Home Books Ganong’s Review of Medical Physiology, 25e

SECTION IV: GASTROINTESTINAL PHYSIOLOGY

SECTION IV. GASTROINTESTINAL PHYSIOLOGY

Water is absorbed in the jejunum, ileum, and colon and excreted in the feces. Arrange these in order of the amount of water absorbed or excreted from greatest to smallest.

A. Colon, jejunum, ileum, feces

B. Feces, colon, ileum, jejunum

C. Jejunum, ileum, colon, feces

D. Colon, ileum, jejunum, feces

E. Feces, jejunum, ileum, colon

Following a natural disaster in Haiti, there is an outbreak of cholera among displaced persons living in a tent encampment. The affected individuals display severe diarrheal symptoms because of which of the following changes in intestinal transport?

A. Increased Na⁺–K⁺ cotransport in the small intestine

B. Increased K⁺ secretion into the colon

C. Reduced K⁺ absorption in the crypts of Lieberkühn

D. Increased Na⁺ absorption in the small intestine

E. Increased Cl⁻ secretion into the intestinal lumen

A 50-year-old man comes to see his clinician complaining of severe epigastric pain, frequent heartburn, and unexplained weight loss of 20 pounds over a 6-month period. He claims to have obtained no relief from over-the-counter H₂ antihistamine drugs. He is referred to a gastroenterologist, and upper endoscopy reveals erosions and ulcerations in the proximal duodenum and an increased output of gastric acid in the fasting state. The patient is most likely to have a tumor secreting which of the following hormones?

A. Secretin

B. Somatostatin

C. Motilin

D. Gastrin

E. Cholecystokinin

Which of the following has the highest pH?

A. Gastric juice

B. Colonic luminal contents

C. Pancreatic juice

D. Saliva

E. Contents of the intestinal crypts

A 60-year-old woman undergoes total pancreatectomy because of the presence of a tumor. Which of the following outcomes would not be expected after she recovers from the operation?

A. Steatorrhea

B. Hyperglycemia

C. Metabolic acidosis

D. Weight gain

E. Decreased absorption of amino acids

Maximum absorption of short-chain fatty acids produced by bacteria occurs in the

A. stomach.

B. duodenum.

C. jejunum.

D. ileum.

E. colon.

A premenopausal woman who is physically active seeks advice from her primary care clinician regarding measures she can take to ensure adequate availability of dietary calcium to ensure bone health later in life. Which of the following dietary components should enhance calcium uptake?

A. Protein

B. Oxalates

C. Iron

D. Vitamin D

E. Sodium

A decrease in which of the following would be expected in a child exhibiting a congenital absence of enterokinase?

A. Incidence of pancreatitis

B. Glucose absorption

C. Bile acid reabsorption

D. Gastric pH

E. Protein assimilation

In Hartnup disease (a defect in the transport of neutral amino acids), patients do not become deficient in these amino acids due to the activity of

A. PepT1.

B. brush border peptidases.

C. Na⁺, K⁺ ATPase.

D. cystic fibrosis transmembrane conductance regulator (CFTR).

E. trypsin.

A newborn baby is brought to the pediatrician suffering from severe diarrhea that worsens with meals. The symptoms diminish when nutrients are delivered intravenously. The child most likely has a mutation in which of the following intestinal transporters?

A. Na⁺, K⁺ ATPase

B. NHE3

C. SGLT-1

D. H⁺, K⁺ ATPase

E. NKCC1

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

A. histamine.

B. increased circulating levels of CCK.

C. the gastrocolic reflex.

D. increased circulating levels of somatostatin.

E. the enterogastric reflex.

The symptoms of the dumping syndrome (discomfort after meals in patients with intestinal short circuits such as anastomosis of the jejunum to the stomach) are caused in part by

A. increased blood pressure.

B. increased secretion of glucagon.

C. increased secretion of CCK.

D. hypoglycemia.

E. hyperglycemia.

Gastric pressures seldom rise above the levels that breach the lower esophageal sphincter, even when the stomach is filled with a meal, due to which of the following processes?

A. Peristalsis

B. Gastroileal reflex

C. Segmentation

D. Stimulation of the vomiting center

E. Receptive relaxation

The migrating motor complex is triggered by which of the following?

A. Motilin

B. NO

C. CCK

D. Somatostatin

E. Secretin

A patient is referred to a gastroenterologist because of persistent difficulties with swallowing. Endoscopic examination reveals that the lower esophageal sphincter fails to fully open as the bolus reaches it, and a diagnosis of achalasia is made. During the examination, or in biopsies taken from the sphincter region, a decrease would be expected in which of the following?

A. Esophageal peristalsis

B. Expression of neuronal NO synthase

C. Acetylcholine receptors

D. Substance P release

E. Contraction of the crural diaphragm

A patient suffering from severe ulcerative colitis undergoes a total colectomy with formation of a stoma. After a full recovery from surgery, and compared to his condition prior to surgery, which of the following would be expected to be decreased?

A. Ability to absorb lipids

B. Ability to clot the blood

C. Circulating levels of conjugated bile acids

D. Urinary urea

E. Urinary urobilinogen

A surgeon is studying new methods of liver transplantation. She performs a complete hepatectomy in an experimental animal. Before the donor liver is grafted, a rise in the blood level of which of the following would be expected?

A. Glucose

B. Fibrinogen

C. 25-Hydroxycholecalciferol

D. Conjugated bilirubin

E. Estrogens

Which of the following cell types protects against sepsis secondary to translocation of intestinal bacteria?

A. Hepatic stellate cell

B. Cholangiocyte

C. Kupffer cell

D. Hepatocyte

E. Gallbladder epithelial cell

P450s (CYPs) are highly expressed in hepatocytes. In which of the following do they not play an important role?

A. Bile acid formation

B. Carcinogenesis

C. Steroid hormone formation

D. Detoxification of drugs

E. Glycogen synthesis

A 40-year-old woman comes to her primary care clinician complaining of severe, episodic abdominal pain that is particularly intense after she ingests a fatty meal. An imaging procedure reveals that her gallbladder is acutely dilated, and a diagnosis of cholelithiasis is made. A gallstone lodged in which location will also increase her risk of pancreatitis?

A. Left hepatic duct

B. Right hepatic duct

C. Cystic duct

D. Common bile duct

E. Sphincter of Oddi

Compared to hepatic bile, gallbladder bile contains a reduced concentration of which of the following?

A. Bile acids

B. Chloride ions

C. Protons

D. Glucose

E. Calcium ions

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

SECTION IV: GASTROINTESTINAL PHYSIOLOGY

Send Email

Citation

Jump to a Section

SECTION IV. GASTROINTESTINAL PHYSIOLOGY

Pop-up div Successfully Displayed