GASTROINTESTINAL SYSTEM - PHYSIOLOGY

1. the term "metabolism":

a. refers to all chemical reactions that occur in the body

b. includes the synthesis of complex molecules from simpler ones

c. includes the breakdown of complex molecules into simpler ones

d. includes anabolism and catabolism

e. all of the above

e. all of the above

2. which of the following statements concerning energy storage in the body is true?

a. most of the energy is stored in the form of ATP

b. most of the energy is stored in the form of glucose

c. most of the energy is stored in the form of fats

d. most of the energy is stored in the form of protein

e. most of the energy is stored in the form of DNA

c. most of the energy is stored in the form of fats

3. the enzyme amylase is secreted by:

a. salivary glands and liver

b. liver and duodenum

c. duodenum and pancreas

d. stomach and duodenum

e. pancreas and salivary gland

e. pancreas and salivary gland

4. a function of the small intestine is to:

a. absorb nutrients

b. filter waste

c. make vitamins

d. secrete bile

e. secrete HCl

a. absorb nutrients

5. the main sources of energy in food are:

a. proteins

b. vitamins

c. nucleic acids

d. lipids

e. carbohydrates

e. carbohydrates

6. which of the following has the lowest pH?

a. saliva

b. bile

c. pancreatic juice

d. gastric juice

e. intestinal glands' secretion

d. gastric juice

7. calcium absorption is facilitated by:

a. hypercalcaemia

b. oxalates in the diet

c. iron overload

d. 1,25-dihydroxycholecalciferol

e. increased Na+ absorption

d. 1,25-dihydroxycholecalciferol

8. when parietal cells are stimulated, they secrete:

a. HCl and HCO3-

b. HCl and pepsinogen

c. HCl and intrinsic factor

d. HCO3- an intrinsic factor

e. mucus and pepsinogen

c. HCl and intrinsic factor

9. HCl, secreted by gastric parietal cells is needed for:

a. activation of pancreatic lipase

b. activation of salivary lipase

c. activation of intrinsic factor

d. conversion of pepsinogen into pepsin

e. formation of micelles

d. conversion of pepsinogen into pepsin

10. fat absorption occurs mainly in the:

a. stomach

b. duodenum

c. terminal ileum

d. coceum

e. sigmoid colon

b. duodenum

11. the movements of small intestine are:

a. antiperistaltic contraction

b. propulsive contractions

c. mixing and propulsive contractions

d. hunger contractions

e. receptive relaxation

c. mixing and propulsive contractions

12. where protein digestion starts:

a. oral cavity

b. stomach

c. small intestine

d. duodenum

e. large intestine

b. stomach

13. which of the following organs or issues utilizes glucose as its sole energy source during the fed state and early stages of the starving state

a. liver

b. brain

c. adipose tissue

d. skeletal muscle

e. cardiac muscle

b. brain

14. After the absorption of dietary fats by the enterocytes, most of the fat is:

a. released in the portal circulation and transported to the liver

b. released in the portal vein and transported in the hepatic artery

c. released as chylomicrons in the lymphatic system

d. released as triglycerides into the portal vein and bypass the liver

e. released in the duodenum

c. released as chylomicrons in the lymphatic system

15. in order to assure that fat digestion occurs properly:

a. lingual lipase is essential

b. gastric lipase is essential

c. pancreatic lipase and bile secreted in duodenum are essential

d. receptor-mediated endocytosis of micelles by the enterocytes is the only means of fat uptake

e. all of the above

c. pancreatic lipase and bile secreted in duodenum are essential

16. gastric juice secretion is decreased by:

a. distention of bowel wall

b. ingestion of protein

c. noradrenaline

d. M1 cholinergic antagonist show the same efficacy at reducing gastric acid secretion

e. vagal inhibition

e. vagal inhibition

17. release of which one of the following increases pH of duodenal contents?

a. secretin

b. gastrin

c. intrinsic factor

d. cholecystokinin

e. gastrin releasing peptide

a. secretin

18. in the small intestine, glucose is absorbed:

a. via an antiporter it gets exchanged with sodium

b. via a symporter

c. by facilitated diffusion through a GLUT transporter

d. by co transport with chloride

e. actively by insulin dependent uptake

b. via a symporter

19. during the postprandial state:

a. digestion of fats and carbohydrates starts in the mouth while protein digestion in the stomach

b. carbohydrates and proteins digestion begins in the mouth

c. proteins are digested in mouth and fats and carbohydrates in the stomach

d. most fluids and electrolytes are absorbed in the large bowel

e. composition of the food has no effect on the transit time through the bowel

a. digestion of fats and carbohydrates starts in the mouth while protein digestion in the stomach

