MCAT Topical Tests

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BIOLOGY TOPICAL:
Digestive and Excretory Systems
Test 1
Time: 21 Minutes*
Number of Questions: 16

* The timing restrictions for the science topical tests are optional.
If you are using this test for the sole purpose of content
reinforcement, you may want to disregard the time limit.

MCAT

DIRECTIONS: Most of the questions in the following

test are organized into groups, with a descriptive
passage preceding each group of questions. Study
the passage, then select the single best answer to
each question in the group. Some of the questions
are not based on a descriptive passage; you must
also select the best answer to these questions. If you
are unsure of the best answer, eliminate the choices
that you know are incorrect, then select an answer
from the choices that remain. Indicate your selection
by blackening the corresponding circle on your answer
sheet. A periodic table is provided below for your use
with the questions.

PERIODIC TABLE OF THE ELEMENTS

1
H
1.0

2
He
4.0

3
Li
6.9

4
Be
9.0

5
B
10.8

6
C
12.0

7
N
14.0

8
O
16.0

9
F
19.0

10
Ne
20.2

11
Na
23.0

12
Mg
24.3

13
Al
27.0

14
Si
28.1

15
P
31.0

16
S
32.1

17
Cl
35.5

18
Ar
39.9

19
K
39.1

20
Ca
40.1

21
Sc
45.0

22
Ti
47.9

23
V
50.9

24
Cr
52.0

25
Mn
54.9

26
Fe
55.8

27
Co
58.9

28
Ni
58.7

29
Cu
63.5

30
Zn
65.4

31
Ga
69.7

32
Ge
72.6

33
As
74.9

34
Se
79.0

35
Br
79.9

36
Kr
83.8

37
Rb
85.5

38
Sr
87.6

39
Y
88.9

40
Zr
91.2

41
Nb
92.9

42
Mo
95.9

43
Tc
(98)

44
Ru
101.1

45
Rh
102.9

46
Pd
106.4

47
Ag
107.9

48
Cd
112.4

49
In
114.8

50
Sn
118.7

51
Sb
121.8

52
Te
127.6

53
I
126.9

54
Xe
131.3

55
Cs
132.9

56
Ba
137.3

57
La *
138.9

72
Hf
178.5

73
Ta
180.9

74
W
183.9

75
Re
186.2

76
Os
190.2

77
Ir
192.2

78
Pt
195.1

79
Au
197.0

80
Hg
200.6

81
Tl
204.4

82
Pb
207.2

83
Bi
209.0

84
Po
(209)

85
At
(210)

86
Rn
(222)

87
Fr
(223)

88
Ra
226.0

89
Ac
227.0

104
Unq
(261)

105
Unp
(262)

106
Unh
(263)

107
Uns
(262)

108
Uno
(265)

109
Une
(267)

58
Ce
140.1

59
Pr
140.9

60
Nd
144.2

61
Pm
(145)

62
Sm
150.4

63
Eu
152.0

64
Gd
157.3

65
Tb
158.9

66
Dy
162.5

67
Ho
164.9

68
Er
167.3

69
Tm
168.9

70
Yb
173.0

71
Lu
175.0

90
Th
232.0

91
Pa
(231)

92
U
238.0

93
Np
(237)

94
Pu
(244)

95
Am
(243)

96
Cm
(247)

97
Bk
(247)

98
Cf
(251)

99
Es
(252)

100
Fm
(257)

101
Md
(258)

102
No
(259)

103
Lr
(260)

GO ON TO THE NEXT PAGE.

as developed by

Digestive and Excretory Systems Test 1

Passage I (Questions 15)
The kidneys regulate hydrogen ion (H + )
concentration in extracellular fluid primarily by
controlling the concentration of bicarbonate ion
(HCO3). The process begins inside the epithelial cells of
the proximal tubule, where the enzyme carbonic anhydrase
catalyzes the formation of carbonic acid (H2CO 3) from
CO 2 and H2O. The H2CO 3 then dissociates into HCO3
and H+. The HCO3 enters the extracellular fluid, while
the H+ is secreted into the tubule lumen via a Na+ H +
countertransport mechanism, which takes advantage of the
Na+ gradient established by the Na+K+ pump.
Since the renal tubule is not very permeable to the
H C O 3 filtered into the glomerular filtrate, the
reabsorption of HCO3 from the lumen into the tubular
cells occurs in a roundabout way. Carbonic anhydrase
causes this HCO3 to combine with the secreted H+ ,
forming H2CO 3. The H2CO 3 then dissociates into CO2
and H2O. The H2O remains in the lumen, while the CO2
enters the tubular cells
Looking at Figure 1, it can be seen that inside the
cells, every H+ secreted into the lumen is countered by an
HCO 3 entering the extracellular fluid. Thus, the basic
mechanism by which the kidneys regulate body fluid pH
is by the titration of H+ with HCO3.

