Bodypractice 1
Acid-Base Balance and Gastrointestinal Physiology Quiz
Test your knowledge on acid-base balance, renal physiology, and gastrointestinal processes with our engaging quiz! Designed for those interested in clinical medicine and physiology, this quiz covers a range of topics relevant to understanding human biology.
- Assess your understanding of metabolic and respiratory disorders.
- Explore the complexities of renal fun
ction and fluid balance. - Challenge yourself with questions on digestive processes and reflexes.
A young man is found comatose, having taken an unknown number of sleeping pills an unknown time before. An arterial blood sample yields the following values: pH = 7.02, HCO3− = 14 mEq/L, and Pco2 = 68 mm Hg. Which of the following describes this patient’s acid-base status most accurately?
Uncompensated metabolic acidosis
Simultaneous respiratory and metabolic acidosis
Uncompensated respiratory acidosis
Respiratory acidosis with complete renal compensation
Respiratory acidosis with partial renal compensation
In a person with chronic respiratory acidosis who has partial renal compensation, you would expect to find which changes, compared with normal: ______ urinary excretion of NH4+; ______ plasma HCO3− concentration; and _____ urine pH.
Increased, increased, decreased
No change in, increased, decreased
Increased, decreased, decreased
No change in, no change in, decreased
Increased, no change in, increased
Which change would you expect to find in a patient who developed acute renal failure after ingesting poisonous mushrooms that caused renal tubular necrosis?
Metabolic acidosis
Decreased hydrostatic pressure in Bowman’s capsule
Decreased blood urea nitrogen concentration
Decreased plasma potassium concentration
Increased plasma bicarbonate concentration
A 71-year-old man with upper abdominal pain and blood in the stool takes NSAIDs for the pain and washes it down with whiskey. Pentagastrin administration produced lower than predicted levels of gastric acid secretion. Secretion of which substance is most likely to be diminished in this patient with gastritis?
Intrinsic factor
Ptyalin
Saliva
Rennin
Trypsin
A 65-year-old man had a heart attack and experiences cardiopulmonary arrest while being transported to the emergency department. Use the following laboratory values obtained from arterial blood. Plasma pH = 7.12 Plasma Pco2 = 60 mm Hg Plasma HCO3− concentration = 19 mEq/L In this patient, which of the following laboratory results would be expected, compared with normal?
Increased renal excretion of bicarbonate (HCO3−)
Decreased urinary titratable acid
Increased urine pH
Increased renal excretion of ammonia (NH4+)
Urea diffuses out of the __________ , and into the __________ .
Proximal tubule, distal tubule
Proximal tubule, descending limb of the loop of Henle
Descending limb of the loop of Henle, ascending limb of the loop of Henle
Collecting duct, descending limb of the loop of Henle
Ascending limb of the loop of Henle, descending limb of the loop of Henle
In a person with normal kidneys and normal lungs who has chronic metabolic acidosis, you would expect to find all of the following, compared with normal, except:
Increased renal excretion of NH4Cl
Decreased urine Ph
Increased plasma HCO3− concentration
Decreased plasma PCo2
The ascending limb of the loop of Henle is __________ to water.
Impermeable
Moderately permeable
Permeable
A 43-year-old man eats a meal consisting of 40 percent protein, 10 percent fat, and 50 percent carbohydrate. Thirty minutes later the man feels the urge to defecate. Which reflex results in the urge to defecate when the duodenum is stretched?
Enterogastric
Duodenocolic
Intestino-intestinal
Rectosphincteric
Which of these chemicals is able to help in compensating for metabolic acidosis?
Bicarbonate ion
Carbonic acid
Amino group ion and amino acid or protein
Sodium chloride
Lipids are emulsified by ____________ and digested by ______________.
Lipase; bile salts
Amylase; lipase
Bile salts; lipase
Pepsin; bile salts
Stimulation of the internal anal sphincters by the sympathetic nervous system or stimulation of the external anal sphincter by the somatic motor nervous system would
Stimulate the defecation reflex.
Inhibit the defecation reflex
Stimulate mass movements.
Inhibit mass movements.
Respiratory alkalosis would be indicated if blood pH is _____ and blood carbon dioxide levels are ______.
High; high
High; low
Low; high
Low; low
A 65-year-old man eats a healthy meal. Approximately 40 minutes later the ileocecal sphincter relaxes and chyme moves into the cecum. Gastric distention leads to relaxation of the ileocecal sphincter by way of which reflex?
Enterogastric
Gastroileal
Gastrocolic
Intestino-intestinal
Rectosphincteric
Buffer systems do which of the following?