20. calcium absorption in duodenum is:

a. transcellular and controlled by vitamin D3

b. via H+/K+ pump

c. passive

d. when there is electrical chemical gradient for Cl-

e. facilitated by phosphate

a. transcellular and controlled by vitamin D3

21. which one of the following is a water-soluble vitamin?

a. retinol

b. calciferol

c. thiamin

d. alpha-tocopherol

e. phylloquinone

c. thiamin

22. which of the following is released in duodenum in response to acidic chyme:

a. cholecystokinin

b. gastrin

c. secretin

d. peptide

e. amylase

c. secretin

23. Which of the following accurately reflects the correct temporal order of events during the swallowing process:

a) upward movement of the soft palate, medial placement of palatopharyngeal folds, peristaltic contractions of the pharynx, relaxation of the upper esophageal sphincter;

b) peristaltic contractions of the pharynx, upward movement of the soft palate, medial placement of palatopharyngeal folds, relaxation of the upper esophageal sphincter;

c) upward movement of the soft palate, medial placement of palatopharyngeal folds, relaxation of the upper esophageal sphincter, peristaltic contractions of the pharynx

d) peristaltic contractions of the pharynx, relaxation of the upper esophageal sphincter, medial placement of palatopharyngeal folds, upward movement of the soft palate,

e) upward movement of the soft palate, medial placement of palatopharyngeal folds, relaxation of the upper esophageal sphincter, perista

e) upward movement of the soft palate, medial placement of palatopharyngeal folds, relaxation of the upper esophageal sphincter, perista

24. Which of the following can inhibit gastric acid secretion:

a) secretin, enterogastrones, the sympathetic branch of ANS;

b) somatostatin, GIP, the sympathetic branch of ANS;

c) secretin, enterogastrones;

d) GIP, the sympathetic branch of ANS;

e) somatostatin, secretin, GIP, enterogastrones, the sympathetic Branch of ANS.

e) somatostatin, secretin, GIP, enterogastrones, the sympathetic Branch of ANS.

25. The function of the ileum is to: e

a) absorb bile acids;

b) absorb vitamin B12 and bile salts;

c) it is the site where bile and pancreatic juice are released;

d) absorb alcohol and aspirin;

e) all of the above.

b) absorb vitamin B12 and bile salts;

26. Gastrointestinal hormones:

a) are secreted by exocrine glands of the gut mucosa and affect metabolism;

b) are secreted into the blood stream by specialized cells in the gut walls, and modulate the motor and secretory activity of the gastrointestinal tube;

c) are secreted by the gastric walls and protect the gut mucosa fromthe effect of HCI and proteolytic enzymes;

d) are situated in the epithelial intestinal cells (enterocytes) and controla the cell metabolism of nutrients:

e) are secreted by the gastric walls and colon and protect the gut mucosa from the effect of HCl and proteolytic and nucleic enzymes.

b) are secreted into the blood stream by specialized cells in the gut walls, and modulate the motor and secretory activity of the gastrointestinal tube;

27. The gastrointestinal enzymes:

a) are situated in the epithelial intestinal cells (enterocytes) and control cell metabolism;

b) are secreted into the blood stream by specialized cells in the gut wallsand modulate its motor and secretory activity;

c) are secreted by exocrine glands of the gut mucosa and serve to break down nutrients;

d) are secreted by the gastric walls and protect the gut mucosa fromathe effect of HCl and proteolytic enzymes;

e) are secreted by the gastric walls into the small intestine and protectthe gut mucosa from the effect of HCI, proteolytic and nucleic enzymes.

c) are secreted by exocrine glands of the gut mucosa and serve to break down nutrients;

28. Which enzymes get secreted in the gastric juice:

a) pepsinogens and gastric lipase;

b) pepsinogene, tripsinogene and maltase;

c) pepsinogene, lipase and HCI;

d) proteolytic, lipolytic and amylolytic enzymes;

e) proteolytic, nucleolytic, lipolytic and amylolytic enzymes.

a) pepsinogens and gastric lipase;

