1.

Select the system composed of structures of mesenteric lymph nodes, intestinal lamina propria, Payers's patches, lymphoid follicles, and cells that undergo migration, differentiation and have functions including the release of antibodies and mediators: A. Autonomic nervous system B. Parasympathetic nervous system C. Gastrointestinal immune system D. Sympathetic nervous system E. Sympathetic cholinergic nervous system 2. The administration of live bacteria such as Lactobacillus and Bifodobacterium species and some yeasts such as Saccharomyces boularidii to relieve symptoms of irritable bowel syndrome is known as: A. Prokinetic therapy B. Prebiotic therapy C. Probiotic therapy D. Antibiotic therapy E. Passive antibody therapy [3] Omeprazole is approved for clinical use in children 1 to 2 years of age, for all of the conditions EXCEPT: A. Heartburn B. Symptoms associated with gastroesophageal reflux disease C. Short term erosive esophagitis D. Maintenance of healing of erosive esophagitus E. Antibacterial effects on E. coli [4] A young college student, age 18, has loss of appetite and refuse to eat. This person MOST LIKELY has clinical symptoms of: A. Dumping syndrome B. Enteritis C. Achlorhydria D. Loss of GALT (gutassociated lymphoid tissue) E. Anorexia [5] Acquired intestinal obstruction in infants due to telescoptic or invagination of one portion of the intestine into another is called: A. Retching B. Endoscopy C. Absorption D. Intussusception E. Pepsinogen [6] Select the usual term for vermiform (wormlike) structure indicating outpouching of the cecum: A. Appendix B. Chyme C. Feces D. Enteroendocrine cell E. Barrett's esophagus [7] Select the procedure for visualizing the internal organs with an endoscopic instrument introduced into the abdominal cavity through the abdominal wall: A. Laparoscopy B. Endotracheal tube C. Intraperitoneal injection D. Anorexia E. Achlorhydria [8] The passing of black stools typically due to bleeding from the upper gastrointestinal tract where the black color results from the interaction of hydrochloric acid and blood is termed: A. Enterokinase B. Flatulence C. Paralytic ileus D. Melena E. Achalasia [9] Antihistamines in therapeutic doses would MOST LIKELY: I. Inhibit salivary secretion II. Stimulate salivary secretion III. Stimulate the formation of pernicious anemia A. I B. III C. I & II D. II & III E. I, II, and III [10] Select the most important gland that secretes hydrochloric acid, pepsinogen, and gastric intrinsic factor of pernicious anemia: A. Oxyntic parietal cells of the gastric mucosa B. Pyloric hyaline membrane C. Liver Kuffer's cells D. Functional pancreatic paraganglioma E. Splanchnic blood cells and pheochromocytoma [11] Magnesium hydroxide and aluminum hydroxide when used to treat peptic ulcer disease are classified pharmacologically as: A. H2 receptor antagonists B. Prostaglandins inhibitors + + C. Inhibitors of H /K ATPase pump D. Anticholinergics E. Antacids [12] Select the gram negative bacterium that has been recognized as a major factor in the pathogenesis of peptic ulcer disease including duodenal ulcers: A. Clostridium difficile B. Tape worm and heart worm C. Helicobacter pius D. Helicobacter pylori E. Histamine pylori [13] Inflammatory membrane derived lipid mediators released by activated mast cells include: A. Epinephrine, norepinephrine, and GI tract dopamine B. Leucotrienes (LTC 4, LTB 4) and prostaglandin (PGD 2) C. Cortisol and hydrocortisol D. Insulin and glucagon E. Glucocorticoid and mineralcorticoid