tubular cell
K+

HCO3

Na+

Na+

HCO3 + H+

H+ + HCO3

H2CO3

CO2

Na+ + HCO3

2K+

3Na+

H2O
+
CO2

carbonic
anhydrase

A.
B.
C.
D.

Facilitated diffusion
Passive diffusion
Active transport
Endocytosis

2 . Administration of acetozolamide to a patient would

result in an increase in the excretion of:
I. Na+.
II. HCO3.
III. H +.
IV. H2O.
A . II only
B . IV only
C . I, II, and IV only
D . I, II, III, and IV

3 . The kidneys excrete acidic urine when:

tubule
lumen

extracellular
fluid

1 . Based on information in the passage, which of the

following is the mechanism by which Na + is
transported into the tubular cells?

carbonic
anhydrase

H2CO3

CO2 + H2O

A . more hydrogen ions are secreted into the tubular

lumen than bicarbonate ions are filtered into the
glomerular filtrate.
B . more bicarbonate ions are filtered into the
glomerular filtrate than hydrogen ions are secreted
into the tubular lumen.
C . more hydrogen ions are filtered into the
glomerular filtrate than bicarbonate ions are
secreted into the tubular lumen.
D . more bicarbonate ions are secreted into the
tubular lumen than hydrogen ions are filtered into
the glomerular filtrate.

Figure 1
The drug acetozolamide is a potent noncompetitive
inhibitor of carbonic anhydrase. Acetozolamide is a
diuretica drug that increases the rate of urine formation
and thereby increases the excretion of water and other
solutes. Diuretics can be used to maintain adequate urine
output or to rid the body of excess fluid.

KAPLAN

GO ON TO THE NEXT PAGE.

MCAT
4 . Which of the following hormones would have the
opposite effect on blood volume as acetozolamide?
A.
B.
C.
D.

ADH
FSH
Calcitonin
Somatostatin

5 . Spironolactone is an adrenocorticosteroid that acts as

a diuretic by inhibiting aldosterone. A patient taking
this drug would most likely have a(n):
A . increased blood volume and a decreased plasma
concentration of Na+.
B . increased blood volume and an increased plasma
concentration of Na+.
C . decreased blood volume and a decreased plasma
concentration of Na+.
D . decreased blood volume and an increased plasma
concentration of Na+.

GO ON TO THE NEXT PAGE.

as developed by

Digestive and Excretory Systems Test 1

Passage II (Questions 610)
Despite its bad reputation, cholesterol plays a vital
role in health maintenance. Cholesterol serves as a
precursor for bile salts, steroid hormones, and other
specialized molecules, and is a constituent of membranes.
Cholesterol is primarily supplied by the diet or
synthesized by the liver, though all cells have cholesterol
biosynthesis capability.
Most of the cholesterol in plasma is carried by LDL
(low-density lipoproteins), which is the product of VLDL
(very low-density lipoproteins) metabolism. Almost every
body cell has LDL membrane receptors. Binding of LDL
to these receptors triggers an invagination of the cell
membrane and engulfment of the LDL-cholesterol
complex. Inside the cell, enzymes break down the LDL,
releasing the cholesterol for incorporation into membranes
or other specialized molecules. Intracellular free
cholesterol inhibits its own biosynthesis by inhibiting the
rate-limiting enzyme involved in the process. Thus,
dietary and liver-produced cholesterol is utilized before the
cell produces its own. When intracellular free cholesterol
is low, the cells produce more LDL receptors in order to
increase cholesterol uptake from the plasma.
Another carrier, called HDL (high-density
lipoproteins), lowers plasma cholesterol concentration by
binding to free cholesterol from dying plasma membranes.
These HDL-cholesterol complexes are metabolized by
liver cells, yielding free cholesterol that is secreted into
bile. The bile eventually empties into the duodenum,
where it is reabsorbed from the intestine or excreted into
the feces. Alternatively, liver cells may metabolize the
free cholesterol into bile acids. The bile acids then pass
through the bile duct and into the small intestine, where
the biliary cholesterol is reabsorbed from the intestine or
excreted into the feces.