29. Which enzymes are secreted in the pancreatic juice:

a) lipolytic: lipase and esterase;

b) proteolytic: trypsinogen, chymotrypsinogen, elastase,carboxypeptidase, etc.;

c) amilolitic: amylase, maltase, sacharase, lactase;

d) nucleic: RNA-ase and DNA-ase;

e) all of the above.

e) all of the above

30. The enzymes, secreted with the intestinal juice are:

a) aminopeptidase, dipeptidase, nuclease;

b) endo- and exopeptidases, esterase and amylolytic enzymes;

c) exopeptidases, lipase, maltase, nucleic (nuclease, nucleotidases, nucleosidases);

d) aminopeptidase, dipeptidase, nuclease, somatostatin, secretin, cholecystokinin-pancreozimin;

e) trypsinogen, chymotrypsinogen, elastase and lipase.

a) aminopeptidase, dipeptidase, nuclease;

31. Which of the bile components play a role in digestion:

a) secretin and hepatocrinin;

b) bile salts, phospholipids, cholesterol;

c) acid phosphatase, secretin and hepatocrinin;

d) proteolytic, lipolytic and amylolytic enzymes;

e) cholecystokinin-pancreozymin and hepatocrinin.

b) bile salts, phospholipids, cholesterol;

32. The humoral factors inhibiting gastric motility are:

a) gastrin;

b) gastrin and motilin;

c) secretin and cholecystokinin-pancreozymin;

d) GIP, catecholamines, secretin, somatostatin, cholecystokinin-pancreozymin;

e) intestinal hormones, somatostatin, secretin and cholecystockinin -pancreozymin.

d) GIP, catecholamines, secretin, somatostatin, cholecystokinin-pancreozymin;

33. The humoral factors stimulating gastric motility are:

a) catecholamines, secretin, gastric peptide, somatostatin, cholecystokinin-pancreozymin;

b) secretin and cholecystokinim-pancreozimin;

c) motilin and gastrin;

d) GIP, VIP, somatostatin, secretin and cholecystokinin-pancreozymin;

e) gastrin, histamine, secretin.

c) motilin and gastrin;

34. The humoral factors that stimulate intestinal motility are:

a) catecholamines and intestinal hormones;

b) secretin and hepatocrinin;

c) secretin, cholecystokinin-pancreozymin, GIP, VIP, substance Pand bombesin;

d) intestinal hormones;

e) gastrin, secretin, cholecystokinin-pancreozymin and hepatocrinin.

c) secretin, cholecystokinin-pancreozymin, GIP, VIP, substance Pand bombesin;

35. The humoral factors that inhibit gastric secretion are:

a) gastrin, histamine, acetylcholine, cholecystokinin-pancreozymin,

bombesin, motilin;

b) secretin, cholecystokinin-pancreozymin, somatostatin, catecholamines;

c) GIP, secretin, cholecystokinin-pancreozymin, VIP, enterogastrone;

d) enkephalines, endorphines, angiotensinogens;

e) corticoglomerolotropin, prolactin, substance P.

c) GIP, secretin, cholecystokinin-pancreozymin, VIP, enterogastrone;

36. Which humoral factors stimulate gastric secretion:

a) secretin, cholecystokinin, somatostatin;

b) secretin, cholecystokinin-pancreozymin, histamine, acetylcholine,

bombesin, motilin, meatand vegetable extracts;

c) VIP, somatostatin, GIP, cholecystokinin-pancreozymin;

d) corticoglomerulotropin, prolactin, substance P:

e) gastrin, histamine, secretin.

e) gastrin, histamine, secretin.

37. The physiological effect of gastrin on gastric secretion is:

a) increased amount of gastric juice of high acidity and high proteolytic activity;

b) increased amount of gastric juice of low acidity and high proteolyticactivity;

c) to decrease the amount of gastric juice;

d) decreased amount of gastric juice of high acidity and low proteolyticactivity;

e) increased amount of gastric juice of high acidity and lowproteolytic activity.

e) increased amount of gastric juice of high acidity and lowproteolytic activity.

