Gastrointestinal Practice Questions
Gastrointestinal Practice Questions PGY 451LEC
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This 20 page Study Guide was uploaded by UBnotetaker on Friday November 6, 2015. The Study Guide belongs to PGY 451LEC at University at Buffalo taught by Baizer, J S in Fall 2015. Since its upload, it has received 225 views. For similar materials see Human Physiology I in Physiology at University at Buffalo.
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Date Created: 11/06/15
PGY300 GI Practice Questions 1) Which of the following is secreted by the endocrine pancreas? a) Pepsinogen b) Gastrin c) Insulin d) Trypsinogen 2) Salivary secretion is stimulated by a) Somatostatin b) Secretin c) Acetylcholine d) Vasopressin e) Gastrin 3) The primary signal for secretion of pancreatic digestive enzymes is a) Secretin b) Cholecystokinin c) Bile salts d) Insulin e) Bicarbonate 4) The following statements are true regarding the mechanism of hydrogen secretion by the parietal cells of the stomach except: a) It depends upon sodium-hydrogen exchange at the lumen-facing membrane b) It depends upon the enzyme, carbonic anhydrase (CA) c) It is stimulated by histamine, acetylcholine, and gastrin d) H r2ceptor blockers inhibit it e) Requires ATP 5) Pancreatic digestive enzymes are a) Secreted by the jejunum. b) Activated in the duodenum. c) Stored in the gallbladder. d) Recycled via reabsorption by the distal ileum. e) Recycled via reabsorption by the colon. 6) The following statements are true regarding the mechanism of fat digestion and/or assimilation by the gastro-intestinal tract except: a) Occurs in the mouth. b) Occurs in the stomach. c) Requires functioning liver. d) Requires functioning gall bladder. e) Requires functioning ileum. Page 1 of 20 PGY300 GI Practice Questions 7) Secretory diarrhea is NOT caused by a) An imbalance between intestinal absorption and secretion. b) Inappropriate activation of intestinal chloride transport. c) Over activation of the sodium transport. d) Hypersecretion of sodium chloride. 8) Contractions of intestinal circular smooth muscle may be influenced by each of the following EXCEPT: a) Parasympathetic nerves b) Chemicals present in the lumen c) Somatic nerves d) Gastrointestinal hormones e) Enteric nerves 9) Dietary protein is absorbed in an the adult primarily a) in the stomach b) in the ileum c) as protein d) as free amino acids e) as di- and tri- peptides 10) Acid in the duodenum a) inhibits gastric acid secretion b) stimulates pancreatic bile acid secretion c) stimulates pancreatic bicarbonate secretion d) all of the above e) a and c 11) Which of the following secretions is most dependent on parasympathetic nerve (vagus) stimulation? a) Saliva b) Hydrochloric acid c) Pepsin d) Pancreatic juice e) Bile 12) Gastric acid secretion increases when food enters the stomach because a) Protein digestion products stimulate parietal secretion. b) Food lowers the pH of the stomach, allowing more acid to be released. c) Carbohydrate digestion products directly stimulate parietal cell secretion. d) Intrinsic factor potentiates the effect of gastrin on parietal cell secretion. Page 2 of 20 PGY300 GI Practice Questions 13) The Chief cell secretes a) Gastrin b) Motilin c) Cholecystokinin d) Pepsinogen e) Secretin 14) The major stimulus for gastric acid secretion during the cephalic phase is a) Histamine b) Gastrin c) Secretin d) Cephalic acid releasing factor e) Acetylcholine 15) The major stimulus for the release of secretin is/are a) Protein digestion products b) Histamine c) Somatostatin d) Hydrochloric acid e) Cholecystokinin 16) Fats are transported from intestinal cells to the vascular space primarily in the form of a) Micelles b) Chylomicrons c) Triglycerides d) Free fatty acids e) Bile salt conjugates 17) Intrinsic factor is necessary for absorption of a) Bile salts b) Iron c) Cholesterol d) Vitamin D3 e) Vitamin B12 18) All of the following do not