincter. The woman reports that for several years she has suffered from severe itchy, dry eyes and always has thick, "stringy" saliva. She also says that food really doesn't taste of much these days. Reduced production of which of the following components of saliva is the most likely contributor to her esophageal damage?
- A.
Lactoferrin
- B.
Mucin
- C.
Bicarbonate
- D.
Amylase
- E.
Lipase
- 8.A normal swallow triggers a series of motor events including which one of the following?
- A.
Concentration of the lower esophageal sphincter
- B.
Relaxation of the gastric antrum
- C.
Secondary esophageal peristalsis
- D.
Relaxation of the pyloric sphincter
- E.
Relaxation of the gastric cardia
- 9.A hormone is injected intravenously into a human volunteer. The hormone initiates a phase of intense sequential contractions of the duodenum that appears to migrate slowly towards the cecum. What is the likely identity of the hormone that was injected?
- A.
Cholecystokinin (CKK)
- B.
Gastrin
- C.
Motilin
- D.
Secretin
- E.
Vasoactive intestinal polypeptide (VIP)
- 10.Intraluminal pressure is monitored by manometery in a region of the colon that exhibits a relatively constant resting pressure (of about 20 mm Hg). When an adjacent region of the colon is distended, the resting pressure falls to near 0 mm Hg and then increases slowly, back towards the resting pressure even though the distension of the adjacent region persists. Where is the region being monitored likely to be?
- A.
External Anal Sphincter
- B.
Ileocecal Sphincter
- C.
Internal anal sphincter
- D.
Transverse colon
- E.
Ascending colon
- 11.The presence of a solution of pH less than 4.0 in the duodenum will cause which of the following responses?
- A.
Stimulation of gastrin release by somatostatin
- B.
Increased pancreatic secretion of HCO3
- C.
Decreased secretion of secretin
- D.
Increased gastric acid production
- E.
Decreased secretion of CCK
- 12.Of the 8 to 10 litres of fluid entering the digestive tract, which of the following best describes its processing?
- A.
100 to 200 mL is excreted in feces
- B.
Most of the fluid is derived from the diet
- C.
Most of the fluid is absorbed by the large intestine
- D.
Gastric secretions contribute around twice that of the pancreas
- E.
Most of the fluid is absorbed againsst a concentration gradient
- 13.A laboratory study is undertaken to determine the features of intestinal amino acid absorption. Which is the most likely conclusion to come from this study?
- A.
Amino acids are absorbed primarily in the distal gut
- B.
Amino acids compete with glucose transport
- C.
Amino acids are transported primarily by passive mechanisms
- D.
Amino acids appear more rapidly in the blood when administered as small peptides rather than the free amino acid
- E.
Amino acids are produced in the lumen of the gut primarily by the action of peptidases
- 14.Of the following conditions, which would NOT result in osmotic diarrhea?
- A.
Cholera
- B.
Lactase deficiency
- C.
Pancreatic lipase deficiency
- D.
Gastrinoma
- E.
Reduced small intestinal surface area
- 15.The effects of vagal stimulation on pancreatic function is likely due to which of the following mechanisms?
- A.
Acetylcholine (ACh) potentiated the effects of Cholecystokinin (CCK) on pancreatic acinar cells
- B.
ACh stimulates directly pancreatic enzyme secretion
- C.
ACh causes the release of CCK from the duodenum
- D.
ACh inhibits the effect of secretin on pancreatic duct cells
- E.
ACh releases secretin from the duodenum
- 16.The fact that patients with a congenital absence of one of the amino acid carriers do not become deficient in that amino acid is due to which of the following features?
- A.
The amino acid is transported by another amino acid carrier
- B.
The amino acid is absorbed by passive diffusion
- C.
The amino acid is transported by facilitated diffusion
- D.
The amino acid is an essential amino acid
- E.
The amino acid can be transported as a peptide by different carriers
- 17.Pertaining to the absorption of lipids by enterocytes, which of the following are correct?
- A.
Triglycerides are resynthesized in smooth endoplasmic reticulum
- B.
Chylomicrons are synthesized in smooth endoplasmic reticulum
- C.
Fatty acid-binding proteins transport long chain fatty acids to the Golgi
- D.
Triglycerides are synthisezed from medium and short-chain fatty acids
- E.
The major triglyceride resynthesis pathway utilizes dietary glycerol
- 18.You are in ER. A distressed mother brings in her 7-year-old son who as part of a dare from his friends has swallowed one or two stainless steel ball bearings from his father's unattended toolbox. The mother shows you the type of ball bearing: which is about half a centimeter in diameter. You tell her not to worry, but to take the child home and withhold food overnight, and that the bearings will probably pass in the childs's stools over the next day. What is the physiological basis for your advice?
- A.
Raised plasma gastrin will increase peristaltic movements of the stomach
- B.
Raised plasma histamine will cause increased acid secretion which will dissolve the bearing
- C.
Raised plasma motilin will cause increased phase 3 MMC activity
- D.
Raised plasma CCK will increase gastric emptying
- E.
Raised plasma somatostatin will stimulate small intestinal peristalsis
- F.
Raised plasma secretin will increase gastric emptying
- 19.A mouse is genetically engineered so that it no longer is able to activate pancreatic proteases, though secretion of the inactive forms is unaffected. Which protein is the mouse most likely to be lacking?
- A.
Pancreatic amylase
- B.
Enterokinase
- C.
Pepsinogen
- D.
Ptyalin
- E.
Trypsin
- 20.A small intestinal epithelial cell layer is removed from an animal and bathed in physiological saline solution on the both apical and basolateral surfaces. Under these conditions there is a steady state in which there is constant absorption of Na+, Cl-, and H2O. A specific inhibitor of the basolateral Na+/K+-ATPase is then added to the fluid bathing the basolateral surface. Absorption is observed to fall. What are the changes in intracellular ion concentrations that might underlie this inhibitory effect?
- A.
Increased Na+ and K+ unchanged
- B.
Decreased Na+ and increased K+
- C.
Increased Na+ and decreased K+
- D.
Unchanged Na+ and decreased K+
- E.
Unchanged Na+ and unchanged K+
- 21.A mildly disorientated 44-year-old male is admitted to the ER. He reports that he has had a watery diarrhea that has lasted for the last 48 hours and has similar bouts of diarrhea several times over the previous month. He reports no other symptoms such as vomiting or fever. An ECG recording shows abnormal waveforms. His plasma potassium level is found to be 2.1 mmol/L. What is the likely mechanism causing this man's cardiac symptoms?
- A.
Excess secretion of potassium in the small intestine
- B.
Excess secretion of potassium in the colon
- C.
Reduced absorption of potassium in the small intestine
- D.
Reduced absorption of potassium in the colon
- 22.A deficiency in which of the following vitamins is likely to result from cystic fibrosis?
- A.
A and B1
- B.
A and C
- C.
A and D
- D.
B1 and C
- E.
B1 and D
- F.
C and D
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