PHYSIOLOGY 2020

EVALUATION 11: GASTROINTESTINAL PHYSIOLOGY

1. A 17-year-old male developed loose watery stools and was diagnosed with an antibiotic-
associated diarrhea. The increased gastrointestinal motility in this patient is due to the antibiotic’s
activation of which gastrointestinal hormone?
a. Gastric Inhibitory Peptide (GIP) d. Motilin
b. Secretin e. Cholecystokinin
c. Gastrin

2. A 25-year-old patient presents with the chief complaint of intermittent mid-epigastric pain that is
relieved by antacids or eating. Gastric analysis reveals that basal and maximal acid output exceed
normal values. The gastric acid hypersecretion can be explained by an increase in the plasma
concentration of _______?
a. Histamine c. Gastrin
b. Somatostatin d. Secretin

3. A 42-year-old-male develops a gastric carcinoma affecting the proximal third of his stomach. He
is scheduled for a partial gastrectomy of the affected region, which will primarily affect which of
the following processes?
a. Segmentation c. Peristalsis
b. Retropulsion d. Accommodation

4. A 47-year-old woman with hypermenorrhea develops an iron-deficiency anemia requiring iron

supplements. Which of the following statements is correct regarding iron digestion and
absorption?
a. About 100 mg of iron is absorbed per day
b. In general, iron must be oxidized from the ferrous to the ferric state for efficient absorption
c. Iron is transported in the blood bound to transferrin
d. Iron is absorbed rapidly from the small intestine

5. A 49 y/o man undergoes vagotomy for his peptic ulcer disease. As a result, which of the following
gastrointestinal motor activities will be affected most?
a. Secondary esophageal peristalsis
b. Distension-induced intestinal segmentation
c. Proximal stomach accommodation
d. Migrating Myoelectric Complex

6. A 57-year-old man undergoes resection of the distal 100 cm of the terminal ileum as part of
treatment for Crohn’s disease. The patient likely will develop malabsorption of which of the
following?
a. Folate d. Bile salts
b. Protein e. Lactose
c. Iron

7. A new mother calls the pediatrician because she is concerned that her infant defecates after every
meal. Which of the following is the cause of these normal bowel movements in newborns?
a. The gastroileal reflex b. The intestino-intestinal reflex
 c. The gastrocolic reflex d. The defecation reflex

8. A newborn with severe diarrhea is found to have an inherited defect in a glucose transporter
resulting in glucose/galactose malabsorption, necessitating a glucose and galactose-free diet.
Which of the following is the transport protein responsible for entry of glucose into the intestinal
enterocyte?
a. Glut-2 d. SGLT 1
b. SGLT 2 e. SGLT 5
c. Glut-5

9. A patient reports substernal burning pain that is most pronounced after ingestion of coffee,
chocolate, french fries, and alcohol. Which of the following is the most likely cause of
gastroesophageal reflux disease (GERD) in this patient?
a. Decreased upper esophageal sphincter tone
b. Decreased esophageal motility
c. Delayed gastric emptying time
d. Decreased lower esophageal sphincter tone

10. Acid in the antrum stimulates release of this agent to inhibit meal-stimulated gastrin secretion?
a. Somatostatin d. Pepsin
b. Acetylcholine e. Gastrin
c. Histamine

11. After a high-protein meal, which type of cells will be more active in the stomach?
a. G cells c. M cells
b. D cells d. S cells

12. After secretion of trypsinogen into the duodenum, the enzyme is converted into its active form,
trypsin, by which of the following?
a. Procarboxypeptidase d. Enterokinase
b. Pancreatic lipase e. An alkaline pH
c. Chymotrypsin

13. An 18-year-old college student reports that she experiences severe abdominal bloating and
diarrhea within 1 hour of consuming dairy products. The diarrhea and bloating can be explained
by which of the following?
a. A deficiency in the brush border and enzyme lactase
b. Carbohydrate-induced secretory diarrhea
c. Decreased intestinal surface area
d. Decreased carbohydrate absorption

14. An 18-year-old male with pernicious anemia lacks intrinsic factor, which is needed for absorption
of cyanocobalamin. Vitamin B12 is absorbed primarily from which portion of the GI tract?
a. Ileum d. Jejunum
b. Stomach e. Colon
c. Duodenum

15. Atrophic gastritis is often associated with which of the following?

 a. Hyperchlorhydria c. Pernicious anemia
b. Steatorrhea d. Microcytic anemia

16. Benedict’s result is positive in which of the following solutions:

a. Test tube C - starch, amylase, pH 7.0 buffer (boiled)
b. Test tube D - starch, deionized water, pH 2.0 buffer
c. Test tube B - starch, amylase, pH 7.0 buffer
d. Test tube A - starch, deionized water, pH 7.0 buffer

17. Dietary fat, after being processed is extruded from the intestinal cells by exocytosis into the
lymphatic ducts in the form of:
a. Free fatty acids d. Chylomicrons
b. Diglycerides e. Monoglycerides
c. Triglycerides

18. Distension of the stomach:

a. Results in salivation c. Triggers gastro-colic reflex
b. Causes glucose absorption d. Inhibits gastric emptying

19. Fat digestion is maximal in which solution:

a. Test tube A - lipase, vegetable oil, bile salts, pH 7.0 buffer (boiled)
b. Test tube B - lipase, vegetable oil, bile salts, pH 7.0 buffer
c. Test tube D - lipase, vegetable oil, bile salts, pH 9.0 buffer
d. Test tube C - lipase, vegetable oil, deionized water, pH 7.0 buffer

