Medi Call FCPS – 1 | Physiology - Cell Physio

PHYSIOLOGY

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G.I.T
GIT Structure and Innervation
1. During Defecation which of following statement is
correct regarding opening of sphincters ? (Surg 30 Aug 2021
(A.N) +9 in past) - ID: 15925
Ⓐ Opening of internal sphincter by Sacral Parasympathetics
Ⓑ External sphincter is smooth muscle controlled by somatic
system
Ⓒ Internal sphincter is smooth muscle controlled by somatic
system
Ⓓ External sphincter is smooth muscle controlled by
parasympathetics
Ⓐ External sphincter ☛ Striated Muscle ➜ Controlled by fibers
in pudendal nerve ( somatic nervous system ) ➜ under Voluntary
Control
Internal sphincter ☛ Smooth Muscle ➜ Controlled by Myenteric +
Parasympathetic reflexes ➜ strong peristaltic wave ➜ sphincter is
relaxed ➜ if External anal sphincter is also consciously, voluntarily
relaxed at same time ➜ Defecation occurs
✦ Guyton, Pg. 815, 815
2. In spleen worn out blood cells come and filter at which
part? (Surg 16 May 2022 (M) +1 in past) - ID: 37735
Ⓐ Capillaries and White pulp Ⓑ Capillaries and Red pulp
Ⓒ Red Pulp and Sinusoids
Ⓒ Sinusoid in splenic red pulp ☛ Filter worn out RBCs as they
squeeze and pass through fenestrations.
✦ Guyton, Pg. 451
3. There is a bomb blast in area it will affect which
system? (Surg 16 Nov 2022 (M)) - ID: 84168
Ⓐ Nose Ⓑ GIT
Ⓒ Renal Ⓓ Hematopoietic
Ⓑ Bomb Blast ☛ traumatic injuries to GIT, such as perforation,
rupture, or ischemia due to damage to blood supplys.
If Nuclear Blast ☛ Hematopoietic most affected
4. Parasympathetic effect on GIT is ? (Med 2 Dec 2021 (M) +6 in
past) - ID: 22555
Ⓐ Contraction of fundus Ⓑ Contraction of pyloric sphincter
Ⓒ Relaxation of fundus Ⓓ Overall Relaxation
Ⓒ ✪ Food entry into stomach ➜ Vagus stimulation ➜ fundus relax and
accommodate food (Receptive Relaxation).
✦ Ganong, Pg. 473
5. Viscera have following layers (from outermost to
innermost surface): (Med 22 Feb 2023 (A.N)) - ID: 84205
Ⓐ Mucous, muscular, serous, and subserous layers.
Ⓑ Mucous, serous, subserous and muscular layers
Ⓒ Muscular, serous and mucous layers
Ⓓ Serous, submucous, mucous and muscular layers.
Ⓔ Serous, subserous, muscular, submucous and mucous layers
Ⓔ 17. Most dependent on vasovagal reflex ☛ Receptive relaxation
6. Thoracic Vagotomy results in? (Radio 21 Feb 2023 (A.N) +4 in
past) - ID: 12462
Ⓐ Dec contraction of distal stomach
Ⓑ Dec peristalsis of esophagus Ⓒ Dec Gastrin secretion
Ⓓ Dec Contraction on Antrum distention
Ⓓ Thoracic vagotomy involves cutting vagus nerve fibers that
innervate upper part of gastrointestinal tract.
Gastrin secretion is primarily regulated by presence of food in
stomach, particularly proteins, and release of GRP from G cells in
stomach. thoracic vagotomy doesn't have a significant impact on
gastrin secretion compared to other effects
Thoracic vagotomy reduces parasympathetic input to stomach ➜
leads to decreased contractions + impaired gastric emptying ➜ results
in a decreased response to antrum distention
✦ N.I.H USA, Pg. , ✦ RJ Last, Pg. 392
7. Old men want to pass stool but have passive defecation
defect. During defecation, Sensation of rectal distention is
carried by ? (Med 16 Aug 2022 (E) +19 in past) - ID: 22552
Ⓐ Sacral Parasympathetic Nerves
Ⓑ Autonomic activation Ⓒ Sympathetic activation
Ⓓ Myenteric Plexus
Ⓐ Defecation is controlled by 2 Reflexes :
➊ Intrinsic myenteric reflex ( Weak )
➋ Parasympathetic reflex by sacral segments ( Strong )
✔ Enough stool moves to rectum ➜ Nerve endings stimulated ➜
signals to spinal cord ➜ then parasympathetic nerve fibers ➜ then
signals back to descending colon, sigmoid, rectum, and Anus ➜
Defecation
✦ Guyton, Pg. 815
8. Which one is not neoplasia and a normal pancreatic
tissue found in gastric mucosa (CPSP Demo +10 in past) - ID:
10712
Ⓐ Choristoma Ⓑ Meningioma
Ⓒ Lymphoma Ⓓ Leiomyoma
Ⓐ Choristoma☛ Normal tissue at abnormal sites (e.g pancreatic
tissues in stomach) . its not neoplasia
Leiomyoma ☛ Benign tumor of smooth muscles , GIST is leiomyoma -
＞ 20-25% develop leiomyosarcoma (Neoplasia)
✦ Goljan, Pg. 229 ✦ Robbins, Pg. 285
9. Vagal trunk cut will cause (Med 19 Nov 2022 (M) +11 in past) -
ID: 15043
Ⓐ Incomplete gastric emptying Ⓑ Decreased Gastric Acid
Ⓒ Augmented pepsin Ⓓ Augmented enterogastric reflex
Ⓑ Truncal Vagotomy ➜ Effective in diminishing gastric secretion (
done for Peptic Ulcer Treatment ) but often accompanied by gastric
stasis as a side effect.
✦ RJ Last, Pg. 392
10. Action potential in git is by? (Med 17 May 2022 (A.N)) - ID:
79287
Ⓐ Meissner plexus Ⓑ Myenteric plexus
Ⓒ Autonomic nerves Ⓓ Cells of cajal
Ⓓ Cells of Cajal ☛ “pacemakers” of intestine ➜ play critical role in
small intestinal contractile activity ➜ distributed within submucosal,
intramuscular and intermuscular layers throughout GIT.
11. Sympathetic system acts on ☛ Pyloric sphincter
12. Cause of sudden loss of colon mass movement ☛ Sacral
parasympathetic nerves injury (Supply descending colon)
13. Immunological filtering occurs in spleen in ☛ Marginal zone of
sinusoid vessels
14. Defecation reflex is due to ☛ relaxation of Internal sphincter
15. Which of following is not a permanent mucosal fold in GIT ☛
Gastric rugae
16. Most important reflex in defection ☛ Rectoanal reflex
18. Cells not found in stomach ☛ Goblet cells
19. Mucus-secreting cells ☛ Have nucleus located at base
 Medi Call FCPS – 1 | Physiology - GIT