38. The physiological effect of histamine on gastric secretion is:

a) to decrease the amount of the gastric juice;

b) increased amount of gastric juice of high acidity and lowproteolytic activity;

c) increased amount of gastric juice of low acidity and high proteolytic activity;

d) increased amount of gastric juice of high acidity and high proteolytic

activity;

e) decreased amount of gastric juice of high acidity and low proteolytic

activity.

b) increased amount of gastric juice of high acidity and lowproteolytic activity

39. The humoral factors that stimulate the formation and secretion of bileare:

a) angiotensin, thyroxine, somatostatin;

b) glucagon,calcitonin , VIP;

c) secretin, gastrin, cholecystokinin-pancreozymin, bile salts;

d) catecholamines, glucagon, calcitonin, VIP;

e) alkaline and acid phosphatase.

c) secretin, gastrin, cholecystokinin-pancreozymin, bile salts;

40. The humoral factors that inhibit the formation and secretion of bile

are:

a) secretin, gastrin, cholecystokinin-pancreozymin, acetylcholine;

b) catecholamines;

c) alkaline and acid phosphatase;

d) angiotensin, tiroxin, somatostatin;

e) insulin, glucagon, catecholamines, growth hormone, glucocorticoids,

thyroid hormones.

b) catecholamines;

41. The humoral factors that stimulate the secretion of pancreatic juice are:

a) glucagon, calcitonin, somatostatin;

b) tripsin, amilase, lipase;

c) somatostatin, GIP;

d) secretin, cholecystokinin-pancreozymin, gastrin, serotonin, VIP, insulin;

e) glucagon, insulin, catecholamines, growth hormone, glucocorticoids,

thyroid hormones.

d) secretin, cholecystokinin-pancreozymin, gastrin, serotonin, VIP, insulin;

42. The carbohydrates are absorbed as:

a) mono- and disaccharides;

b) monosaccharides - pentoses and hexoses;

c) glucose and glycogen;

d) glucosamines;

e) glucose, glycogen, glucosamine.

b) monosaccharides - pentoses and hexoses

43. The hormones regulating carbohydrate metabolism (synthesis,

catabolism) are:

a) androgens, estrogens, progesterone, a-MSH;

b) insulin, glucagon, catecholamines, growth hormone, glucocorticoids (ACTH), T3 and T4 (TTH);

c) somatostatin, bombesin, gastrin, histanime, kinins;

d) glucagon, calcitonin, somatostatin, catecholamines, serotonin;

e) catecholamines, glucagon, dehydroepiandroserone, somatotropin.

b) insulin, glucagon, catecholamines, growth hormone, glucocorticoids (ACTH), T3 and T4 (TTH);

44. The hormones that increase significantly the basic metabolic rate (BMR)are:

a) insulin and glucocorticoids;

b) glucagon and parathyroid hormone;

c) testosterone and estrogens;

d) T3, T4, catecholamines and glucocorticoids;

e) insulin and growth hormone

d) T3, T4, catecholamines and glucocorticoids;

45. Glucose enters the blood stream via:

a) absorption in the mouth;

b) glycogenolysis and gluconeogenesis in the skeletal muscles:

c) absorption in the GIT and the proximal renal tubules, livera glycogenolysis, gluconeogenesis occurring in the liver and kidneys:

d) degradation of glycogen in the skeletal muscles:

e) glucogenolysis in the hepatocytes.

c) absorption in the GIT and the proximal renal tubules, livera glycogenolysis, gluconeogenesis occurring in the liver and kidneys:

46. The basal metabolic rate (BMR) is the energy consumption of the body

under the following conditions:

a) adequate intake of vitamins regulating the intermediate processes of

metabolism of the various substances;

b) normal function of the endocrine glands;

c) after a period of rest devoid of psychological or excessive physiological stressors, 12 hours after the last meal in a room at a temperature of 20-22°C;

d) during physical activity;

e) during sleep, pregnancy or lactation.

c) after a period of rest devoid of psychological or excessive physiological stressors, 12 hours after the last meal in a room at a temperature of 20-22°C;

47. The chief cells of the gastric glands secrete:

a) proteolytic enzymes;

b) hydrochloric acid;

c) mucus;

d) gastrointestinal hormones;

e) autonomously active substances.

a) proteolytic enzymes;

48. The humoral and pharmacological factors inhibiting salivary secretion are:

a) catecholamines;

b) cholinolytics;

c) adrenomimetics;

d) catecholamines, cholinolytics; adrenomimetics;

e) adrenolytics and cholinomimetics.

d) catecholamines, cholinolytics; adrenomimetics;

49. Humoral factors taking part in the calcium/phosphorus homeostasis are:

a) parathyroid hormone and thyroxine:

b) parathyroid hormone, thyrocalcitonin and vitamin D3;

c) thyrocalcitonin and epinephrine;

d) thyrocalcitonin and aldosterone:

e) antidiuretic hormone, androgens and angiotensin II.