6 . Which cell organelle is responsible for the enzymatic

degradation of LDL-cholesterol complexes?
A.
B.
C.
D.

7 . Normal VLDL production by the liver is inhibited

by the ingestion of high concentrations of the
vitamin niacin. Which of the following would most
likely occur in an individual consuming excess
niacin?
A . Decreased bile cholesterol levels
B . Decreased cholesterol secretion into the small
intestine
C . Increased activity of cellular cholesterolsynthesizing machinery
D . Increased plasma concentration of VLDL

8 . Research has shown that ingestion of saturated fatty

acids (SFAs) tends to raise plasma cholesterol both
by inhibiting the conversion of free cholesterol to
bile acids and by stimulating cholesterol
biosynthesis. Which of the following would best
account for these findings?
A . Chylomicrons containing SFAs inhibit the ratelimiting enzyme involved in cellular cholesterol
biosynthesis.
B . SFAs resemble cholesterol molecules to the
extent that the body is often unable to
differentiate between them.
C . Chylomicrons containing SFAs bind to LDL
receptors, thereby blocking the receptor-mediated
endocytosis of LDL-cholesterol complexes.
D . SFAs mimic the action of HDL molecules,
thereby increasing cholesterol transport and
increasing cholesterol metabolism in liver cells.

Lysosomes
Mitochondria
Endoplasmic reticulum
Ribosomes
GO ON TO THE NEXT PAGE.

KAPLAN

MCAT
9 . An individual with an average daily intake of
cholesterol discovers that she has abnormally high
plasma cholesterol. Which of the following steps
would be effective in lowering her plasma cholesterol
concentration?
I.
II.
III.
IV.
A.
B.
C.
D.

Increase bile cholesterol

Increase plasma HDL level
Decrease plasma HDL level
Decrease dietary cholesterol intake

IV only
II and IV only
III and IV only
I, III, and IV only

1 0 . Familial hypercholesterolemia is a disease in which

certain afflicted individuals maintain a plasma
cholesterol level five times higher than the normal
level. Which of the following best explains this
phenomenon?
A . Afflicted individuals have abnormally low
cholesterol requirements for normal body
functioning.
B . Afflicted individuals are unable to produce the
rate-limiting enzyme involved in cellular
cholesterol biosynthesis.
C . Afflicted individuals have defective livers that
metabolize LDL-cholesterol complexes as well as
HDL-cholesterol complexes.
D . Afflicted individuals lack the gene that codes for
LDL receptors.

GO ON TO THE NEXT PAGE.

as developed by

Digestive and Excretory Systems Test 1

Questions 11 through 16 are
NOT based on a descriptive
passage.
11. If the hormone secretin were not released when
chyme entered the small intestine, which of the
following would NOT occur?
A.
B.
C.
D.

Secretion of enterogastrone
Secretion of cholecystokinin
Secretion of insulin
Secretion of bicarbonate ion

1 4 . Children who develop acute glomerulonephritis, in

which the renal glomeruli are inflamed and therefore
fail to filter adequate quantities of fluid, would be
expected to develop all of the following EXCEPT:
A.
B.
C.
D.

an excess of extracellular fluid in body tissue.

a high concentration of urea in the blood.
a decreased urine output.
a high concentration of sodium in the urine.

1 5 . Vitamin K cannot be synthesized by human cells.

While the amount of vitamin K in ingested foods is
not normally sufficient to maintain adequate blood
coagulation, the normal plasma concentration of
vitamin K is sufficient. Which of the following best
accounts for this apparent contradiction?
1 2 . The hunger pangs that may be experienced in the
stomach 12 to 24 hours after the last ingestion of
food are due to:
A . the emptying of the stomach contents into the
small intestine through the pyloric sphincter.
B . peristaltic contractions of the stomach.
C . the excess secretion of mucus in the stomach.
D . the highly acidic environment of the stomach.

A . Vitamin K is synthesized in the liver using

hormones absorbed from ingested plant cells.
B . Vitamin K is a byproduct of protein degradation
during digestion.
C . Degraded vitamin K is reabsorbed into the blood
from the kidneys.
D . Vitamin K is synthesized by bacteria that inhabit
the colon.