stimulate cholecystokinin secretion EXCEPT a) Amino acids b) Fatty acids c) Peptides d) Bile acids Page 3 of 20 PGY300 GI Practice Questions 19) Which stimulus is most important for the regulation of pancreatic enzyme secretion? a) Secretin b) Histamine c) Cholecystokinin d) Bombesin e) Insulin 20) Which stimulus is most important for the regulation of the gallbladder emptying? a) Secretin b) Histamine c) Cholecystokinin d) Bombesin e) Insulin 21) Surgical removal of the distal ileum will affect the absorption of a) Acid b) Protein c) Fat d) Carbohydrate e) Vitamin C 22) Helicobactor pylori a) Stimulates an inflammatory response b) Inhibits the H-K ATPase of parietal cells c) Potentiates gastrin receptors d) Potentiates acetylcholine receptors e) Activates cystic fibrosis transconductance regulator (CFTR) 23) Which of the following best describes the mechanism of absorption of glucose at the luminal membrane of the enterocyte? a) Facilitated diffusion b) Primary active transport c) Secondary active transport d) Endocytosis e) Diffusion 24) Secretory diarrhea and cystic fibrosis are both caused by a dysfunctional ion transport mechanism. Which of the following transport mechanism best describes that ion transport mechanism? a) sodium-hydrogen exchanger b) chloride-bicarbonate exchanger c) potassium channel d) chloride channel e) hydrogen pump Page 4 of 20 PGY300 GI Practice Questions 25) Digestion refers to a) the progressive dehydration of indigestible residue. b) the input of food into the digestive tract. c) the enzymatic breakdown of food. d) the absorption of nutrients in the gut. e) the effects of chewing, churning, and segmentation. 26) Which function(s) is/are NOT continuously regulated by the GI tract? a) absorption b) motility c) secretion d) All of the above are regulated. e) None of the above are regulated. 27) In the body, 80% of all lymphocytes, a type of immune system cell, are thought to be present in the a) small intestine. b) large intestine. c) appendix. d) stomach. e) mouth. 28) Which of the following is an accessory organ of digestion? a) stomach b) pancreas c) spleen d) colon e) esophagus 29) The __________ is a significant site of absorption of water and electrolytes, but NOT of nutrients. a) mouth b) stomach c) small intestine d) large intestine e) none of the above 30) Which of the following is the sequence of layers from the lumen to the outer wall of the digestive tract? a) serosa, submucosa, mucosa, muscularis externa b) submucosa, mucosa, serosa, muscularis externa c) mucosa, submucosa, serosa, muscularis externa d) submucosa, muscularis externa, serosa, mucosa e) mucosa, submucosa, muscularis externa, serosa Page 5 of 20 PGY300 GI Practice Questions 31) The lamina propria and mucous epithelium are components of the a) serosa. b) adventitia. c) muscularis mucosa. d) mucosa. e) submucosa. 32) The layer of loose connective tissue beneath the digestive epithelium is the a) lamina propria. b) muscularis mucosae. c) submucosa. d) submucosal plexus. e) myenteric plexus. 33) Contraction of the __________ alters the shape of the intestinal lumen and moves epithelial pleats and folds. a) mucosa b) submucosa c) submucosal plexus d) muscularis mucosa e) adventitia 34) Rugae, plicae, and villi are all features that accomplish a) secretion of enzymes. b) secretion of hormones. c) an increase in surface area. d) immune function. e) mechanical digestion. 35) The motor activity of the muscularis externa is controlled by the a) submucosal plexus. b) myenteric plexus. c) migrating motor complex. d) extrinsic neurons. e) motilin. 36) Intestinal crypts a) increase the surface area of the mucosa of the small intestine. b) carry products of digestion that will not pass through the walls of blood capillaries. c) produce new cells for the mucosa of the small intestine. d) function in the absorption of nutrients. e) A and C Page 6 of 20 PGY300 GI Practice Questions 37) Chief cells secrete a) pepsinogen. b) gastrin. c) mucus. d) hydrochloric acid. e) intrinsic factor. 