b) parathyroid hormone, thyrocalcitonin and vitamin D3;

50. Which of the following will catalyze the breakdown of starches?

a) protease;

b) amylase;

c) lipase;

d) sucrase;

e) peptidase.

b) amylase;

51. Which is the storage form of carbohydrates in the liver?

a) glycogen;

b) glucagon;

c) disaccharide;

d) lactic acid;

e) carbonic acid.

a) glycogen;

52. As far as bile is considered:

a) contains enzymes required for the digestion of fat;

b) contains unconjugated bilirubin;

c) bile salts emulsify lipids, thus facilitating the action of pancreatic

lipase and colipase;

d) decrease the surface area of fat droplets;

e) becomes more alkaline during storage in the gallbladder.

c) bile salts emulsify lipids, thus facilitating the action of pancreatic

53. Saliva:

a) from different salivary glands has a similar composition;

b) contains enzymes essential for the digestion of proteins;

c) has more than twice the iodide level of plasma;

d) has less than half the ionic calcium level of plasma;

e) has a pH between 5.0 and 6.0.

c) has more than twice the iodide level of plasma;

54. Swallowing is a reflex which:

a) has its reflex centers in the cervical segments of the spinal cord;

b) is initiated by a voluntary act and includes inhibition of respiration;

c) has its reflex centers in the thoracic segments of the spinal cord;

d) is not dependent on intrinsic nerve networks in the esophagus;

e) is more effective when the person is lying down rather than when standing.

b) is initiated by a voluntary act and includes inhibition of respiration;

55. Appetite is increased:

a) by the secretion of cholecystokinin;

b) by the secretion of calcitonin;

c) when the stomach is distended;

d) the stomach is denervated;

e) by the secretion of ghrelin.

e) by the secretion of ghrelin.

56. Secretion of saliva increases when:

a) atropine is applied;

b) the mouth is flushed with fluids with a pH of about 7;

c) the subject thinks of unappetizing food;

d) sympathetic outflow increases, making it less viscous;

e) the saliva gland's parasympathetic nerve supply is stimulated.

e) the saliva gland's parasympathetic nerve supply is stimulated.

57. Defaecation is a reflex action:

a) that is coordinated by reflex centers located in the spinal cord;

b) whose afferent limb carries impulses from stretch receptors in the colon;

c) whose efferent limb travels mainly in sympathetic autonomic nerves;

d) which is more likely to be initiated just before a meal than just after it;

e) which can be involuntarily inhibited or facilitated.

a) that is coordinated by reflex centers located in the spinal cord

58. In the stomach:

a) pH rarely falls below 4.0;

b) pepsinogen is converted to pepsin by hydrochloric acid;

c) ferrous iron is reduced to ferric iron by hydrochloric acid;

d) acid secretion is inhibited by pentagastrin;

e) there is a rise in the bacterial count after histamine H, receptor block.

b) pepsinogen is converted to pepsin by hydrochloric acid

59. Intestinal juice contain:

a) potassium in a concentration similar to that in extracellular fluid;

b) enzymes that are released when the vagus nerve is inhibited;

c) enzymes that hydrolyze disaccharides;

d) enzymes that hydrolyze monosaccharides;

e) enzymes that suppress pancreatic proteolytic enzymes.

c) enzymes that hydrolyze disaccharides;

60. Pancreatic secretion:

a) in response to vagal stimulation is copious, rich in bicarbonate but poor in enzymes;

b) in response to acid in the duodenum is scanty but rich in enzymes;

c) in response to secretin secretion is low in bicarbonate:

d) contains enzymes that convert disaccharides to monosaccharides.

e) contains enzymes that digest neutral fat to glycerol and fatty acids.

e) contains enzymes that digest neutral fat to glycerol and fatty acids.

