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TEST AP101-3.3

Digestion, Nutrition & Metabolism


25 Multiple-Choice Questions and 4 Short-Answer Questions

Test Duration:

50 minutes

Reading Time:

10 minutes

Only Bilingual Dictionaries allowed, NO NOTES. This test consists of two part: a) 25 multiple choice questions
(numbers 1 to 25) to be answered on the computer answer sheet (25 marks), and b) 4 short-answer (15
marks) questions. A total of 40 marks is available.
Write your name and student number in the spaces provided on the computer answer sheet. Carefully fill in
the shapes on the computer-marked answer sheet under your name and ID number with a 2B pencil. You
must only use a 2B pencil on the computer answer sheet. Please read the instructions on the answer sheet
carefully and follow them precisely. Select the best answer to questions. If you are unsure of an answer,
eliminate the alternatives that you know to be incorrect and select answer from the remaining alternatives.
To indicate your selection, use a 2B pencil to blacken the corresponding oval on the computer answer sheet,
AP101-1. No marks are deducted for wrong answers. So students are advised to move on quickly without
wasting too much time on one question.


Multiple-Choice Questions
1. The solutes contained in saliva include:
A. only proteases and amylase
B. mucin, lysozyme, electrolytes, salts, and minerals
C. only salts and minerals
D. electrolytes, digestive enzyme, mucin, lysozyme, wastes, and IgA
2. The function of the hepatic portal circulation is to:
A. collect absorbed nutrients for metabolic processing
B. return glucose to the general circulation when blood sugar is low
C. distribute hormones
D. carry toxins to the venous system for disposal through the urinary tract
3. Hydrochloric acid is secreted by which of the secretory cells of the stomach?
A. parietal cells
B. serous cells
C. chief cells
D. mucous neck cells
4. Peristaltic waves are:
A. waves of muscular contractions that propel contents from one point to another
B. pendular movements of the gastrointestinal tract
C. churning movements of the gastrointestinal tract
D. segmental regions of the gastrointestinal tract
5. Chyme is created in the:
A. mouth
B. esophagus
C. stomach
D. small intestine
6. Which of the following enzymes is specific for proteins?
A. trypsin
B. lipase
C. dextrinase
D. amylase
7. Which vitamin requires intrinsic factor in order to be absorbed?
A. C
B. K
C. B12
D. A


8. The pancreas:
A. secretes pancreatic juice through a duct into the stomach
B. secretes lipase, nuclease, and amylase
C. is an immune organ that humans can easily live without
D. secretes bile
9. Digestion in the oral cavity:
A. is mechanical
B. is mechanical and chemical
C. involves pancreatic amylase
D. does not occur (only ingestion occurs)
10. In order to prevent self-digestion of the pancreas, activation of pancreatic proteases occurs in the:
A. duodenum
B. pancreas
C. stomach
D. liver
11. What is the main organic molecule digested in the stomach?
A. proteins
B. nucleic acids
C. carbohydrates
D. lipids
12. Which of the following is a characteristic of the large intestine?
A. it is the site for acid neutralization
B. it contains a large number of bacteria
C. is longer than the small intestine
D. it provides no absorptive function
13. What sequence of organs do substances pass through, as they move through the digestive system?
A. Mouth → stomach → pancreas → small intestine → liver → large intestine → anus
B. Mouth → stomach → small intestine → pancreas → liver → large intestine → anus
C. Mouth → esophagus → stomach → small intestine → large intestine → anus
D. Mouth → esophagus → stomach → large intestine → small intestine → anus
14. What is absorption?
A. Food entering the mouth and being chewed
B. Food entering the stomach for digestion
C. Taking digested food into the blood stream
D. Making complex organic molecules in cells using digested foods
15. The digestive system in a cadaver is longer than in a living person because, in a cadaver, there is no:
A. muscle tone
B. digestion taking place
C. food in the tube
D. nervous system influence