1 6 . Which of the following would most likely cause

malabsorption in the small intestine?
1 3 . In the process of fat emulsification, bile salts make
fats more susceptible to the action of lipases by:
A . transporting fat globules to the region of lipase
activity.
B . increasing the surface area of the fat globules.
C . functioning as a catalyst to the lipases.
D . lowering the pH of the small intestine.

A . Presence of extremely dilute chyme in the small

intestine
B . Destruction of the intestinal villi
C . Deceased secretion of HCl in the stomach
D . Presence of alkaline fluid in the small intestine

END OF TEST

KAPLAN

MCAT
ANSWER KEY:
1.
A
6.
2.
C
7.
3.
A
8.
4.
A
9.
5.
C
10.

A
C
C
B
D

11.
12.
13.
14.
15.

D
B
B
D
D

16.

as developed by

Digestive and Excretory Systems Test 1

DIGESTIVE AND EXCRETORY SYSTEMS TEST 1 TRANSCRIPT
Passage I (Questions 1-6)
1.
The correct answer is choice A. Referring to both Figure 1 and the passage, you see that H+ is secreted into the
lumen via a Na+-H+ countertransport mechanism. After carbonic anhydrase catalyzes the formation of carbonic acid inside the
tubular cell, the carbonic acid spontaneously degrades into bicarbonate ion and H+, causing a buildup of H+ within the cell.
The H+ is secreted into the lumen in exchange for Na+. The Na+ binds to a carrier protein on the luminal side of the cell
membrane, while at the same time, an H+ binds to the opposite side of the same carrier protein. Since there is a greater
concentration of Na+ outside the cell than inside, due to the Na+ -K+ pump, Na+ moves down its concentration gradient into the
cell. This movement supplies the energy for moving the H+ into the tubular lumen. Therefore, it is said that the Na+ moves
into the cell via facilitated diffusion; no energy is required because movement is with the concentration gradient, not against
it. Thus, choice A is the correct answer. Choice C is wrong because although active transport requires a protein carrier, it also
requires APT. Choice D can also be eliminated. Endocytosis is the uptake of extracellular material via invagination of the
plasma membrane. Clearly, that's not occurring here. In this case, one ion is being exchanged for another ion. Choice B,
passive diffusion, is also incorrect. Passive diffusion is the movement of an ion down its concentration gradient without the
aid of a carrier protein and the countertransport of another ion. Again, the correct answer is choice A.
2.
The correct answer is choice C. The key to solving this question is understanding the effects of carbonic anhydrase.
From Figure 1, we know that carbonic anhydrase is found in both the lumen and within the tubular cells of the kidney. In the
lumen, hydrogen ions and bicarbonate ions are converted to carbonic acid, which then dissociates into carbon dioxide and
water. This reaction is catalyzed by carbonic anhydrase. The water remains in the lumen, while the carbon dioxide enters the
cells. Inside the cells, carbonic anhydrase catalyzes the formation of carbonic acid from water and carbon dioxide. The carbonic
acid dissociates into a bicarbonate ion and a hydrogen ion. The bicarbonate ion enters the extracellular fluid, while the
hydrogen ion is secreted into the lumen in exchange for a sodium ion. According to the passage, acetozolamide is an inhibitor
of carbonic anhydrase. Thus, administering acetozolamide would prevent those reactions that are catalyzed by carbonic
anhydrase. And this would mean that the sodium ion-hydrogen ion countertransport would come to a halt, as would the reabsorption of bicarbonate ion from the lumen into the tubular cells. Since the fluid remaining in the lumen is eventually