61. The liver is the principal site for:

a) synthesis of plasma albumin;

b) synthesis of plasma globulin;

c) synthesis of vitamin B12;

d) storage of vitamin C:

e) activation of some polypeptide hormones.

a) synthesis of plasma albumin;

62. The gastric juice:

a) is secreted when the vagal nerves are stimulated;

b) is secreted in vagotomized animals when food is chewed but not swallowed;

c) activates the digestive enzymes secreted with saliva;

d) digests the gastric mucosa because it is not protected by a pepsin in activator;

e)does not irritate the esophageal mucosa if regurgitated from the stomach.

a) is secreted when the vagal nerves are stimulated;

63. The Respiratory Quotient (RQ):

a) is the volume of O2 consumed to the volume of CO2 produced ratio;

b)depends essentially on the type of substrate being metabolized and is 1.0 when the substrate is glucose;

c) is 1.0 in conditions of metabolic alkalosis;

d) is between 0.9 and 1.0 in the second week of fasting;

e) is above 0.8 if fats are mainly metabolized.

b) depends essentially on the type of substrate being metabolized and is 1.0 when the substrate is glucose;

64. Oxygen consumption tends to increase when the:

a) concentration of oxygen in inspired air rises;

b) body temperature rises and environmental temperature falls;

c) metabolic rate falls;

d) environmental temperature increases;

e) before a meal is ingested.

b) body temperature rises and environmental temperature falls;

65. Brown fat is:

a) relatively more abundant in adults than in infants;

b) richer in mitochondria than ordinary fat and has an extensive sympathetic innervation;

c) produces less heat and more ATP than other tissues:

d) stimulated to generate more heat when its parasympathetic nerve supply is stimulated;

e) less important than shivering in neonatal thermoregulation.

b) richer in mitochondria than ordinary fat and has an extensive sympathetic innervation;

66. The nitrogen balance:

a) is usually negative in childhood;

b) is the relationship between the body's nitrogen intake and nitrogen loss;

c) becomes more positive when dietary protein is decreased;

d) becomes positive whenever a single essential amino acid is omitted from the diet;

e) becomes less negative in the final stages of fatal starvation.

b) is the relationship between the body's nitrogen intake and nitrogen loss;

67. The normally innervated stomach:

a) is stimulated to secrete gastric juice when food is chewed, even if it is not swallowed;

b) secrete HCl when its H- receptors are blocked;c) increases gastric secretion when there are fear and depression:

d) empties slower than the denervated stomach:

e) is stimulated to secrete gastric juice by the hormone secretin.

a) is stimulated to secrete gastric juice when food is chewed, even if it is not swallowed;

68. The passage of acidic gastric contents to the duodenum may cause:

a) copious secretion of pancreatic juice rich in bicarbonate;

b) increased gastric motility;

c) relaxation of the gallbladder;

d) contraction of the sphincter of Oddi;

e) inhibition of pancreozymin secretion.

a) copious secretion of pancreatic juice rich in bicarbonate;

69. Bile salts:

a) derived from cholesterol, are the only constituents of bile necessary for digestion;

b) have a characteristic molecule, being water-soluble:

c) are reabsorbed mainly in the upper small intestine:

d) increase surface tension:

e) are absorbed in the colon.

a) derived from cholesterol, are the only constituents of bile necessary for digestion;

70. The specific dynamic action of food:

a) is the decrease in metabolic rate that results from ingestion of food:

b) persists for about an hour after a meal is ingested;

c) is due to the additional energy expended in digesting and absorbing the food;

d) results in about 30 percent of the energy value of ingested protein being unavailable for other purposes:

e)results in about 20% of the energy value of ingested fat and carbohydrate being unavailable for other purposes.

d) results in about 30 percent of the energy value of ingested protein being unavailable for other purposes:

71. Secretion of the intrinsic factor of Castle:

a) decreases when food stimulates mucosal cells in the pyloric region:

b) is associated with a decrease in the pH of venous blood draining the stomach;

c) is essential for absorption of vitamin B12;

d) is essential for carbohydrate digestion;

e) in response to food is increased after vagotomy.

c) is essential for absorption of vitamin B12;

72. In the small intestine:

a) the enzyme concentration in intestinal juice is higher in the ileum than in the jejunum; -

b) vitamin B₁2 is absorbed mainly in the jejunum;

c) absorption of calcium occurs mainly in the terminal ileum;

d) glucose absorption is dependent on sodium absorption;

e) water absorption is independent on the active absorption of sodium and glucose.

d) glucose absorption is dependent on sodium absorption;

73. The cells of the liver:

a) help to maintain the normal blood glucose level;

b) deaminate amino acids to form NH4 which is excreted as ammonium a salt in the urine;

c) synthesize vitamin D3 (cholecalciferol);

d) manufacture most of the immune globulin:

e) activate steroid hormones manufactured in the gonads.

a) help to maintain the normal blood glucose level;

