1.

Gastric emptying
a) takes 1-3 hours
b) 2-8 hours
c) 2 hours
d) 6 hours
e) 1 hour

2.The majority of water ingested or secreted in the bowel is usually absorbed in the
a) stomach / duodenum
b) jejunum
c) ileum
d) ascending colon
e) descending colon

3. With regard to the parasympathetic nerve supply of the gut it is

a) essential
b) non-essential
c) modulator
d) passive
e) active
f)

4. How much fluid is secreted by the digestive tract

1) • saliva 1500mL per day
2) • stomach 2500mL per day
3) • bile 500mL per day
4) • pancreas 1500mL per day

5. What is the mean length of the intestinal segments

1) • pharynx, oesophagus and stomach 65cm
2) • duodenum 25cm
3) • jejunum and ileum 260cm
4) • colon 110cm

6. Which of the following statement is TRUE?

A. Intestinal blood vessel is entirely regulated by enteric nervous system.
B. Nitric oxide is the major neurotransmitter for gastrointestinal smooth muscle relaxation.
C. Peristalsis is a type of spinal response to stretch
D. All of the above
E. None of the above

7. Gastrin:
A. is only made in gastric antral G cells
B. is inactivated in liver
C. stimulates insulin secretion after protein meal
D. secretion reduces withgastricdistention
E. All of the above
8. CCK does NOT:
A. stimulates gall bladder contraction
B. inhibits gastric emptying
C. stimulate secretion of pancreatic juice rich in enzymes
D. stimulates insulin secretion
E. None of the above

9. Volume of Saliva secreted daily is:

A. 500ml
B. 1000ml
C. 1500ml
D. 2000ml
E. 2500ml

10. Which of the following is TRUE?

A. Parotid gland provides most of the saliva produced daily.
B. pH of saliva at rest is 7.0
C. Lingual lipase is produced by salivary gland
D. Reflex salivary secretion upon eating is mediated by vagus nerve
E. Peristalsis is a gravity dependent process.

11. Which of the following pairing is TRUE?

A. Parietal cells – secretes HCl& intrinsic factor
B. Chief cells – secretes pepsinogen
C. Mucous cells – secretes bicarbonate
D. G cells – secretes gastrin
E. All of the above

12. Volume of daily gastric secretion is:

A. 500ml
B. 1000ml
C. 1500ml
D. 2000ml
E. 2500ml

13. pH of stomach is:

A. 1-2
B. 4-5
C. 7.4
D. 8-10
E. None of the above

14. Which of the following statement is FALSE?

A. Carbonic anhydrase is found ingastric parietal cells
B. H+ is secreted into stomach by active H/K antiport in the gastric parietal cells
C. Cl- is actively transported into the stomach by gastric parietal cells
D. Gastric venous blood is alkalinic after a meal.
E. All of the above
15. Which of the following causes increased gastric secretion by stimulating vagus nerve?
A. Alcohol
B. Hypoglycemia
C. Caffeine
D. All of the above
E. None of the above

16. pH of duodenum
A. 1-2
B. 4-5
C. 6-7
D. 8-9
E. None of the above

17. Volume of pancreatic juice produced daily is:

A. 500 ml
B. 1000 ml
C. 1500 ml
D. 2000 ml
E. 2500 ml

18. Which of the following is TRUE?

A. Trypsin can activates all pancreatic enzymes
B. Pancreas normally has trypsin inhibitor to prevent autolysis
C. Secretin stimulates pancreatic duct to increase alkaline content of pancreatic juice
D. CCK stimulates pancreatic acinar to increase enzyme content of pancreatic juice
E. All of the above

19. Amount of bile secreted daily:

A. 500 ml
B. 1000 ml
C. 1500 ml
D. 2000 ml
E. 2500 ml

20. Which of the following is TRUE?

A. 50% of bile salts are reabsorped in enterohepatic circulation through Na/bile acid
cotransport.
B. Primary bile salts are converted to secondary bile salts in the colon
C. Conjugation of bilirubin render it more fat soluble
D. Unconjugated bilirubin is partly excreted in urine
E. All of the above

21. Which of the following causes conjugated hyperbilirubinemia?

A. Hemolytic anaemia
B. Reduced bilirubin uptake into hepatocytes
C. Reduced intracellular (hepatic) protein binding to bilirubin
D. Biliary obstruction
E. All of the above
22. Amount of intestinal secretion daily:
A. 500ml
B. 1000ml
C. 1500ml
D. 2000ml
E. 2500ml

23. In small bowel obstruction:

A. local ischemia may occur in the dilated proximal segment due to elevated
intraluminal pressure
B. Vomiting & hypotension is mediated by visceral afferent in the distended segment
C. Severe metabolic alkalosis may occur
D. All of the above
E. None of the above