excreted in the urine, acetozolamide would result in a decrease in urinary hydrogen ion, an increase in urinary bicarbonate ion,
and an increase in urinary sodium ion. This increase in urine osmolarity would draw water into the lumen, to counter the
increase in lumen fluid osmolarity. Thus, there will be an increase in the urinary amounts of Roman numerals I, II, and IV,
and a decrease in Roman numeral III, and so choice C is the right answer. Once you had determined that Roman numeral I was
a component of the correct answer, you should have ruled out choices A and B, narrowing it down to C and D. Again, choice
C is correct.
3.
Choice A is correct. According to the passage, the secretion of hydrogen ions into the lumen is countered by the
movement of bicarbonate ions into the extracellular fluid from the filtrate, and that this titration is the means by which the
kidneys regulate body fluid pH. Acidity is a function of hydrogen ion concentration. Therefore, when the kidneys excrete
acidic urine, it means that there is a high concentration of hydrogen ions in the urine relative to the concentration of
bicarbonate ions. Since urine is formed from the fluid in the tubule lumen, acidic urine results when the lumen fluid has a
high hydrogen ion concentration relative to the bicarbonate ion concentration. This means that more hydrogen ions are
secreted into the tubule than bicarbonate ions are filtered into the lumen from the glomerulus. Thus, choice A is correct and
choice B is wrong. Now even if you weren't able to figure out the origin of acidic urine, you should have been able to narrow
it down to choice A and B right off the bat based on Figure 1 alone. As you can clearly see, it is the hydrogen ions that are
secreted INTO the tubular lumen, thereby eliminating choice C and D. Again, choice A is the correct answer.
4.
The correct answer is A. Answering this question requires an understanding of the effect acetozolamide and various
hormones have on the body's fluid status. Acetozolamide inhibits carbonic anhydrase and thus inhibits both the excretion of
hydrogen ions into the lumen and the re-absorption of bicarbonate. The excretion of hydrogen ions into the lumen is
important because it provides the means by which sodium is taken up into the tubular cell. If no hydrogen ions are produced
in the tubular cell due to the inhibition of carbonic anhydrase, the sodium cannot be taken up and so remains within the
lumen, increasing its osmolarity. Water will diffuse back into the lumen due to the increased osmolarity of the lumen, and
thus, urine volume will increase. Indeed, this is the way in which this diuretic acts to rid the body of excess fluid. The
hormone with the opposite effect then, is one that causes a decrease in water excretion. In other words, this hormone must
cause an increase in water re-absorption--and ADH is the hormone we're looking for. ADH, or antidiuretic hormone, increases
the re-absorption of water in the kidneys. Even its name, ANTI-diuretic hormone, should have made this question a dead
giveaway, since acetozolamide is a diuretic. Thus choice A is the correct answer. Choice B is incorrect because FSH, or
follicle-stimulating hormone, causes the maturation of an ovum in preparation for ovulation. Choice C, calcitonin, is also
incorrect, since calcitonin is a hormone that decreases plasma calcium. Calcitonin is secreted by the thyroid gland in response
to high plasma calcium ion concentration. Similarly, choice D, somatostatin, is also incorrect. Somatostatin is secreted by