38) G cells of the stomach secrete a) cholecystokinin. b) secretin. c) gastrin. d) enterokinase. e) pepsin. 39) In the intestine, the epithelial cells have a) leaky-tight junctions. b) tight-tight junctions. c) electrical gap junctions. d) electrical tight junctions. e) zipper-tight junctions. 40) The subepithelial connective tissue of the GI tract, immediately beneath the epithelium, is the a) muscularis mucosae. b) lamina propria. c) submucosa. d) serosa. e) submucosal plexus. 41) Sandwiched between the layer of circular and longitudinal muscle in the muscularis externa is the a) mucosa. b) submucosa. c) muscularis mucosa. d) myenteric plexus. e) submucosal plexus. 42) The myenteric plexus is a) a layer of circular smooth muscle. b) a layer of longitudinal smooth muscle. c) a network of neurons. d) the mucus secreting layer of the digestive tract. e) primarily composed of connective tissue. Page 7 of 20 PGY300 GI Practice Questions 43) Peyer's patches are characteristic of the a) stomach. b) esophagus. c) pancreas. d) small intestine. e) colon. 44) Features of the submucosa include a) blood and lymph vessels. b) a major nerve network. c) Peyer's patches. d) A and B e) A, B, and C 45) The __________ are double sheets of peritoneal membrane that hold some of the visceral organs in their proper position. a) serosa b) adventitia c) mesenteries d) fibrosa e) lamina propria 46) Slow waves are a) cycles of smooth muscle contraction and relaxation. b) spontaneous cycles of depolarization and repolarization. c) reflexes that originate and are integrated in the enteric nervous system. d) peristaltic contractions. e) segmental contractions. 47) __________ are pacemakers for slow wave activity. a) Interstitial cells of Cajal b) Intrinsic neuron cells c) Extrinsic neuron cells d) G cells e) Chief cells 48) Powerful contractions that occur a few times each day in the colon are called a) segmentation. b) tonic contractions. c) phasic contractions. d) peristalsis. e) mass movements. Page 8 of 20 PGY300 GI Practice Questions 49) The swallowing center in the brain, which coordinates the muscular reflexes, is located in the a) cerebrum. b) medulla oblongata. c) pons. d) cerebellum. e) hypothalamus. 50) Which of the following events does NOT occur when you swallow? a) Respiration is inhibited. b) The upper esophageal sphincter closes. c) The glottis and epiglottis close. d) The lower esophageal sphincter relaxes. 51) Mucus functions in a) protection. b) lubrication. c) enzyme activation. d) A and B e) A, B, and C 52) In the digestive system, HCl is released by __________, whereas HCO - is 3 secreted primarily from the __________. a) parietal cells of the stomach, pancreas b) the pancreas, parietal cells of the stomach c) parietal cells of the stomach, liver d) the liver, parietal cells of the stomach 53) Nutrient absorption occurs primarily in the a) stomach. b) liver. c) small intestine. d) large intestine. e) A and C 54) Amylases, the enzymes used to digest carbohydrates, are secreted by a) salivary glands into the mouth. b) gastric glands into the stomach. c) the pancreas into the intestine. d) A and B e) A and C Page 9 of 20 PGY300 GI Practice Questions 55) When eaten, nearly 90% of our dietary calories from fat are in the form of a) steroids. b) phospholipids. c) triglycerides. d) cholesterol. e) fat-soluble vitamins. 