[14] Excess gas in the gastrointestinal tract, either swallowed air or gas formed by bacterial actions on substrate, can produce the discomfort called: A. Iron deficiency anemia B. Valine gastric lavage C. Peptic ulcer D. Colic E. Night blindness [15] The mechanism of intestinal absorption of fat-soluble vitamins is: A. Prokinetic actions B. Antispasmodic actions of intestines C. Micelle formation with bile salts D. Coupled with intrinsic factor of pernicious anemia E. Segmentation and peristalsis movements [16] The chief site of Vitamin B12 absorption, as well as bile salts, is most likely to occur in: A. Stomach orad and caudad regions (fundus, body, antrum) B. Red blood cell in pulmonary circulation C. White blood cell in systemic circulation D. Ileum E. Colon [17] Once food has been mixed with gastric secretions, it is referred to as: I. Extrinsic factor & intrinsic factor of pernicious anemia II. Feces III. Chyme A. I B. III C. I & II D. II & III E. I, II, & III [18] Stimulation of the medulla oblongata chemoreceptor trigger zone located in the area postrema (a circumventricular structure at the caudal end of the fourth ventricle) but outside the blood-brain will cause: A. Diverticulitis B. Hemorroids C. Antispasmodic action via subtype 2 dopamine receptor activation D. Vomiting, emesis, and retching E. Anticholinergic action [19] Congenital aganglionic megacolon is a condition that is generally associated with the failure of the parasympathetic nervous system to produce intramural ganglion cells in the enteric nervous system. This condition is termed: A. Pyloric stenosis B. Hirschprung's disease C. Gastroesophageal reflux D. Melena E. Colorectal cancer [20] Small intestines and large intestines are contracted by autonomic nerve: I. Sympathetic nerve stimulation II. Atropine release and nitric oxide release III. Parasympathetic nerve stimulation A. I B. III C. I & II D. II & III E. I, II, and III [21] The 2 main intramural plexuses in the gastrointestinal tract are the myenteric plexus (Auerback's plexus) and Meissner's plexus (submucous plexus) and these are parts of the: A. Central nervous system spinal lamina B. Cerebrospinal fluid C. Blood circulatory system murmur or bruit D. Enteric nervous system E. Lymph system and extracellular fluid [22] Mechanical twisting of the intestine called volvulus can: I. Occlude blood flow to the gut II. Cause ischemic sites to develop III. Cause necrosis A. I B. III C. I & II D. II & III E. I, II, and III [23] The term inflammatory bowel disease is best represented by: A. Ulcerative colitis and Crohn's disease B. Laxatives, cathartics, purgatives, and evacuants therapy C. Pernicious anemia and megaloblastic anemia D. Esophageal pain E. Loss of peristalsis in lower esophagus [24] A defect in the diaphragm that allows a portion of the stomach to pass through the diaphragmatic opening into the thorax is best called: A. Gastroesophageal reflex B. Piles C. Pseudomembraneous colitis D. Appendicitis E. Hiatal hernia [25] In the absence of adequate lactase, the digestive enzyme that breaks down lactose into glucose and galactose in the intestine, lactose undergoes bacterial fermentation which results in gas production in the intestinal lumen which causes: A. Chills and fever B. Cancer and malignant neoplasm C. Abdominal distention and excessive flatus D. Excessive hydrochloric acid production E. Antispasmodic effects [26] Borborygni rumbling noises in the intestinal tract are most likely caused by: A. Extrinsic factor of pernicious anemia B. Vitamin K deficiency, purpura, and petechiae C. Intestinal gases D. Proton pump inhibitors E. Antihistaminic drug

[27] Select the suffix meaning formation of an opening: A. -penia B. -plegia C. -pnea D. -ostomy E. -phragm [28] Indicate the disorder of esophageal smooth muscle function resulting in difficulty in swallowing both liquids and solids: A. Acromegaly B. Anorexia nervosa C. Achalasia of the esophagus D. Epiphyseal plate E. Cholasma [29] Outpouching of one or more layers of the wall of a structure in the gastrointestinal tract, especially in the colon or esophagus is called: A. Enterohepatic circulation B. Stroke C. Diurnal variation in folic acid D. Diverticulum/diverticula E. Gastrectomy [30] Esophageal varix (esophageal varices) can represent abnormally dilated blood vessels lying just below the mucous membranes of the esophagus that connect the hypertensive portal system with the systemic blood circulation. The MOST LIKELY effect of esophageal varices rupture is: A. Erythroblastosis