74. Absorption of dietary fat:

a) can only occur after the neutral fat has been split into glycerol and fatty acids;

b) does not depend on their size;

c) is impaired when bile salt reabsorption is prevented by resection of the terminal ileum;

d) is carried out by passive diffusion;

e) is greatest in the lower parts of the small intestine.

c) is impaired when bile salt reabsorption is prevented by resection of the terminal ileum;

75. One gram of:

a) carbohydrate, metabolized in the body, yields more energy when oxidized in a bomb calorimeter;

b) carbohydrate, metabolized in the body, yields about the same energy as 1g of protein;

c) fat, metabolized in the body, yields 10 percent more energy than 1g of carbohydrate;

d) protein, metabolized in the body, yields the same energy as when oxidized in a bomb calorimeter.

e) protein per kg body weight is not the adequate daily protein intake for a sedentary adult.

b) carbohydrate, metabolized in the body, yields about the same energy as 1g of protein;

76. Cholesterol:

a) can be absorbed from the gut by intestinal lymphatics following its incorporation into chylomicrons;

b) can be synthesized in the spleen;

c) in the diet comes mainly from vegetable sources;

d) is eliminated from the body mainly by metabolic degradation;

e) is not a precursor of adrenal medulla hormones.

a) can be absorbed from the gut by intestinal lymphatics following its incorporation into chylomicrons;

77. Free (non-esterified) fatty acids in plasma:

a) are provided to fat cells and other tissues by chylomicrons and VLDL;

b) are not synthesized in the fat depots where they are stored;

c) are bound to albumin;

d) can be metabolized to release energy in smooth muscle;

e) decrease when the level of blood adrenaline rises.

c) are bound to albumin;

78. Impaired intestinal absorption of:

a) iron occurs frequently following removal of most of the stomach:

b) iodine leads to a reduction in size of the thyroid gland;

c) water occurs in infants who cannot digest lipids:

d) calcium may occur following removal of the terminal ileum:

e) bile salts may occur following resection of the stomach.

a) iron occurs frequently following removal of most of the stomach:

79. Peptic ulcer pain is typically relieved by:

a) raising the pH of the fluid bathing the ulcer and a drug blocking the gastric proton pump;

b) a drug decreasing the pH;

c) H2 stimulators;

d) a drug which interferes with the action of acetylcholinesterase:e) a drug which stimulates the gastric proton pump.

a) raising the pH of the fluid bathing the ulcer and a drug blocking the gastric proton pump;

80. Fat stores in the adult:

a) make up less than 5% of average body weight:

b) make up a smaller percentage of body weight in women than in men:

c) release fatty acids when insulin is injected:

d) release fatty acids when there is increased sympathetic nerve activity;

e) enlarge by increasing the number of adipocytes they contain.

d) release fatty acids when there is increased sympathetic nerve activity;

81. Metabolic rate can be estimated via:

a) the calorific value of the food consumed in the previous 24 hours

b) oxygen consumption and respiratory quotient;

c) carbon dioxide production and the respiratory quotient;

d) specific dynamic action of food

e) total heat loss.

b) oxygen consumption and respiratory quotient;

82. Complications that may arise after total gastrectomy include:

a) depletion of vitamin B12 stores in the liver;

b) inability to digest carbohydrates;

c) impaired defaecation due to loss of the gastrocolic reflex:

d) inability to digest protein;

e) inability to digest fats.

a) depletion of vitamin B12 stores in the liver

83. Severe diarrhea causes:

a) increase in body mass;

b) increase in extracellular fluid volume;

c) decrease of total vascular peripheral resistance;

d) decrease in body potassium;

e) increase in the specific dynamic action of food.

d) decrease in body potassium;

84. Surgical removal of 90% of the small intestine would mostly impact:

a) the fat content of the stools.

b) bone mineralization (osteomalacia).

c) extracellular fluid volume.

d) blood hemoglobin level.

e) body weight.

c) extracellular fluid volume.