Consist of a weak acid plus a strong acid
Are not present in intracellular fluid
Increase the severity of pH changes in the body fluids
Minimize pH changes in body fluids by converting stronger acids or bases into weaker acids or bases
All of these conditions could cause respiratory acidosis EXCEPT
Obstruction of the respiratory passageways
Emphysema
Hyperventilation
Pneumonia
A person who is hyperventilating maya
Be compensating for respiratory alkalosis
Be compensating for metabolic acidosis
Have respiratory acidosis
B and C
The greatest volume of water is reabsorbed from the nephron by the
Proximal tubule.
Loop of Henle.
Distal tubule.
Collecting duct.
Dimished salivary secretion that leads to difficulty in chewing and swallowing is due to a condition called...
Malocclusion
Xerostomia
Dental caries
Temporomandibular joint dysfunction
Which of the following is true of the gastroenteric reflex?
It leads to increased peristaltic activity in the small intestine
It stimulates contractions of the colon
It leads to defecation
It increases peristaltic activity of the stomach
Prolonged vomiting may cause
Respiratory acidosis
Respiratory alkalosis
Metabolic alkalosis
Metabolic acidosis
Which of these ions is used to cotransport amino acids, glucose, and other solutes through the apical membrane of nephron epithelial cells?
K+
CL-
Na+
Ca2+
Mg2+
Stimulation by the sympathetic nervous system will cause which one of the following effects in the inferior esophagus, stomach, small intestine and large intestine?
Nothing, because skeletal muscle is found in the walls of these areas
Increases peristalsis by stimulation of smooth muscle
Decreases peristalsis by inhibition of smooth muscle
Decreases peristalsis by stimulation of smooth muscle
Which of the following contribute to the formation of a hyperosmotic environment in the medulla of the kidney?
Effects of ADH on water permeability of the ascending limb of the loop of Henle
Impermeability of the ascending limb of the loop of Henle to water
Cotransport of Na+, K+, and Cl- out of the ascending limb of the loop of Henle
Both A and C
Both B and C
Which one of the following does not occur during swallowing?
The larynx raises.
The epiglottis moves anteriorly to close the glottis.
The uvula and soft palate move inferiorly to block the oropharynx.
The vestibular folds move medially.
Increased aldosterone causes
Decreased blood volume.
Increased reabsorption of Na+.
Decreased reabsorption of Cl-.
Increased permeability of the distal tubule to water.
Increased volume of urine.
Stimulation of the parasympathetic neurons in the GI tract from Auerbach's or myenteric plexus will cause
Inhibition of local secretions.
Inhibition of peristalsis.
Stimulation of local secretions.
Stimulation of peristalsis
Reabsorption of most solute molecules from the proximal tubule is linked to the primary active transport of Na+
Across the apical membrane and out of the cell.
Across the apical membrane and into the cell.
Across the basal membrane and out of the cell.
Across the basal membrane and into the cell.
Which one of the following is absorbed in the GI tract without being digested?
Vitamins
Triglycerides
Proteins
Starch
Which of the following is a direct effect of parathyroid hormone (PTH)?
Reduced 1-hydroxylase activity
Increased osteoclast activity.
Increased intestinal synthesis of calcium-binding protein
Increased renal tubular phosphate reabsorption
Reduced 25-hydroxylase activity
A decrease in plasma ionized calcium together with an increase in PTH is most likely to be found in a patient with:
Vitamin D deficiency
Hypoparathyroidism
Primary hyperparathyroidism
The combination of amenorrhea and galactorrhea is most likely caused by excess:
Growth hormone (GH)
Prolactin
Thyroxine (T4)
Adrenocorticotropic hormone (ACTH)
Parathyroid hormone (PTH)
Which of these conditions causes inhibition of gastric secretion?
All of these
Hypotonic or hypertonic solution in the duodenum
Distention of the duodenal wall
In the glia limitans pH less than 2 in the duodenum
Fats in the duodenum
Which of these inhibits secretion and motility of the stomach?
Enterogastric reflex
Parasympathetic stimulation
Gastrin
Intrinsic factor
Distention of stomach wall
Duodenal gland secretion is stimulated by
Stimulation of the sympathetic division of the ANS.
Amylase
Chemical (acid) or tactile stimulation.
Gastric inhibitory polypeptide.
The duodenocolic reflex.
Which statement about antidiuretic hormone (ADH) is true?
It is synthesized in the posterior pituitary gland
It increases salt and water reabsorption in the collecting tubules and ducts
It increases salt and water reabsorption in the collecting tubules and ducts
It has opposite effects on urine and plasma osmolality
Which of the following increases secretion of GH?
