PMS Practice Quiz
PMS Practice Quiz
Test your knowledge on gastrointestinal health and related disorders with our comprehensive PMS Practice Quiz! This quiz covers a range of topics, including the digestive system, reflexes, and more.
Whether you're preparing for an exam or just want to enhance your understanding, this quiz is perfect for you. Key features include:
- 30 multiple-choice questions
- In-depth explanations of answers
- Immediate feedback on your answers
Which layer of the GI tract is responsible for digestion, absorption, secretion?
Lamina propria
Serosa
Mucous epithelium
Muscularis mucosae
The gastrocolic and gastroileal reflex work together to?
Reduce stomach emptying
Stimulate the urge to defecate
Slow peristalsis
Increase acid secretion in the stomach
All of these increase salivary flow except?
Parasympathetic NS
Bitter food
Nausea
Aldosterone
What causes relaxation of the LES?
A. Splanchnic nerves
B. Vagus nerve
C. Glossopharyngeal nerve
D. Both A & B
Pt presents with progressive dysphagia, weight loss, and foul smelling breath due to acid reflux x 4 wks. What is the underlying mechanism of the disease?
A. Increased peristalsis in distal 2/3 of esophagus
B. Increase in LES tone and impaired relaxation during swallowing
C. Upper esophageal sphincter dilation
D. Both A & B
Which of the following act on G cells to suppress gastrin?
A. Somatostatin
B. Gastric inhibitory peptide
C. Secretin
D. A & C
E. All of the above
A gram-negative rod with multiple flagella colonize the epithelial cells of the stomach. What would you expect to be increased?
Glucose
Lipase
Urease
Pepsin
Which of these is not absorbed in the small bowel via active co-transport with the Na/K/ATPase pump?
Amino Acids
Fatty Acids
Iron
Minerals
A pt presents with large volume watery diarrhea and mild cramping often associated with food. The pain is relieved by fasting. Pt denies any weight loss or fever. What is the likely reason for these sx?
IBD
Parkinson's
Lactose intolerance
Psychogenic
A pt presents with fever, chills, and watery diarrhea that kept them up the night before. What are these sx consistent with?
Osmotic diarrhea
Secretory diarrhea
Diarrhea secondary to decreased transit time
None of the above
What would you expect to see in a left-sided central palsy (CNS lesion)?
Paralysis of the entire left side of the face
A right sided mouth droop but still able to raise eyebrows on right side
Paralysis of the entire right side of the face
A left sided mouth droop but still able to raise eyebrows on left side
T/F: H. Pylori is categorized as erosive gastritis
True
False
Where are the chief cells of the stomach located?
Proximally in fundic glands
Submucosa
Base of fundic glands
Top of fundic glands
Type II hiatal hernia is characterized by what?
Entire stomach or other organs slide into thorax
Paraesophageal
Up/down sliding
Mixed
T/F: Gastrin is realeased when the stomach has emptied its contents into the duodenum.
True
False
T/F: The cerebrocerebellum helps with coordination of eye and head movements as well as posture and equilibrium.
True
False
Which of the following disorders is associated with “sigmoid esophagus” on imaging?
CREST syndrome
Achalasia
Hiatal hernia
Presbyesophagus
Pertaining to the prior question, what is the pathophysiology behind this diagnosis?
Increased relaxation of the LES during swallowing
Decreased LES tone
Loss of peristalsis in the distal 2/3 of esophagus
Loss of peristalsis in proximal 1/3 of esophagus
Chronic diarrhea can cause:
Metabolic alkalosis
Increased bicarb
Metabolic acidosis
Reversal of electrolyte imbalances
Which of the following is the last symptom to develop in peripheral neuropathies?
Tingling sensation
Pain
Vibration
Weakness
Which of these is NOT a change in the small intestine caused by celiac disease:
Villous atrophy
Crypt lengthening in the lamina propria
Increase in intraepithelial lymphocytes
Bile salts insufficiency
Complication of ascites could be Spontaneous bacterial peritonitis that can lead to sepsis
True
False
Which of the following is a characteristic of an injury to a lower motor neuron?
(+) babinski sign
Hypertonic muscles
Muscle fasciculations
Clonus
Intrahepatic obstruction causes obstruction of ______ and the bilirubin is ______?
Common bile duct; Unconjugated
Common bile duct; Conjugated
Bile Canaliculi; Conjugated
Bile Canaliculi; Unconjugated
Red blood cells get broken down into ______?