fetalis B. Release of histamine and the intrinsic factor of pernicious anemia C. Massive hemorrhage D. Helicobacter pylori infection of the GI tract E. Immunosuppression [31] Select the condition where there is mild to massive bleeding due to a tear in the mucosa or submucosa of the cardia or lower esophagus and can be caused by forceful or prolonged vomiting during which the upper esophageal sphincter fails to relax: A. Mallory-Weiss syndrome B. Hemorrhoids C. Permissive endogenous action of drug D. Prostatitis E. Segmentation contractions and GI motility [32] The most likely cause of pseudomembraneous colitis is: A. Clostridium difficle infection B. Helicobacter pylori infection C. Stress incontinence D. Treponema pallidum infection E. Transmission of pathogenic Trichomonas vaginalis [33] Mr. M.J. has an inflammatory disease of the mucosa of the rectum and colon. The distal portion of the colon and the entire colon are affected. The condition is characterized by exacerbations and remissions, abdominal pain, diarrhea, and rectal bleeding. This person most likely has: A. Xerostomia B. Depressed sympathetic nervous system C. Intestinal colic D. Excessive flatus E. Ulcerative colitis [34] An inflammation of the oral mucosa that may extend to the buccal mucosa, lips, and plate is best known as: A. Diverticulitis B. Diverticulosis C. Dermatone D. Steatorrhea E. Stomatitis [35] A swollen appendix bursts before surgery. Select the condition that MOST significantly increases the risk of postoperative complications: A. Peritonitis B. Acid rebound in the stomach C. Antacid therapy D. GERD E. Antihistamine therapy [36] Changes in bowel habits resulting in diarrhea or constipation may occur in colorectal cancer. In addition a strong warning sign of colorectal cancer is: A. Normal menses B. Essential hypertension C. Diabetes insipidus D. Occult or frank blood in the stool E. Antibiotic therapy with chloromycetin [37] The main example of a condition that significantly indicates the secretion of excessive gastrin is: 3 A. Proton-pump inhibitor toxicity B. Malabsorption of fat soluble vitamins and fatty foods C. Zollinger-Ellison syndrome D. Anticholinergic drug induced constipation E. Hirschsprung's disease [38] Select the drug that is MOST LIKELY to cause gingival hypeplasia: A. Potassium nitrate B. Sodium fluoride C. Sensodyne paste D. Dilantin E. Magnesium sulfate solution [39] In the diagnosis of cystic fibrosis, a 72-hour stool collection combined with the dietary history during that time is used to determine fat absorption and fat excretion. A coefficient of fat absorption of less than 95% (85% in infants) can be used to define fatty stools. Fatty stool is also called: A. Stress incontinence B. Substantia nigra C. Cholecystokinin

D. Steatorrhea E. Heimlich Maneuver [40] Identify the chemical structural category of endogenous gastrin: A. Catecholamine B. Carbohydrate C. Lipid D. Steroid E. Protein [41] The prototypical central nervous system emetic drug is _________ and the prototypical gastric emetic drug is _______. A. Apomorphine HCl . ... ... .... Ipecac syrup B. Ipecac syrup .......... Morphine HCl C. Aspirin .................. NSAID D. Epinephrine ........... Norepinephrine E. Antispasmotic ........ Cholinergic [42] Which of the following IS NOT true about serotonin? A. Found in central nervous system and reuptake by serotonergic neurons in serotonergic systems can occur B. Released from enterochromaffin cells C. Modulate motor and secretory functions of the gut D. Also called 5-HT E. Also called cyanocobalamin [43] The intestinal tract has smooth muscle cells in their walls. Which of the following best describes the effects of acetylcholine and epinephrine on the smooth muscle of the intestinal tract when given separately? A. Acetylcholine contracts and epinephrine contracts B. Acetylcholine contracts and epinephrine relaxes C. Acetylcholine contracts and epinephrine has no effects D. Acetylcholine relaxes and epinephrine contracts E. Acetylcholine relaxes and epinephrine