Senescence
Insulin-like growth factor-1 (IGF-1)
Somatostatin
Hypoglycemia
Exogenous GH administration
Which of the following hormones is LEAST likely to have a nocturnal peak?
ACTH
Cortisol
Thyroxine (T4)
Prolactin
Growth hormone (GH)
For those substances that are actively reabsorbed, the maximal amount that can be transported per unit time by the kidney tubules:
A. Depends on the maximum rate at which the transport mechanism itself operates
B. Is directly related to the plasma concentration of the substance
C. Is termed the tubular transport maximum
D. Is dependent upon tubular load
E. A and C are correct.
Exposure to ultraviolet light directly facilitates which of the following?
Conversion of cholecalciferol to 25 hydroxycholicalciferol
Conversion of 25-hydroxycholicalciferol to 1,25- dihydroxycholecalciferol
Transport of calcium into the extracellular fluid
Formation of calcium-binding protein
Storage of vitamin D3 in the liver
By which mechanism do LH and FSH return to baseline levels?
LH surge
Negative feedback on GnRH by estradiol
Negative feedback on gonadotropin-releasing hormone (GnRH) by progesterone
Negative feedback on GnRH from testosterone
Spermatogenesis is regulated by a negative feedback control system in which FSH stimulates the steps in sperm cell formation. Which negative feedback signal associated with sperm cell production inhibits pituitary formation of FSH?
Testosterone
Estrogen
Inhibin
LH
PTH does what directly?
Controls the rate of 25-hydroxycholicalciferol formation
Controls the rate of calcium transport in the mucosa of the small intestine
Controls the rate of formation of calcium-binding protein
Controls the rate of formation of 1,25-dihydroxycholicalciferol
Stimulates renal tubular phosphate reabsorption
An unconscious patient is dehydrated, has rapid deep respirations, and has a fruity breath odor. The most likely explanation is:
Hypercalcemia
Diabetic ketoacidosis
Hypoglycemia
Adrenal insufficiency
Hypothyroidism
Co-transport of glucose:
Will not be affected if the Na+/K+ pump is blocked
Is equivalent to a uniport for glucose
Cannot move glucose against its concentration gradient
Is equivalent to an antiproton
Depends on the interaction of Na+ with the glucose carrier
The volume of plasma needed each minute to supply a substance at the rate at which it is excreted in the urine is known as the:
Diffusion constant of the substance
Tubular mass of the substance
Extraction ratio of the substance
Filtration rate of the substance
Clearance of the substance
Renin is produced and secreted from granules located in the:
Macula densa
Afferent arteriole
Intercalated cells
Interstitial cells
Mesangial cells
About 4 to 6 days after you place a normal person on a low-sodium diet, which of the following will be observed?
A. Plasma renin and aldosterone are below normal
B. Plasma renin and aldosterone are above normal
C. Plasma sodium concentration is below normal
D. Plasma sodium concentration is normal
E. B and D are correct.
The portion of the male urethra that passes through the urogenital diaphragm is called the:
Penile urethra
Spongy urethra
Membranous urethra
Prostatic urethra
External urethral sphincter
Which of the following is located at the opening between the small and large intestines?
Ligament of Treitz
Cardiac sphincter
Ileocecal valve
Pyloric sphincter
Tricuspid valve
The common bile duct and major pancreatic duct join to form the:
Hepatic duct
Common hepatic duct
Cystic duct
Cisterna chili
Ampulla of Vater
The common bile duct, hepatic artery and postal vein are found grouped together in the:
Gastrosplenic ligament
Gastrohepatic ligament
Hepatoduodenal ligament
Gastrocolic ligament
Falciform ligament
Most of the small intestine receives its blood supply from branches of a single artery. The artery that supplies most of the small bowel is the:
Middle colic
Superior mesenteric
Celiac
Gastroduodenal
Inferior mesenteric
The kidneys which are positioned ________ lie on either side of the vertebral column, high on the posterior wall of the abdominal cavity
Retroperitonially
Periotonially
Anterolaterally
None of the above
Components of the urinary system include
2 kidneys
2 ureters
1 urinary bladder
1 urethra
All of the following
Adults normally have __________ permanent teeth; children have __________ deciduous teeth.
36,36
32,32
32,20
20,32
Given these structures: 1. cecum 2. Descending colon 3. rectum 4. Sigmoid colon 5. Transverse colon Choose the arrangement that lists the structures in the order food passes through them from the small intestine to the anus.