20. Fat digestion occurs in which of the following solutions:

a. Test tube A - lipase, vegetable oil, bile salts, pH 7.0 buffer (boiled)
b. Test tube B - lipase, vegetable oil, bile salts, pH 7.0 buffer
c. Test tube C - lipase, deionized water, bile salts, pH 9.0 buffer
d. Test tube D - deionized water, vegetable oil, bile salts, pH 7.0 buffer

21. In the experiment, digestion of protein occurred in which of the following solutions:
a. Test tube A - pepsin, BAPNA, pH 2.0 buffer
b. Test tube C - pepsin, deionized water, pH 7.0 buffer
c. Test tube D - BAPNA, deionized water, pH 2.0 buffer
d. Test tube B - pepsin, BAPNA, pH 2.0 buffer (boiled)

22. Protein digestion is maximal in which of the following solutions:

a. Test tube A - pepsin, BAPNA, pH 2.0 buffer
b. Test tube B - pepsin, BAPNA, pH 2.0 buffer (boiled)
c. Test tube D - pepsin, BAPNA, pH 9.0 buffer
d. Test tube C - pepsin, BAPNA, pH 7.0 buffer

23. Saliva contains the carbohydrate-digesting enzyme?

a. Carboxypeptidase d. Amylase
b. Lysozyme e. Mucins
c. Lipase
24. Spike potentials superimposed on depolarizing portion of the slow waves do increase muscle
tension. The depolarizing portion of each spike is due to:
a. Ca2+ influx c. Na+ influx
b. Na+ efflux d. K+ efflux

25. Starch will be detected in the following solutions, EXCEPT:

a. Test tube A - starch, deionized water, pH 7.0 buffer
b. Test tube D - starch, amylase, pH 2.0 buffer
c. Test tube C - starch, amylase, pH 7.0 buffer (boiled)
d. Test tube B - starch, amylase, pH 7.0 buffer

26. Stomach emptying is controlled mostly by which of the following?

a. local neurohumoral mechanisms originating in the stomach itself
b. local neurohumoral mechanisms originating in the duodenum
c. activity of the small intestine
d. vasovagal reflexes that reduce the tone in the muscle wall of the body of the stomach

27. The extent of fat digestion was measured by:

a. pH meter c. Spectrophotometer
b. Colorimeter

28. The extent of protein digestion was measured by:

a. Spectrophotometer c. colorimeter
b. pH meter

29. The following agonist/s of the parietal cell promote parietal cell secretion by increasing
intracellular cyclic adenosine 3’,5’-monophosphate (cAMP):
a. Acetylcholine c. Gastrin
b. Histamine d. Gastrin and acetylcholine

30. The rate of gastric emptying increases with an increase in which of the following?
a. Intragastric volume c. Fat content of duodenum
b. Osmolality of duodenum d. Intraduodenal volume
e. Acidity of duodenum
31. True of Interstitial Cells of Cajal (ICC):
a. Located in the submucosal border of the circular muscle layer in the colon
b. Frequency of ICC pacemaker activity is constant in the different regions of the gastrointestinal
tract
c. Two of the choices are true
d. All of the choices are true
e. Act as the pacemakers of smooth muscle slow waves

32. What is the only protease that can function in the presence of acid?
a. Procarboxypeptidase A c. Trypsin
b. Pepsin d. Chymotrypsin

33. What is the reagent that detects for the presence of starch in a solution?
a. Deionized water b. Benedict’s solution
 c. Deiodinated water d. IKI solution

34. What is the result when IKI solution is added to a solution containing starch?
a. Solution turns black c. Solution turns yellow
b. Solution becomes clear d. Solution remains clear blue

35. Which of the following is true about pancreatic secretions?

a. Secretin causes secretion of enzymes
b. Cholecystokinin causes secretion of enzymes
c. Cholecystokinin (CCK) stimulates bicarbonate secretion
d. Vagal stimulation releases bicarbonate secretion into the ducts

36. Which of the following is true regarding contraction of the gallbladder following a meal?
a. It occurs simultaneously with the contraction of the sphincter of Oddi
b. It is inhibited by the presence of amino acids in the duodenum
c. It occurs in response to cholecystokinin
d. It is inhibited by a fat-rich meal

37. Which of the following occurs during the phase III of the Migrating Myoelectric Complex (MMC)?
a. The fundus receptively relaxes
b. The pylorus contracts to prevent gastric emptying and allow grinding of gastric contents
c. Contractions propagate indigestible material from the stomach into the small bowel
d. Contractions become unorganized and non-propagated

38. Which of the following statements about gastric emptying is correct?

a. acidification of the duodenum increases gastric emptying
b. hyperosmolality of duodenal contents initiates a decrease in gastric emptying
c. meals containing fat empty faster that carbohydrate-rich food
d. vagal stimulation decreases receptive relaxation in upper portion of stomach
e. solids empty more rapidly than liquids

39. Which of the following statements about small intestinal motility is correct?
a. migrating motor complexes move down the gastrointestinal tract at a regular rate during
fasting
b. Contractions are strong and effective even without background excitation from the myenteric
plexus
c. peristalsis is the only contractile activity that occurs during feeding
d. frequency of peristalsis is constant from duodenum to terminal ileum

40. Which of the following statements best describes water and electrolyte absorption in the
gastrointestinal tract?
a. Majority of the reabsorption occurs in the jejenum
b. Most water and electrolytes came from ingested fluids
c. The small intestines and colon have similar absorptive capacities
d. Majority of fluids are lost in the stools