Globin and albumin
Albumin and bilirubin
Heme and globin
Albumin and heme
The liver makes bile acids and bile salts from ______?
Protein
Cholesterol
Carbohydrates
Fat
T/F: More blood is supplied to the liver by the portal vein compared to the hepatic artery.
True
False
Which secretion of the small bowel contracts the GB and relaxes the sphincter of Oddi?
Cholecystokinin (CCK)
Crypts of Lieberkuhn
Secretin
Somatostatin
A patient presents with motor problems in their calf and hamstrings, and a hypoactive achilles reflex. The patient also has urinary incontinence, bowel incontinence, and “saddle area” numbness. Which of the following could be the diagnosis?
Anterior Cord Sdr
Cauda Equina Sdr
MS
ALS
Which of the following is not a characteristic of CREST syndrome?
Calcinosis cutis
Slcerodactyl
Tinea versicolor
Telangiectasia
Portal vein carries blood from all of the following EXCEPT:
GI tract
Pancreas
Spleen
Kidneys
Presence of the HLA DQ2 or HLA DQ8 haplotypes means the patient suffers from meals that include what substance?
Carbohydrates
Gluten
Protein
Fat
These are all types of Specific gastritis EXCEPT:
Larvae (parasite)
Fungal
Viral infection
Bacterial infection
NSAID use
T/F: With GERD, the LES pressure increases.
True
False
This is considered the pacemakers for the GI tract and contain Na and Ca channels?
Cells of Cajal
Enteric nervous system
Myenteric plexus
Meissner cells
What is the most common cause of osmotic diarrhea?
Lactose intolerance
IBS
Celiac disease
Medications
Which of the following can cause Dorsal column syndrome?
Posterior spinal artery thrombus
Anterior spinal artery thrombus
Lateral extradural tumor
Intramedullary tumor
Which of the following substances of stomach are INCORRECTLY matched with their secretory cells:
Enterochromaffin-like cells secrete histamine
Chief cells secrete gastroferrin
D cells secrete somatostatin
Chief cells secrete pepsinogen
Parietal cells secrete HCL
Which of the following is not a cause of Central Cord Syndrome?
Syringomyelia
Intramedullary tumor
Ependymoma
Tabes Dorsalis
What three structures make up the Portal Venous System?
Portal veins, Bile Ducts, Sinusoids
Portal veins, Bile Ducts, Hepatic veins
Portal veins, Superior mesenteric vein, Hepatic veins
Portal veins, Sinusoids, Hepatic veins
Fibrosis is connective tissue and collagen that accumulates due to scar tissue formation and is associated with apoptosis of hepatocytes.
True
False
The liver conjugates the indirect bilirubin in order to make it water soluble and this conjugated bilirubin gets excreted by:
A. The kidneys via urine
B. Feces
C. Reabsorbed by the portal vein and into the enterohepatic portal system
D. A & B
All of the above
Which vitamin is NOT stored in the liver?
A
B12
B6
D
E
These structures line the sinusoids in the liver and act as macrophages.
Kuppfer cells
Hepatocytes
Canaliculi
Oval cells
There is a high concentration of aerobes in the small intestine?
True
False
All of the following are factors that depolarize the GI membrane (make it more excitable) EXCEPT:
Stimulation of specific GI hormones
Stretching of the muscle
Effects of NE and E
Stimulation by Ach by parasympathetic nerves
What connects Broca’s and Wernicke’s areas?
Corpus callosum
Basal nuclei
Arculate fasciculus
Internal capsule
Which of the following increases the salivary flow in the mouth?
Nausea
Dehydration
Drugs
Sleep
The two most important biochemical functions of the liver are?
Storage of vitamins and Conjugating bilirubin
Synthesis of blood clotting factors and synthesis/secretion of albumin
Breaking ammonia down to urea and Gluconeogenesis
Breakdown of Medications and Enzyme activation
Treatment for NAFLD and NASH is diet and exercise
True
False
What two byproducts of red blood cells form unconjugated (indirect) bilirubin?
Heme and Albumin
Heme and Globin
Globin and Albumin
Glucuronic Acid and Heme
What layer of the mucosa is the innermost layer of the GI tract and is in direct contact with chyme?
Lamina propria
Mucous epithelium
Muscularis mucosae
Peritoneum
Which is the correct characteristic of Achalasia?