16. Bile salts in bile are important in lipid digestion because it break fat droplets apart. This process of
breakdown is called:
A. lipolysis
B. hydrolysis
C. emulsification
D. oxidation
17. ________________ is the major means of propulsion in the digestive system.
A. ingestion
B. mechanical digestion
C. defecation
D. peristalsis
18. Where does digestion begin?
A. buccal cavity
B. pancreas
C. stomach
D. small intestine
19. The ___________ phase of gastric secretion is considered a conditioned reflex.
A. esophageal
B. intestinal
C. gastric
D. cephalic
20. Mass movement:
A. powerful segmental waves in large intestine faster than in small intestine
B. occurs before food enters stomach
C. powerful peristaltic waves in large intestine slower than in small intestine
D. begins in descending colon which drives compacted food residues into rectum
21. Which of the following is true?
A. digested fats are absorbed into lymphatic lacteals
B. the vermiform appendix essentially has no known purpose
C. the hepatopancreatic ampulla is composed of the pancreatic duct and the lesser hepatic duct
D. the submucosa is in direct contact with food
22. The pancreas is an organ connected to the digestive tract of humans by a duct (tube) through which
digestive enzymes flow. These enzymes are important to the digestive system because they …:
A. form the acids that break down food
B. change food substances into molecules that can pass into the bloodstream and cells
C. change food materials into wastes that can be passed out of the body
D. form proteins needed in the stomach


23. Which substances are released into the small intestine of a human and aid in the digestion of the
intestinal contents?
A. salivary amylase, intestinal juice, and pancreatic juice
B. bile, hydrochloric acid, and salivary amylase
C. bile, pancreatic juice, and intestinal juice
D. hydrochloric acid, pancreatic juice, and intestinal juice
24. What is the role of teeth in digestion?
A. They break down food mechanically, increasing the surface area of the food for enzyme action
B. They break down food mechanically, stimulating enzyme synthesis in the food
C. They break down food chemically, aiding the movement of the food through the esophagus
D. They break down food chemically, mixing saliva with the food for easier digestion
25. The liver is involved in a number of metabolic and haematologic processes that are vital to the normal
functioning of our body. What does the liver do to help digestion?
A. Makes important enzymes
B. Neutralizes stomach acid
C. Produces bile
D. Regulates insulin

Short Answer Questions
1. What is the difference between ingestion and digestion? (2 Marks)

2. You are a student nurse, looking after Justin and other patients. You noticed that the total dose of one of
his oral tablets (e.g. carvedilol, a beta-blocker) is lower than that of other patients’. Justin B is a 51 year
old man who has a long history of advanced liver cirrhosis. Your preceptor nurse asks you the following
questions during lunch break:
a) Based on the case information, explain why the total dose (or dosage) of his oral medications is
reduced, in terms of the phenomenon called the first-pass effect (3 Marks).


b) Mr B’s prolonged clotting times and excessive bruising are related. Referring to normal physiological
functioning of the liver, explain why do these two things happen when the liver cells, hepatocytes, are
damaged? (2 Marks).

3. Explain what could happen to the effectiveness of pancreatic enzymes in the small intestine if bile was not
available. Note bile is a solution that contains the alkaline, bicarbonate (2 Marks)

4. Mr John A, a 39 year old man with type 1 diabetes mellitus, was admitted with diabetic ketoacidosis
precipitated by an upper respiratory tract infection. His admitting biochemistry showed BGL of 51.8
mmol/L (reference: 4.0 – 7.8 mmol/L), bicarbonate of 14.7 mmol/L (reference: 22 – 31 mmol/L) and
arterial pH of 7.15 (reference: 7.35 – 7.45). A urine dip stick test showed glycosuria and ketonuria (2
Marks). 1
a) Diabetic ketoacidosis is a serious, acute complication of type 1 diabetes. Explain how type 1 diabetes
is related to diabetic ketoacidosis, in terms of pancreatic hormones and blood glucose level regulation
(3 Marks).

b) What hormone is not released in his body, and from which organ is it produced and secreted? Based
on this information, what type of intervention might the doctors initiate in order to address the
hyperglycaemia and diabetic ketoacidosis? (3 Marks).


For personal use only, last update:
1st August 2015 by Incognitus
16th February 2014 by RD

Case reference: Loh et al. 2014 from Clinical Chemistry, vol 60, no. 10. DOI: 10.1373/clinchem.2013.214676