KAPLAN

MCAT
the hypothalamus and is a potent inhibitor of many other hormones, including: growth hormone, TRH (thyroid-releasing
hormone), ACTH, insulin, glucagon, gastrin, and renin. Once again, the correct answer is choice A.
5.
Choice C is the correct answer. Coming up with the answer to this question required no information from the
passage itself. According to the question stem, spironolactone is a diuretic that inhibits aldosterone. Aldosterone is the
hormone that causes an increase in the re-absorption of sodium ions from the lumen of the nephron and an increase in the
secretion of potassium ions into the lumen of the nephron. Thus, aldosterone increases the plasma concentration of sodium
ions. Therefore, a drug that inhibits aldosterone will inhibit the re-absorption of sodium ions and will thereby decrease the
plasma concentration of sodium ions. Based on that piece of information, you know that we can eliminate choices B and D.
To distinguish between choices A and C, you need to know about aldosterone's effect on blood volume. Osmolarity is the
number of solute particles in a certain volume of liquid. And you know that if you have two compartments divided by a
membrane permeable to water, water will diffuse from the area of lower osmolarity to the area of higher osmolarity. Sodium
is re-absorbed from the tubular filtrate into the tubular cells, and eventually enters the bloodstream. This movement of sodium
from the tubular lumen to the cells, and finally to the blood results in an increase in the osmolarity of these regions, resulting
in a concomitant movement of water. So where the sodium ions go, the water follows, which means than an increase in the
plasma concentration of sodium will be accompanied by an increase in blood volume. Therefore, when you inhibit
aldosterone, not only do you inhibit the re-absorption of sodium, but you inhibit the movement of the water as well,
resulting in a decrease in blood volume. And so, choice C is the correct answer. Even if you didn't remember the effects of
aldosterone there was still a way to get the right answer. You're told in the question stem that spironolactone is a diuretic.
And from the passage you know that diuretics increase the loss of water and other solutes. Therefore, upon administration of a
diuretic, you would expect a decreased plasma concentration of solutes along with a decrease in blood volume, since urine
excretion has increased. So by this line of reasoning, it is obvious that choice C must be the correct answer.
Passage II (Questions 6-10)
6.
The correct answer is choice A. To answer this question, you needed to remember the basic functions of these four
cell organelles. Lysosomes are the garbage disposal system of cells. Lysosomes make use of hydrolytic enzymes to accelerate
the breakdown of unwanted proteins, polysaccharides, nucleic acids, and lipids. In this passage, we have lysosomes separating
the LDL from the cholesterol molecules, thereby freeing the cholesterol for use by the cell. Thus, choice A is right. Choice B
is wrong because the primary function of mitochondria is cellular respiration--the process by which usable energy is derived
from food materials and stored in the high-energy phosphate bonds of ATP. Choice C is wrong because the endoplasmic
reticulum (ER) serves as the main intracellular transport mechanism for molecules, especially proteins. While some cells do
contain large amounts of ER, some of which has associated degradative enzymes, intracellular degradation is not the primary
function of most cellular ER and certainly cannot be considered the main degradative source for the breakdown of LDLcholesterol complexes. Ribosomes, choice D, either float freely within the cytoplasm or are connected to the membranes of
the ER (rough endoplasmic reticulum). Ribosomes are responsible for translating messenger RNA transcripts into peptide
chains. Thus, choice D is wrong. Again, choice A is correct.
7.
Choice C is the correct answer. VLDL is synthesized by the liver, but it is soon cleaved into LDL by removal of a
lipid moiety. Thus, if the vitamin niacin interferes with VLDL production, which is exactly what happens according to the
question stem, then ingestion of excessive amounts of niacin will effectively reduce the LDL concentration in that individual's
plasma. Thus, right off the bat, you should have eliminated choice D, because VLDL plasma concentration will obviously be
decreased, not increased. An individual with decreased amounts of available LDL will have fewer LDL-cholesterol complexes.
The net result is that cholesterol uptake will decrease, and the rate-limiting enzyme that controls cellular cholesterol
biosynthesis will not be inhibited. This will result in increased activity of the cellular cholesterol-synthesizing machinery to
compensate for the apparent lack of dietary cholesterol. Thus, choice C is correct. Choice A is incorrect because, as stated in
the passage, bile cholesterol levels are primarily a function of HDL concentration. Since VLDL is not the precursor of HDL,
a decrease in VLDL production would not affect HDL levels. On the contrary, if less cholesterol is made available to cells,
and more cholesterol is synthesized intracellularly, then the resulting increase in plasma cholesterol levels would initiate
plasma cholesterol clearance mechanisms. For this reason, liver cells would secrete more cholesterol into the bile, where it
could be excreted into the feces. So, choice A is wrong. Choice B is also wrong, for many of these same reasons. HDL is
responsible for controlling how much cholesterol is transported into liver cells, where it is broken down into bile acids and
secreted into the small intestine. VLDL concentration does not regulate HDL concentration. Also, since a low LDL level
would result in increased plasma cholesterol, this would result in an increase in cholesterol secretion into the small intestine.
Again, choice C is the correct answer.
8.
Choice C is correct. To get this question right, you need to understand the underlying factors responsible for the
regulation of plasma cholesterol levels that are described for you in the passage. The question presents a situation in which
the conversion of cholesterol into bile acids is inhibited and cholesterol synthesis is stimulated. Choice C is correct because it
best accounts for these two effects. You might have remembered that chylomicrons are small lipid droplets that are very
hydrophobic, and thus are able to absorb similarly hydrophobic molecules such as SFAs, effectively removing them from