Increased LES tone
Hypotensive LE sphincter
Injection of botulinum toxin makes the condition worse
Weight gain
Gastrin promotes stomach emptying.
True
False
These types of cells secrete pepsinogen.
Parietal cells
Chief cells
G cells
Enterochromaffin-like
Which of the following is a symptom of a LMN lesion?
Spasticity
Fasciculations
Hypertonic muscle tone
Diffuse weakness
Which of the following is NOT true about the spinocerebellum?
It receives its input from the vestibular nuclei
It is associated with the vermis and intermediate zones
It integrates sensory and motor inputs for timing movements
Damage would lead to impaired gait
This autoimmune disease causes cholestasis via destruction of intrahepatic bile ducts which decreases the bile flow through the bile canaliculi. There is also increased mitochondrial autoantibodies (AMA) and ANA associated with this condition.
Gilbert Syndrome
Cirrhosis
Primary Biliary Cholangitis
Primary Sclerosing Cholangitis
Which is the correct sequence for fat digestion and absorption?
Fat broken down into chylomicrons🡪 Chylomicrons coated with protein and released into the blood as triglycerides🡪 Triglycerides taken up into liver cells 🡪 Triglycerides repackaged into lipoproteins🡪 Lipoproteins released into the blood
Fat broken down into glycerol and fatty acids🡪 Glycerol and fatty acids absorbed into the intestines🡪Glycerol and fatty acids re-formed into chylomicrons inside the intestinal cells🡪Chylomicrons taken up by liver cells🡪 Liver cells repackage triglycerides into lipoproteins🡪Lipoproteins released into the
Fat broken down into glycerol and fatty acids🡪 Glycerol and fatty acids absorbed into the intestines🡪Glycerol and fatty acids re-formed into triglycerides in the intestinal cells 🡪Re-formed triglycerides coated with protein and released into the blood as Chylomicrons🡪 Chylomicrons taken up by liver cells🡪Liver cells repackage triglycerides into lipoproteins🡪 Lipoproteins released into the blood
Diarrhea can occur because of an increase of either water or fat in the stool?
True
False
Which secretion of the small bowel slows gastric emptying and regulates the pH of the duodenum by suppressing gastrin release from G cells?
Cholecystokinin (CCK)
Crypts of Lieberkuhn
Secretin
Somatostatin
This is released from the duodenum and jejunum and acts on the G cell to suppress gastrin release.
Somatostatin
Gastric Inhibitory peptide
Secretin
Insulin
What is Brown-Sequard syndrome?
Syringomyelia cyst in the central cord syrinx
Trauma or thrombus to the anterior spinal artery
Complete transection of the spinal cord
Hemisection of the spinal cord
Extrahepatic obstructive jaundice causes obstruction of _____ and the bilirubin is ______?
Common Bile duct; Unconjugated
Common bile duct; Conjugated
Bile Canaliculi; Conjugated
Bile Canaliculi; Unconjugated
The portal triad consists of ______?
Hepatic artery, Bile duct and Splenic vein
Renal artery, Renal vein and bile duct
Hepatic artery, portal vein and Bile duct
Hepatic artery, Bile duct and Inferior vena cava
This nerve plexus controls digestion and peristalsis in the GI tract by increasing the tone.
Meissner
Vagus
Glossopharyngeal
Myenteric
Saliva contains sodium bicarbonate?
True
False
Which duct comes directly off the gallbladder?
Cystic Duct
Common Hepatic Duct
Common Bile Duct
Left and Right Hepatic Ducts
Which of the following is not a symptom of cerebellar impairment?
Dysdiadochokinesia
Scanning speech
Intention tremor
Aphasia
This condition is characterized by hepatomegaly, ascites and abdominal pain
Gilbert Syndrome
Budd-Chiari syndrome
Cor Pulmonale
Schistosomiasis
Unconjugated (indirect) bilirubin must be conjugated in order to become Conjugated (direct) bilirubin. This conjugation process occurs when _____ conjugate the indirect bilirubin with ______ in order to make it ______ for excretion?
Hepatocytes; Urobilinogen; Water soluble
Hepatocytes; Globin; Lipid soluble
Hepatocytes: Glucuronic acid; Water soluble
Hepatocytes; Stercobilin; Water Soluble
The liver does NOT release thrombopoietin to stimulate stem cells to form platelets.
True
False
Which of the descriptions accurately depicts Secretory diarrhea?