1,2,3,4,5
1,5,2,4,3
2,5,1,3,4
3,1,5,2,4
4,2,1,5,3
The duodenojejunal junction is supported by the attachment of which of the following structures?
Transverse mesocolon
Suspensory muscle of the duodenum (ligament of Treitz)
Falciform ligament
Hepatoduodenal ligament
Greater omentum
The superior anterior and posterior arteries arise from which of the following pancreaticoduodenal arteries?
Right colic
Ileocolic
Gastroduodenal
Hepatic
Splenic
The porta hepatis gives passage to all of the following structures EXCEPT
Portal vein
Hepatic artery
Hepatic ducts
Lymphatic vessels
Cystic artery
All is true about esophagus, except:
Follows the curve of the vertebral column as it descends through the neck and mediastinum.
Its superior third, the external layer consists of voluntary striated muscle
Passes through the esophageal hiatus in the muscular right crus of the diaphragm, just to the left of the median plane at the level of the T10 vertebra
Has only internal longitudinal layer of muscle
All are true
What is correct about Pancreas?
Crossing the bodies of the L1 and L2 vis an elongated, accessory digestive gland that lies retroperitoneally, overlying and transversely ertebra on the posterior abdominal wall.
It lies posterior to the stomach between the duodenum on the right and the spleen on the left.
The transverse mesocolon attaches to its anterior margin.
All of them are correct
None of them are correct
What is not true about Neck of Pancreas?
The posterior surface of the neck, covered with peritoneum, is adjacent to the pylorus of the stomach.
Is short (1.5–2 cm) and overlies the superior mesenteric vessels, which form a groove in its posterior aspect.
The SMV joins the splenic vein posterior to the neck to form the hepatic portal vein.
What is not true about Liver?
It weighs approximately 1500 g and accounts for approximately 2.5% of adult body weight.
In adult —when it serves as a hematopoietic organ—it is proportionately twice as large (5% of body weight).
Except for fat, all nutrients absorbed from the gastrointestinal tract are initially conveyed to the liver by the portal venous system.
The liver stores glycogen and secretes bile.
Additional folds of peritoneum connect the liver to all of the following, except:
The stomach (hepatogastric ligament),
The duodenum (hepatoduodenal ligament),
The diaphragm (hepatoduodenal ligament)
The diaphragm (right and left triangular ligaments and anterior and posterior coronary ligaments)
The visceral surface of the liver is covered with visceral peritoneum except in the fossa for the gallbladder and at the porta hepatis (gateway to the liver), and structures related to it include all of the following except:
The right anterior part of the stomach;
The superior part of the duodenum;
The lesser omentum;
The gallbladder;
The right colic flexure;
The right posterior part of the stomach;
The arterial supply of the bile duct is from the all of the following, except:
Cystic artery: supplying the proximal part of the duct. (branch of right hepatic artery)
Right hepatic artery: supplying the middle part of the duct.
Posterior superior pancreaticoduodenal artery and gastroduodenal artery: supplying the retroduodenal part of the duct.
Cystic artery: supplying the middle part of the duct.
Ptyalin
Is an enzyme produced in mouth, digests the carbohydrates
Is an enzyme produced by pancrease, digests the proteins
Is an enzyme produced by pancrease, digests the lipids
Is an enzyme produced in mouth, digests the lipids
Pepsin is
Peptic enzyme of stomach
Active at a p H of 2
Inactive at a p H of 5
Not capable of collagen digestion
Both trypsin and chymotrypsin split protein molecules into small polypeptides _________________________ then cleaves individual amino acids from the carboxyl ends of the polypeptides.
Elastase
Carboxypolypeptidase
Endopepetidase
Which of the following is true about the Fat digestion?
A small amount (10%) of triglycerides is digested in the stomach by lingual lipase
The first step is emulsification
The average diameter of the fat particles in the intestine after emulsification has occurred is less than 1 micrometer
All if the above
None of the above
Absorption of the fats contains all of the folllowing, except:
Free fatty acids, monoglycerides pass through the membrane of the microvilli to enter the intestinal epithelial cells
Resynthesize triglycerides and phospholipids within the epithelial cells
Triglycerides, phospholipids, and cholesterol are then combined with protein inside the epithelial cells to form small particles called chylomicrons
Absorbed lipids thus pass to the blood directly
Which of the following is true?