56) Bile is a) secreted by hepatocytes. b) manufactured by the gall bladder. c) released into the stomach. d) a and b e) a, b, and c 57) Functions of the large intestine include a) chemical digestion of chyme. b) temporary food storage. c) resorption of water and compaction of feces. d) absorption of the products of digestion. e) all of the above 58) The release of many GI tract hormones is stimulated by a particular food or substance. Which hormone is INCORRECTLY paired with its stimulus? a) CCK - fatty foods b) secretin - acid in the small intestine c) GIP - glucose in the small intestine d) motilin - acid in the stomach e) gastrin - peptides, increased sympathetic activity 59) During the cephalic phase of gastric secretion, a) the stomach responds to distention. b) secretin inhibits parietal and chief cells. c) there is an increased flow of action potentials along the vagus nerve to the stomach. d) the intestine reflexively inhibits gastric emptying. e) production of gastric juice slows down. 60) The gastric phase of gastric secretion is triggered by a) the sight, thought, or smell of food. b) the entry of food into the stomach. c) the entry of chyme into the small intestine. d) the entry of chyme into the large intestine. e) the release of cholecystokinin and secretin by the small intestine. Page 10 of 20 PGY300 GI Practice Questions 61) An enzyme that will digest proteins into peptides is a) lipase. b) amylase. c) nuclease. d) maltase. e) trypsin. 62) Most products of fat digestion are absorbed by a) capillaries. b) veins. c) lymphatic vessels. d) arterioles. 63) Which of the following statements is true about GI muscle contractions? a) Phasic contractions last only seconds and occur in the stomach and small intestine. b) Tonic contractions are sustained for minutes and occur in the small intestine. c) Cycles of smooth muscle contraction and relaxation are associated with fast wave potentials. d) Contractions of the smooth muscle do not depend on calcium. e) none of the above 64) Which of the following statements is true? a) Glucose and galactose absorption uses an apical Na -glucose SGLT symporter. b) Fructose moves across the apical membrane by active transport. c) Glucose and galactose use different transporters in absorption. d) A basolateral GLUT5 transporter moves glucose out of the intestinal epithelial cell. e) none of the above 65) Bicarbonate secretion a) neutralizes acid entering from the stomach into the duodenum. b) is secreted by apical Cl -HCO -antiport. 3 c) is not dependent on high levels of carbonic anhydrase to maintain bicarbonate production. d) is secreted by the acinar cells. e) a and b Page 11 of 20 PGY300 GI Practice Questions 66) Saliva is a) slightly basic, with a pH of 7-8. b) controlled by the autonomic nervous system. c) not stimulated by sympathetic innervation. d) secreted from endocrine glands. e) a and b Match the following structures with the appropriate description. a) appendix b) colon c) duodenum d) ileum e) jejunum 67) location of most peptic ulcers 68) section where chyme is processed to remove water and electrolytes, leaving waste products of digestion 69) located at the ventral end of the cecum 70) distal-most section of small intestine Match the following structures with their functions. a) pancreas b) pylorus c) rectum d) small intestine e) stomach 71) chyme is released from here 72) organ that adds exocrine secretions to the duodenum via a duct 73) location of the sphincter that prevents premature emptying of the stomach 74) organ where most digestion occurs Page 12 of 20 PGY300 GI Practice Questions Match the structure to its function. a) mouth b) stomach c) rectum d) small intestine e) large intestine 75) Carbohydrate digestion begins here. 76) Carbohydrate digestion is completed here. 77) Protein digestion begins here. 78) Protein digestion is completed here. 79) Fat digestion begins here. 80) Fat digestion is completed here. Match each product with the cell or region that secretes or contains it. a) enzymes b) HCl c) HCO 3- d) mucus e) more than one of these 81) parietal cells 82) goblet cells 83) brush border 84) pancreatic cells Page 13 of 20 PGY300 GI Practice Questions Match these choices to the following five questions. a) hepatic portal b) small intestine c) lymphoid d) chyme e) starch 85) The largest collection of __________ tissue in the body is the gut-associated lymphoid tissue (GALT). 86) Digestion is essentially completed in the __________. 