Nonabsorbable substance in the intestine draws water into the lumen by osmosis and causes large volume diarrhea
Large volume diarrhea due to excessive intestinal mucosal secretion of chloride or bicarbonate-rich fluid.
Excessive motility decreases transit time, mucosal contact and opportunities for fluid absorption
Increased frequency of bowel movements due to malignancy that inhibits secretory function of the intestine
Which of the following describes the Gastrocolic reflex?
Stretching of the duodenum inhibits gastric motility and reduced stomach emptying
Gastric distention stimulation the opening of the ileocecal valve and moves contents from the ileum to colon
Increase of food stretches the stomach and urges colon motility and defecate
Increased food content stretches the stomach and causes the closure of the pyloric sphincter
T/F: The cerebellum is involved with motor control.
True
False
Most common cause of ascites?
Splenomegaly
Cor Pulmonale
Cirrhosis
Cholecystitis
MOST of the bile is excreted via feces in comparison to being reabsorbed via the enterohepatic circulation.
True
False
Which of the following describes the Enterogastric reflex?
Stretching of the ileum inhibits gastric motility and reduces stomach emptying
Stretching of the duodenum inhibits gastric motility and reduced stomach emptying
Stretching of duodenum increases gastric motility and increased stomach emptying
Stretching of the ileum increase gastric motility and reduced stomach emptying
Which type of hiatal hernia is characterized by the entire stomach or organs sliding into the thorax?
I
II
III
IV
What is the correct MOA of prostaglandins in relation to the GI tract?
Decreased blood flow, decreased bicarbonate secretion and decreased mucus production
Increased blood flow, decreased bicarbonate secretion and decreased mucus secretion
Decreased blood flow, increased bicarbonate secretion and increased mucus secretion
Increased blood flow, increased bicarbonate secretion and increased mucus secretion
Which of the following is NOT contained within the brain stem?
All cranial nerve nuclei
Corticobulbar tracts
Ascending sensory medial meniscus and ALS pathways
Descending corticospinal tracks
Bile has both hydrophilic AND hydrophobic properties.
True
False
This type of cells secrete the intrinsic factor and hydrochloric acid.
Parietal cells
Chief cells
G cells
Enterochromaffin-like
Brunner’s Glands are found in the duodenum and release alkaline mucus. All of the following stimulate the release of alkaline mucus from these glands EXCEPT:
Secretin Hormone
Vagal stimulation
Sympathetic stimulation
Tactile or irritation of duodenal mucosa
The common bile duct empties into the duodenum through the Sphincter of Oddi.
True
False
6. What two structures make up the lentiform nucleus?
Caudate and globus pallidus
Putamen and globus pallidus
Caudate and putamen
Subthalamic nuclei and putamen
These are small blood vessels in the liver which contains arterial and venous blood and eventually drains into the central vein.
Canalculi
Hepatic portal vein
Sinusoid
Kupper cells
Which is NOT a characteristic of osmotic diarrhea?
Excessive gas
Large volume watery diarrhea
Related to intake of milk products and drugs
Nocturnal urge to defecate
Relieved with fasting
This substance converts pepsinogen to pepsin in order to break down proteins.
Histamine
HCL acid
Gastrin
Somatostatin
Fat completes absorption in what section of the GI tract?
Stomach
Duodenum
Jejunum
Ileum
Colon
A block in this artery would cause ischemia to the gallbladder
Hepatic artery
Renal Artery
Gastric artery
Cystic Artery
Impairment of the indirect pathway of the basal nuclei can be seen in which disease?
Parkinson disease
MS
ALS
Huntington's disease
This part of the liver contains the blood vessels and nerves except for the posterior aspect where it contacts the diaphragm.
Coronary ligament
Glisson capsule
Falciform ligament
Ligamentum teres
These cells secrete histamine which will bind to H2 receptors of parietal cells in order to stimulate Hydrochloric acid secretion
D cells
G cells
Enterochromaffin-like cells
Chief cells
What is the primary function of the colon?
Absorbing water via osmosis
Forming and eliminating feces
Absorption of vitamins
Absorb nutrients and digestive products into the blood
This is released from the duodenum and jejunum and acts on the parietal cells to inhibit acid secretion.
Somatostatin
Gastric inhibitory peptide
Secretin
Insulin
Which vessel supplies the basal nuclei and internal capsule?
ACA
PCA
MCA
Vertebral arteries
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