10

as developed by

Digestive and Excretory Systems Test 1

circulation until they are needed. If the chylomicrons were to bind to LDL receptors on cell membranes, they would compete
with cholesterol molecules, which would prevent or inhibit cholesterol from being absorbed into cells. With less cholesterol
present inside the cells, the rate-limiting enzymes of these cells would not be inhibited, and so intracellular cholesterol
biosynthesis would increase. So, choice C is the right answer. Choice A is incorrect, because if chylomicrons containing
SFAs actually inhibited the rate-limiting enzyme involved in cellular cholesterol biosynthesis, then this enzyme would not be
effective in carrying out its intended function and cholesterol biosynthesis would be impaired. Since the research showed
cholesterol biosynthesis to be stimulated rather than impaired, choice A is wrong. Choice B is also incorrect because if the
SFAs resembled cholesterol molecules to the extent that the body could not distinguish between the two, then ingested SFAs
would affect the body in a manner similar to ingested cholesterol. They would be absorbed via the LDL receptor-mediated
endocytosis and would then inhibit the rate-limiting enzyme within each cell, thus causing intracellular cholesterol
biosynthesis to be impaired. Since this would contradict the research data, choice B must be wrong. Finally, if SFAs
mimicked HDL action to the extent that they could bind with free-floating cholesterol, this would facilitate the transport of
cholesterol into the liver cells. This, in turn, would cause the liver cells to metabolize increased amounts of cholesterol. Bear
in mind, however, that these liver cells convert cholesterol into bile acids, the very process that is inhibited by SFAs
according to the question stem. If choice D were true, cholesterol conversion to bile acids would be stimulated, not inhibited.
Therefore, choice D is wrong. Again, choice C is correct.
9.
Choice B is correct. You're looking for the options that result in a decrease in plasma cholesterol. According to the
passage, your body has two main ways to obtain cholesterol: it's either ingested or synthesized intracellularly. Obviously, by
decreasing your ingestion of dietary cholesterol, you would restrict your body's access to cholesterol, thus decreasing plasma
cholesterol. Thus, Option IV should be included in your answer. Unfortunately, this doesn't narrow the field at all, since
Option IV appears in all 4 choices. Okay, what about the others? HDL complexes with free cholesterol, which eventually
results in the excretion of some of this cholesterol. A person with abnormally high plasma cholesterol would therefore be
particularly responsive to therapy in the form of an increase in plasma HDL. This would allow more cholesterol to be bound,
metabolized by the liver, and excreted through the feces. Thus, Option II would also be effective in lowering her plasma
cholesterol level. So this means that choice B must be the right answer since it's the only one with both of these options.
Option I would not be effective in lowering plasma cholesterol because increasing bile cholesterol would necessarily involve
increasing plasma cholesterol, since bile cholesterol is derived from plasma cholesterol that found its way into liver cells.
Option III would also be ineffective, because lowering HDL levels means that cholesterol uptake by liver cells would
decrease. Again, choice B is correct.
10.
Choice D is correct. From the passage, you know that LDL reduces plasma cholesterol levels by binding to and
transporting cholesterol into cells, where it is metabolized and used in the synthesis of a variety of molecules. Remember,
though, that for the LDL-cholesterol complex to traverse the cell membrane, it must first bind to an LDL receptor. As choice
D suggests, if a person did not possess the gene that codes for the LDL receptor, then they would not be able to synthesize
any LDL receptors. This would result in an elevated plasma cholesterol for two reasons. First, LDLs would not be able to
reduce plasma cholesterol because they would not be able to transport cholesterol into cells. Second, if cholesterol doesn't get
into cells, then the rate-limiting enzyme that controls intracellular cholesterol biosynthesis would not be inhibited. Thus,
even though plasma cholesterol might be high, the body would continue synthesizing cholesterol unchecked, resulting in
hypercholesterolemia. For this reason, choice D is correct. Choice A is wrong because there's simply no information in the
passage to lead you to such a conclusion. You don't even know if there is such a thing as a decreased need for cholesterol.
After all, we all need cholesterol for our membranes and other biological structures. Choice A, therefore, is definitely not the
best explanation for the symptoms of familial hypercholesterolemia, and is thus wrong. Choice B is wrong, because if the
rate-limiting enzyme for cellular cholesterol biosynthesis was not produced, then that individual would simply be unable to
produce cholesterol naturally. Since this would not result in abnormal elevations of plasma cholesterol, choice B is a poor
explanation for hypercholesterolemia. Choice C is wrong, because having a defective liver that metabolized cholesterol from
both LDL- and HDL-cholesterol complexes wouldn't stop other body cells from uptaking the LDL complexes, which would
result in the inhibition of intracellular cholesterol biosynthesis. The net result of this defective liver would be lowered
plasma cholesterol levels, thus choice C is incorrect. Again, choice D is the right answer.
Discretes (Questions 11-16)
11.
The correct answer is choice D. Secretin is the hormone secreted by the duodenum when the acidic chyme enters the
small intestine. Secretin stimulates the pancreas to secrete pancreatic juice, which contains a high concentration of
bicarbonate ion and is therefore alkaline enough to neutralize the chyme. Neutralization of the chyme's acidity is particularly
important for the activity of the small intestine's enzymes, which operate at a slightly basic pH and are denatured in an acidic
environment.
Enterogastrone, choice A, is released by the duodenum when the chyme is fatty. Enterogastrone slows the release of
chyme into the small intestine by inhibiting stomach peristalsis, allowing more time to digest the fats. Cholecystokinin
(CCK), choice B, is secreted by the duodenum in response to the presence of chyme. CCK stimulates the secretion of