24. Which of the following type of intestinal contraction is only seen in the colon?
A. Peristalsis
B. Segmental contraction
C. Massive contraction
D. Tonic contraction
E. All of the above

25. Which of the following statement is FALSE?

A. 90% water of colonic content is reabsorped in the large bowel
B. Sodium is actively reabsorped in colon
C. Water intoxication may result from large volume of enema
D. Longest intestinal transit time occurs in the ascending colon
E. All of the above

26. All of the following are correct statements about pancreatic exocrine secretion
EXCEPT
a. Bicarbonate rich fluid is secreted by ductal epithelial cells in response
to secretin
b. Secretion of enzymes by acinarcells occurs in response to CCK
c. Vagotomy augments secretion of enzymes after a meal
d. Secretin and CCK both act via formation of cyclic nucleotide 2nd
messengers
e. Gastrin stimulates both enzyme and bicarbonate secretion

27. The major mechanism for absorption ofsodium from the small intestine is
a. Non electrolytic cotransport
b. Cotransport with potassium
c. Electrogenic transport
d. Neutral NaCl absorption
e. Solvent drag
 28. All of the following statements about bile acids are correct EXCEPT
a. Bile acids are secreted as conjugated bile salts by the liver
b. Bile acids are dehydroxylated by intestinal bacteria
c. Bile acids are absorbed in the intestine and return to the liver via theportal vein
d. Bile acids facilitate absorptionof fat by emulsifying glycerides
e. Sulfation of bile acids promotes their uptake in the intestine

29. Dietary fat is absorbed chiefly in the

a. Stomach
b. Jejunum
c. Ileum
d. Caecum
e. Ascending colon

30. Gallbladder contraction is controlled primarily by the hormone

a. Enterogastrone
b. CCK
c. Insulin
d. Secretin
e. Glucagon

31. All of the following statements about somatostatin are true EXCEPT
a. It inhibits gastrin secretion
b. It is secreted by the hypothalamus
c. It is secreted by pancreatic islet cells
d. It is released following vagal blockade
e. Its effects are prolonged

32. Compared with the resting state – during prolonged exercise the caloric needs of skeletal muscle
are met by
a. Release of free fatty acids from adipose tissue
b. An increase in hepatic glycogenolysis
c. An increase in gluconeogenesis in muscle
d. Increased intestinal uptake of glucose and amino acids
e. None of the above

33. Binding of a peptide hormone to its receptor may involve all of the following EXCEPT
a. Reversible hydrophobic interactions b. Allosteric regulation
c. Hydrogen bonding
d. Formation of covalent linkages
e. Coupling with an activity site

34. Secretion of pancreatic polypeptide is

a. Subsequent to its cleavage from proinsulin in the αcell
b. A response to both vagal and βadrenergic stimulation
c. The stimulator of release of pancreatic enzymes in response to glucose
d. Inhibited by exercise
e. None of the above
35. Activation of hormone sensitive lipase in adipocytes
a. Causes increased hydrolysis of cholesterol esters
b. Is mediated by a cAMP dependent protein kinase
c. Is prevented by cortisol
d. Is stimulated by insulin
e. Results in accumulation of monoglycerides and diglycerides in adipocytes

36. All of the following statements about the uptake of triglycerides into adipose tissue from plasma
lipoproteins are true EXCEPT
a. It is regulated by the activity of lipoprotein lipase
b. It is decreased by catecholamines
c. It is increased by glucose d. It is increased by insulin
e. It requires receptor mediated endocytosis

37. The islets of Langerhans are characterised by

a. Being more plentiful in the head of the pancreas than in the tail
b. Constituting 20 – 30% of the weight of the pancreas
c. Containing at least 6 distinct cell types
d. Having a meagre blood supply
e. Producing glucagon and insulin

38. Dietary fat, after being processes, is extruded from the mucosal cells of the GI tract into the
lymphatic ducts in the form of
a. Monoglycerides
b. Diglycerides
c. Triglycerides
d. Chylomicrons
e. Free fatty acids

39. The rate of gastric emptying is influenced by all of the following factors EXCEPT
a. Carbohydrate in gastric contents
b. Secretion of gastrin by antral G cells
c. Distension of the duodenum
d. Osmolarity of duodenal contents
e. Acidity of chime entering the duodenum

40. Gas within the colon is primarily derived from which one of the following sources
a. CO2liberated by the interaction of HCO3- and H+
b. Diffusion from the blood
c. Fermentation of undigested oligo saccharides by bacteria
d. Swallowed atmospheric air
e. None of the above
 41. Vitamins synthesised by intestinal bacteria and absorbed in significant
quantities include
a. Vitamin B6
b. Vitamin K
c. Thiamine
d. Riboflavin
e. Folic acid