relaxes [44] Which of the following best describes the pharmacological effects of a parasympathomimetic drug acting on the smooth muscles of the intestinal tract? A. Contract/spasmogenic B. Relax/antispasmotic C. Protoplasmic poison D. Proton pump inhibitor E. Dry up secretions [45] The predominate cyclooxygenase at sites of inflammation is: A. COX-1 B. COX-2 C. Cholinesterase D. Pseudocholinesterase E. Glucocorticoid [46] The systemic or intravaginal administration of prostaglandin E1 analog misoprostol in combination with mifepristone is highly effective in the: A. Termination of early pregnancy B. Treatment of irritable bowel syndrome C. Treatment of GI arterial hypertension D. Treatment of GERD E. Treatment of anorectal disorders [47] The blood circulatory system that conducts the blood from the GI organs to the liver is called: A. Hepatic portal system B. Cholesystokinin C. Secretin D. Auberback's plexus E. Autonomic nervous system [48] Circular and longitudinal smooth muscles cell of the GI tract that allow coordinated contractions are electrically coupled by: A. Gap junctions B. Glia junctions C. Glottis and epiglottis D. Skeletal muscle myoneural junction E. Pepsin and amylase [49] One substance secreted by the GI tract is somatostatin. Select the source of this compound. A. D cells B. G cells C. Parietal cells and enteric nervous system D. Mucus neck cells E. Enterochromoffin cells [50] Indicate the best phases of gastric acid secretions in senior adults: A. Cephalic, gastric, and intestinal B. Duodenum, jejunum, and ileum C. Enterohepatic circulation D. Splanchnic circulation E. Cerebrospinal circulation [51] In most patients with typical angina pectoris, whose symptoms are provoked by exertion, the symptoms are effectively relieved by rest or by the administration of: A. Thyroid hormones B. Mineral oil C. Mild exercise D. Sublingual nitroglycerine E. Osmotic laxative, bulk-forming laxative, or castor oil [52] Select the condition that refers to spasm in a tubular or hollow organ accompanied by pain: A. Urinalysis B. Dialysis C. Analgesia D. Colic E. Plasmaphoresis

[53] When glycerin is used as a laxative for rectal use only this hydroscopic agent and irritant is MOST OFTEN administered as/by: A. IV injection or IA injection B. Buccal preparation C. Intrathecal injection D. IM injection E. Enema and suppository [54] As a laxative, luminally active mineral oil is classified pharmacologically as: A. Bulk-forming drug B. Surfactant C. Lubricant and emollient D. Hyperosmotic agent E. Stimulant and irritant [55] Ranitidine and cimetidine are best classified pharmacologically as: A. Stimulants to HCl secretion B. Cannabinoid receptor agonists C. Proton pump inhibitors D. H1 receptor antagonists E. H2 receptor antagonists [56] Rabeprazole, omeprazole, lansoprazole, pantoprazole, and esomeprazole are best pharmacologically as: A. H1 antagonists B. H2 antagonists to kinin C. Antacids D. Proton pump inhibitors E. Antibiotics [57] The condition of gastroesophageal reflux disease [GERD] is caused by reflux of stomach contents into the esophagus. Because of the pain that occurs when the acid, which is normally present only in the stomach, burns or irritates the esophagus, the condition is called: A. Crohn's disease granulomatus lesions B. Pseudomembraneous colitis C. Heartburn D. Hematemesis E. Aganglionic megacolon [58] Pharmacological drugs used to treat constipation MOST LIKELY include: A. Prokinetic agents used to increase intestinal motility B. Antispasmodic agents C. Antimuscarinic drugs D. Drugs activating dopamine receptors E. Extrinsic factor of pernicious anemia [59] Select the prostaglandin analog that enhances gastric mucosal defense and can increase uterine motility: A. Heparin B. NSAIDS C. Pepsinogen D. Misoprostol E. Progesterone [60] Identify the most important physiological agonist of the normal gastric mucosal defense by the gastric epithelial cells: A. Cholecystokinin B. Histamine paracrine mediator C. Gastrin D. Alcohol and aspirin E. Bicarbonate ions.