87) Most absorbed nutrients first enter the blood of the __________ system. 88) The primary complex carbohydrate ingested and digested by people is __________. 89) After processing in the stomach, the gastric contents are referred to as __________. 90) The three sections of the small intestine, in order according to movement of its contents, are __________, __________, and __________. a) jejunum, ileum, duodenum b) duodenum, jejunum, ileum c) ileum, duodenum, jejunum d) jejunum, duodenum, ileum e) duodenum, ileum, jejunum Page 14 of 20 PGY300 GI Practice Questions Match these choices to the following five questions. a) amylase b) glucose c) emulsifying d) micelles e) flatus 91) Bile salts aid in the digestion of fats by __________ large fat droplets. 92) __________ is intestinal gas produced by bacteria in the colon during the metabolism of undigestible carbohydrates. 93) The enzyme that digests starch into disaccharides and trisaccharides is __________. 94) Maltose is broken down by maltase into two molecules of _________. 95) __________ are tiny droplets of fatty acids, monoglycerides, and bile salts. Match these choices to the following five questions. a) segmental contractions b) acini c) migrating motor complex d) endopeptidase e) interstitial cells of Cajal 96) Slow waves originate in modified smooth muscle cells called __________. 97) The __________ is a "housekeeping function" that sweeps food remnants and bacteria out of the upper GI tract and into the large intestine. 98) __________ are short segments of intestine that alternately contract and relax. They are responsible for mixing. 99) The exocrine portion of the pancreas consists of lobules called __________, which secrete digestive enzymes. 100) __________ digests terminal peptide bonds to release amino acids. Page 15 of 20 PGY300 GI Practice Questions Match these choices to the following five questions. a) long reflexes b) enteric nervous system c) free amino acids d) bile e) emotional 101) __________ is produced in the liver and stored in the gallbladder. 102) Digestive reflexes originating in the CNS are called __________. 103) Long reflexes that originate completely outside the digestive system include feed- forward reflexes and __________ reflexes, which are collectively called cephalic reflexes. 104) Short reflexes of the digestive system are integrated in the __________. 105) The primary products of protein digestion are __________, dipeptides, and tripeptides. Match these choices to the following five questions. a) intrinsic factor b) CFTR c) chloride d) colipase e) lipase 106) Fat digestion is carried out by the enzyme __________, which breaks down triglyceride into two fatty acids and one monoglyceride. 107) __________ is a protein cofactor that is secreted by the pancreas and that allows lipases to access fats inside the bile coating. 108) Vitamin B12 must be complexed with a protein called __________ to be absorbed from the small intestine. 109) Defects in __________ structure or function lead to the disease cystic fibrosis. 110) The disease cystic fibrosis is characterized by the inability to transport _______________. Page 16 of 20 PGY300 GI Practice Questions 111) Put the following steps of fat digestion and absorption in order: 1. Bile salts coat fat droplets. 2. Cholesterol is transported into cells. 3. Chylomicrons are formed. 4. Chylomicrons are released into lymphatic system. 5. Monoglycerides and fatty acids move out of micelles. 6. Pancreatic lipase and colipase break down fats. a) 1, 6, 5, 2, 3, 4 b) 1, 2, 3, 4, 6, 5 c) 2, 6, 5, 1, 3, 4 d) 6, 3, 4, 1, 2, 5 e) none of the above 112) During defecation, a) stretch receptors in the rectal wall activate sympathetic centers in the spinal cord. b) stretch receptors in the rectal wall activate parasympathetic centers in the spinal cord. c) stretch receptors in the rectal wall activate both sympathetic and parasympathetic centers in the spinal cord. d) the internal anal sphincter is consciously relaxed. e) the external anal sphincter contracts. 