Fats contain 4 Calories per 1 gram
Carbohydrates contain 4 Calories per 1 gram
Proteins contain 9 Calories per 1 gram
Average daily requirement of proteins is:
30-50 grams
20-30 grams
70-100
All of the following are true about Vitamin B12, except
Deficiency Causes Pernicious Anemia
It promotes growth
Deficiency is caused by lack of intrinsic factor
Important in synthesis of purines and pyrimidines
Pro-opiomelanocortin (POMC) neurons
Decrease food intake
Produce α-melanocyte-stimulating hormone (α-MSH)
Increase energy expenditure
Decrease energy expenditure
Lateral nuclei of the hypothalamus
Is a feeding center
Stimulation of it causes hyperphagia
Satiety center
Stimulation of it causes aphagia
A patient presents to your office complaining of her tongue feeling funny. On further examination you determine the patient has lost general sensation and taste to the posterior 1/3 of her tongue. Knowing your anatomy of the tongue, which nerve is most likely damaged?
Hypoglossal nerve
Chorda tympani nerve
Lingual nerve
Buccal nerve
Glossopharyngeal nerve
Which of the following statements about the anatomic course of the esophagus is correct
The thoracic esophagus enters the posterior mediastinum anterior to the aortic arch.
The thoracic esophagus passes behind the right mainstem bronchus and the pericardium.
The esophagus enters the diaphragmatic hiatus at the level of T8.
The esophagus deviates anteriorly and to the left as it enters the abdomen.
Which one of these structures does the middle pharyngeal constrictor muscle (musculus constrictor pharyngis medius) proximally attach to?
Cricoid cartilage
Greater horn of hyoid bone
Thyroid cartilage
Median thyroid ligament
Hydrochloric acid (HCl) is secreted by:
Chief cells
Mucous neck cells
Enterochromaffin-like cells
Parietal cell
Intrinsic factor
Is produced in small intestine and needed for absorption of B12
Is produced in stomach and needed for absorption of B12
Is produced in stomach and needed for absorption of B6
Is produced in small intestine and needed for absorption of B6
The urinary bladder is the only unpaired structure of the urinary system.
TRUE
FALSE
Blood and the lymphatic vessels and nerves enter and exit the kidney through what structure?
Hilus
Renal sinus
Renal calyces
Adrenal glands
The major calyces of the kidney converge to form an enlarged channel called the
Renal fascia.
Renal pelvis.
Renal pyramids.
Renal sinus.
All of the following arterial branches provide blood supply to the stomach. All are paired correctly with the artery from which the branch originates EXCEPT the:
Left gastric branch - celiac artery.
Right gastric branch - superior mesenteric artery.
Left gastroepiploic branch - splenic artery.
Right gastroepiploic branch - gastroduodenal artery.
All of the following are normal relationships of the superior mesenteric artery EXCEPT:
It arises from the aorta posterior to the neck of the pancreas.
The splenic vein crosses anterior to it.
It courses posterior to the third (transverse) part of the duodenum.
The left renal vein courses posterior to it.
Pancreas is supplied by all of the following except:
Common hepatic
Left gastric
Splenic
Superior mesenteric
All of the following are the posterior relation of head of the pancreas except?
Common bile duct
First part of duodenum
Right crus of diaphragm
Inferior vena cava
Which of the following arteries provides the abdominal parts of the esophagus with its arterial supply?
Cystic
Gastroduodenal
Left gastric
Hepatic
Left gastroepiploic
Which of the following structures crosses over the inferior or horizontal (third) portion of the duodenum?
Pancreas
Hepatic artery
Portal vain
Superior mesenteric artery
The left gastro-omental artery arises from which of the following arteries?
Gastroduodenal
Left gastric
Right gastric
Hepatic
Splenic
The root of the mesentery crosses all of the following structures EXCEPT
Ascending and horizontal parts of the duodenum
Abdominal aorta
Inferior vena cava
Right ureter
Splenic artery
The appendicular artery is a branch of which of the following arteries?
Inferior mesenteric
Inferior epigastric
Ileocolic
Testicular
Renal
The portion of the hepatic artery extending between the celiac trunk and the gastroduodenal artery is known as the
Proper hepatic
Common hepatic
Right hepatic
Left hepatic
Middle hepatic
The hepatic veins drain into which of the following structures?
Liver
Inferior vena cava
Superior vena cava
Spleen
Portal vain
Which of the following structures is related to the spleen, stomach, pancreas, and the left crus of the diaphragm?
Left kidney
Left suprarenal gland
Left gonadal vein
Transverse mesocolon
Abdominal aorta
The superior suprarenal arteries are branches of which of the following arteries?
Abdominal aorta
Renal
Inferior phrenic
Celiac trunk
Superior mesenteric
Vitamin B12 is absorbed mainly in the:
Stomach
Colon
Jejunum
Ileum
Duodenum
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