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pancreatic enzymes and the release of bile. Insulin, choice C, is the hormone secreted by the pancreas in response to high
glucose blood concentration; it is not directly involved in the digestive process. Again, choice D is the right answer.
12.
The correct answer is choice B. It is the peristaltic contractions of the stomach itself that causes hunger pangs.
Choice A has to be wrong because the emptying of the stomach contents into the small intestine through the pyloric
sphincter occurs much earlier in the digestive process than the 12 to 24 hours following the last ingestion of food. Choice C
is wrong because in addition to lubricating food for ease of transport, mucus provides a major shell of protection for the
stomach from its highly acidic environment and its digestive enzymes. Excess mucus would not cause any sort of pain.
Choice D can be eliminated because the stomach's environment is normally highly acidic, and does not cause pain, and so
there is no reason to think that the acid would cause pain 12 to 24 hours after the last ingestion of food. (This does occur,
however, in cases of peptic ulcer disease.) Again, choice B is correct.
13.
Choice B is the correct answer. Emulsification, which occurs via the detergent action of bile salts, increases the
surface area of fat globules exposed to the lipases. Emulsification involves the breaking of fat globules down into smaller
particles so that the lipases can act on their surfaces. Since the lipases can only attach the fat globules on their surfaces, the
action of bile salts greatly enhances the lipases' capacity for fat digestion. Thus, choice B is correct. Choice A is wrong
because fat digestion occurs in the small intestine; the fat globules do not have to be transported there. Choice C is wrong
because the only compound that comes close to acting as a catalyst for lipase is the protein colipase, without which lipase
could not act on fats. Choice D is wrong because bicarbonate ion is secreted into the small intestine for the sole purpose of
raising pH, and countering the acidic chyme entering from the stomach. Then environment of the small intestine needs to be
slightly alkaline for proper digestion to occur. Again, choice B is the right answer.
14.
The correct answer is choice D. When the glomeruli are unable to filter adequate amounts of fluid, the major
physiological effect is retention of salt and water, since these can no longer be excreted by the kidneys. Urinary output
decreases markedly (choice C) to less than 500 mL/day. The quantity of salt and water in the extracellular fluid increases
drastically and decreases in the urine, which leads to an excess of extracellular fluid in body tissue (choice A), a condition
known as edema. If the glomeruli are shut down, urea cannot be excreted either. Thus, choice A and C are wrong and choice D
is right. And, another consequence of the glomeruli inflammation is the excessive accumulation of urea in the blood (choice
B), a condition known as uremia. So, choice B is also wrong. Again, choice D is the right answer.
15.
The correct answer is choice D. The vitamin K we need for blood coagulation is synthesized by the intestinal bacteria
residing in our colons. Vitamin K is required for the liver to synthesize blood factors VII, IX, and X, and prothrombin.
Deficiency of vitamin K causes hypoprothrombinemia, which manifests itself in defective coagulation of the blood. Choices
A, B, and C are clearly wrong, since they all involve human synthesis of production of vitamin K, and you're clearly told in
the question stem that this is an impossible feat. Again, choice D is the right answer.
16.
The correct answer is choice B. The presence of the millions of small villi over the entire surface of the small
intestine is crucial to its absorptive capacity. The villi greatly enhance the surface area of the small intestine's absorptive
membrane. Extremely dilute chyme (choice A) presents little problem for the small intestine, because water is readily
transported through the intestinal mucosa into the blood of the villi when there is sufficient osmotic pressure. HCl is secreted
in the stomach, not the small intestine. If decreased secretion of HCl in the stomach caused the chyme entering the small
intestine to be less acidic, this would not adversely affect intestinal absorption. In fact, the digestive enzymes of the small
intestine operate best at a slightly basic pH. And so choice C is also wrong. The presence of alkaline fluid in the small
intestine is the norm, due to the secretion of bicarbonate ion into the small intestine. Thus, choice D is wrong since this
would obviously not result in malabsorption. Again, choice B is the right answer.

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