113) Decreased levels of bile salts in the bile would interfere with digestion of a) protein. b) fat. c) carbohydrates. d) nucleic acids. e) vitamins and minerals. 114) In response to the arrival of acidic chyme in the duodenum, the blood levels of a) secretin rise. b) cholecystokinin fall. c) gastrin rise. d) enterocrinin fall. e) all of the above 115) A blockage of the ducts from the parotid glands would a) result in the production of more viscous saliva. b) impair the lubricating properties of saliva. c) interfere with carbohydrate digestion in the mouth. d) impair the sense of taste. e) all of the above Page 17 of 20 PGY300 GI Practice Questions 116) In response to the hormone secretin, the pancreas secretes a fluid a) rich in enzymes. b) rich in bicarbonate. c) rich in bile. d) that contains only proteases. e) that contains only amylase. 117) In response to the hormone cholecystokinin, the pancreas secretes a fluid a) rich in enzymes. b) rich in bicarbonate. c) rich in bile. d) that contains only proteinases. e) that contains only amylase. 118) Digestion of a carbohydrate results in large amounts of the monosaccharides glucose and galactose. This carbohydrate was probably a) sucrose. b) maltose. c) lactose. d) cellulose. e) glycogen. 119) Diarrhea often accompanies intestinal infections. Why? a) The immune system increases the production of enzymes for added protection. b) Bacterial toxins enhance the secretion of KCl from the cells, which pulls fluid into the intestine. c) Dehydration of the body will kill the bacteria causing the infection. d) Loss of electrolytes will kill bacteria. 120) A drug that blocks the action of carbonic anhydrase in parietal cells would result in a) a lower pH during gastric digestion. b) a higher pH during gastric digestion. c) decreased production of pepsinogen by chief cells. d) increased protein digestion in the stomach. e) decreased gastrin production. 121) A drug that blocks the action of the hormone cholecystokinin would affect a) the amount of bile produced by the liver. b) the composition of pancreatic secretions. c) the level of intestinal gastrin. d) secretions of the duodenal glands. e) all of the above Page 18 of 20 PGY300 GI Practice Questions Match the hormone with the correct statement. a) gastrin b) cholecystokinin c) secretin d) motilin e) gastric inhibitory peptide 122) secreted by cells in the stomach 123) inhibits gastric emptying 124) stimulates bile release 125) stimulates insulin release 126) smooth muscle of duodenum is a target Match the structure or compound to its function. a) ezetimbe b) ferroportin c) hepcidin d) DMT1 e) NPC1L1 127) transporter for iron absorption 128) transports iron to the blood 129) hormone that decreases iron absorption 130) blocks cholesterol absorption 131) transporter for cholesterol absorption Page 19 of 20 PGY300 GI Practice Questions Hopefully this key is correct, but sometimes a typo sneaks in. Do not blindly memorize answers. knowing the correct choice. Any concerns must be brought to my attention before the exam. well as Key 1) c 36) e 71) e 106) e 2) c 37) a 72) a 107) d 3) b 38) c 73) b 108) a 4) a 39) a 74) d 109) b 5) b 40) b 75) a 110) c 6) d 41) d 76) d 111) a 7) c 42) c 77) b 112) b 8) c 43) d 78) d 113) b 9) e 44) d 79) a 114) a 10) e 45) c 80) d 115) e 11) a 46) b 81) b 116) b 12) a 47) a 82) d 117) a 13) d 48) e 83) a 118) c 14) e 49) b 84) e 119) b 15) d 50) b 85) c 120) b 16) b 51) d 86) b 121) b 17) e 52) a 87) a 122) a 18) d 53) c 88) e 123) c 19) c 54) e 89) d 124) b 20) c 55) c 90) b 125) e 21) c 56) a 91) c 126) d 22) a 57) c 92) e 127) d 23) c 58) d 93) a 128) b 24) d 59) c 94) b 129) c 25) c 60) b 95) d 130) a 26) a 61) e 96) e 131) e 27) a 62) c 97) c 28) b 63) a 98) a 29) d 64) a 99) b 30) e 65) e 100) d 31) d 66) e 101) d 32) a 67) c 102) a 33) d 68) b 103) e 34) c 69) a 104) b 35) b 70) d 105) c Page 20 of 20
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