85. A decrease in the release of pancreatic juice in the duodenum may lead to:

a) steatorrhea and traces of undigested proteins in the stool;

b) antiperistalsis;

c) aerophagia decrease in the fat of the feces:

d) a high prothrombin level in blood;

e) achalasia.

a) steatorrhea and traces of undigested proteins in the stool;

86. Gastric acid secretion:

a) is stimulated in response to a lowered blood sugar, is mediated by the hormone gastrin;

b) is stimulated primarily in the enteric phase;

c) increases when histamine H2, muscarinic M1 or gastrin receptors are activated;

d) is decreased in response to the presence of oligopeptides in the duodenum;

e) is decreased when the food bolus is swallowed.

c) increases when histamine H2, muscarinic M1 or gastrin receptors are activated;

87. Constipation is a recognized consequence of:

a) diet high in fiber;

b) abnormality of the autonomic nerve supply to the esophagus:

c) psychological stress and/or a poor in fiber diet, leading to little unabsorbed residue in the gut;

d) over-activity of the thyroid gland, as in thyrotoxicosis;

e) aerophagia.

c) psychological stress and/or a poor in fiber diet, leading to little unabsorbed residue in the gut;

88. Absorption of glucose by intestinal mucosal cells:

a) relies on a carrier mechanism on the cell membrane:

b) is blocked not by the same agents that block renal reabsorption of glucose;

c) is enhanced by blockade of active sodium transport in the cells:

d) takes place mainly in the ileum;

e) does not involve the same carriers that are used for the absorption of galactose.

a) relies on a carrier mechanism on the cell membrane:

89. Muscle tone in the lower esophagus is:

a) lower than tone in the middle esophagus;

b) a major factor in preventing heartburn;

c) increased in pregnancy;

d) decreased by gastrin;

e) increased by anticholinergic drugs.

b) a major factor in preventing heartburn;

90. Which of the following are incorrectly paired:

a) pancreatic alpha amylase → starch

b) elastase elastin fibers;

c) cholesterol esterase→ starch;

d) enteropeptidase → trypsinogen;

e) phospholipase A2 phospholipids.

c) cholesterol esterase→ starch;

91. All of these are GIT hormones except:

a) cholecystokinin;

b) gastrin;

c) secretin;

d) chymotrypsin;

e) somatostatin.

d) chymotrypsin;

92. Iron is primarily absorbed in:

a) stomach;

b) duodenum;

c) jejunum;

d) ileum;

e) colon.

b) duodenum;

93. In infants, defecation often follows a meal. The cause of colonic contractions in this situation is:

a) gastroileal reflex;

b) increased circulating levels of CCK;

c) gastrocolic reflex;

d) enterogastric reflex;

e) decreased circulating levels of gastrin.

c) gastrocolic reflex;

94. Which of the following has the highest pH:

a) gastric juice;

b) pancreatic juice;

c) bile in gallbladder;

d) secretions of intestinal glands;

e) saliva.

b) pancreatic juice;

95. The human GIT cannot process and absorb:

a) dextrin

b) glucose;

c) cellulose;

d) glycogen;

e) maltose.

c) cellulose

96. Steatorrhoea may be caused by all factors, except:

a) pancreatectomy;

b) gastrin secreting tumor;

c) resection of distal ileum;

d) hemolytic jaundice;

e) cystic fibrosis.

d) hemolytic jaundice;

97. The correct sequence of events regarding proteins assimilation is:

a) proteolytic action of pepsin, proteolytic action of pancreatic enzymes. release of cholecystokinin, absorption by enterocytes;

b) release of cholecystokinin, proteolytic action of pepsin, proteolytichaction of pancreatic enzymes, absorption by enterocytes;

c) proteolytic action of pepsin, proteolytic action of pancreatic enzymes, release of cholecystokinin, absorption by enterocytes;

d)proteolytic action of pepsin, release of cholecystokinin. proteolytic action of pancreatic enzymes, absorption by enterocytes;

e) release of cholecystokinin, proteolytic action of pancreatic enzymes, proteolytic action of pepsin, absorption by enterocytes.

d) proteolytic action of pepsin, release of cholecystokinin. proteolytic action of pancreatic enzymes, absorption by enterocytes;

98. Secretion of the intrinsic factor of Castle occurs in:

a) parietal cells of the stomach;

b) chief cells of the stomach;

c) upper abdomen;

d) alpha cells of pancreas;

e) cells of the parotid gland.

a) parietal cells of the stomach

99. In which of the following occurs the most water absorption:

a) colon;

b) jejunum;

c) duodenum;

d) stomach;

e) mouth.

b) jejunum;

100. The only hormone secreted by GIT, the secretion of which is NOT stimulated by fat intake, is:

a) secretin;

b) motilin;

c) gastrin;

d) cholecystokinin;

e) glucose-dependent insulinotropic peptide.

c) gastrin;