42. Which one of the following statements about the colon is correct
a. Absorption of Na+ in the colon is under hormonal (aldosterone) control
b. Bile acids enhance absorption of water from the colon
c. Net absorption of HCO3- occurs in the colon
d. Net absorption of K+occurs in the colon
e. The luminal potential in the colon is positive

43. Absorption of fat soluble vitamins requires

a. Intrinsic factor
b. Chymotrypsin
c. Pancreatic lipase
d. Pancreatic amylase
e. None of the above

45. Contraction of the gallbladder is correctly described by which one of the

following statements
a. It is inhibited by a fat rich meal
b. It is inhibited by the presence of amino acids in the duodenum
c. It is stimulated by atropine
d. It occurs in response to CCK
e. It occurs simultaneously with the contraction of the sphincter of oddi

46. Which of the following is a paracrine secretion

a. CCK
b. Gastrin
c. Histamine
d. Secretin
e. None of the above

47. Acidification of the duodenum will

a. Decrease pancreatic secretion of bicarbonate
b. Increase secretion of gastric acid
c. Decrease gastric emptying
d. Increase contraction of the gallbladder
e. Increase contraction of the sphincter of oddi
48. In contrast to secondary oesophageal peristalsis, primary oesophageal
peristalsis is characterised by which of the following statements
a. It does not involve relaxationof the lower oesophageal sphincter
b. It involves contraction ofoesophageal smooth muscle
c. It is not influenced bythe intrinsic nervous system
d. It has an oropharyngeal phase
e. None of the above

49. The stimulation of release of pancreatic secretions normally involves all of the following EXCEPT
a. Ach
b. CCK
c. Histamine
d. Neural stimulation
e. Secretion

50. Intestinal proteolysis is accomplished by all of the following EXCEPT

a. Carboxypeptidase
b. Chymotrypsin
c. Elastase
d. Pepsin
e. Trypsin

51. The concept that active transport is the mechanism for absorption of monosaccharides in the gut
is supported by all of the following statements EXCEPT
a. Transport can be blocked by metabolic inhibitors
b. Transport is selective for different sugars
c. A maximum rate of transport exists for individual monosaccharides
d. Competition exists among sugars for the carrier mechanism
e. Transport can occur bidirectionally

52. Removal of the terminal ileum will result in

a. A decrease in absorption of amino acids
b. An increase in the water content of the faeces
c. An increase in the concentration of bile acid in the enterohepatic
circulation
d. A decrease in the fat content of the faeces
e. An increase in the absorption of iron

53. All of the following statements concerning normal human pancreatic juice are
true EXCEPT
a. Its pH is approximately 8.0
b. It has a high bicarbonate content
c. Over 1000ml are secreted per day
d. It contains cholesterol esterase
e. Its secretion is primarily under neural control
54. Mass movements (strong peristalsis) in the colon would be abolished by
a. Vagotomy
b. Extrinsic denervation
c. Distension of the colon
d. Destruction of Meissner’s plexus
e. Destruction of Auerbach’s plexus

55. Saliva has all the following constituents EXCEPT

a. Bicarbonate
b. Phosphate
c. Chloride
d. Glucose
e. Lysozyme

56. Where are vitamins A, D and K absorbed

a. Stomach
b. Proximal small bowel
c. Terminal ileum
d. Duodenum
e. Ascending colon

57. Regarding carbohydrate metabolism – which of the following statements is correct

a. About 80% of energy supplies are stored in fat
b. Most of the glycogen stores are in the liver
c. Resting muscle utilisesglucose for its metabolism
d. At rest – the brain accountsfor 40 – 50% of glucose utilised
e. 5% of ingested glucose is promptly converted to fat

58. Regarding basal metabolic rate – all are true EXCEPT

a. It is relatively higher in women than men
b. It falls about 10% during sleep
c. It is increased by tension
d. It falls about 40% during prolonged fasting
e. It increases in high and low environmental temperatures

59. All of the following increase gastrin secretion EXCEPT

a. Calcium
b. Luminal peptides and amino acids c. Secretin
d. Epinephrine
e. Increased vagal discharge

60. Regarding GI hormones

a. Luminal somatostatin inhibits gastrin secretion
b. CCK secretion is increased by the presence in the duodenum of fatty acids containing more than 3
carbon atoms
c. GIP is produced by the ileum
d. Secretin increases the section of an enzyme rich pancreatic juice
e. VIP causes contraction of intestinal smooth muscle