20. If mass movements of intestine are affected, pathology most likely 6. Gastric emptying enhances by increase in (Med 17 Nov 2022
in ☛ Myenteric (M)) - ID: 82965

21. Basal electric rhythm of small intestine ☛ Constant in duodenum Ⓐ Intragastric volume Ⓑ Duodenal osmolarity
variable else where (Varies along GI) Ⓒ Heal osmolarity Ⓓ Secretin
22. Vagus nerve in GIT cause ☛ Contraction of longitudinal muscles for
peristalsis (Relax Sphincters) Ⓐ Proteins in bolus ➜ Antrum of stomach ➜ "G Cells" of Pyloric
glands ➜ Entire production of Gastrin ➜ Stimulates ECL cells ➜
23. Fundus along with Lower esophagogastric junction removed ☛ Loss
Release Histamine ➜ stimulate Parietal cells of Oxyntic glands ➜ 3
of Receptive Relaxation (Under Vagus stimulation )
main roles :
24. Difference of muscles in upper and lower esophagus ☛ Striated __➊ HCL Production ( Main Role )
muscles upper third and smooth in lower (Mix in middle) __➋ ↑ Growth of mucosa ➌ ↑ Gastric Emptying
25. In stomach ☛ Parasympathetic activity increases muscular ✪ HCl converts pepsinogen to pepsin
movement, enzyme secretions and Gastric Emptying (↑ Peristalsis) ✦ Guyton, Pg. 802,811,823, 802,811,823, 802,811,823, 802,811,823 ✦
Sceincedirect Elsevier, Pg.
26. If parasympathetic supply to intestine is lost ☛ No effect on
primary peristalsis (Enteric nervous sytem )) 7. Which Hormone is raised in Hypoglycemia to increase
Glucose secretions (CPSP Demo +8 in past) - ID: 771
27. Complete denervation of small intestine results in. ☛ Paralytic ileus
(Peristalsis: Myenteric Plexus) Ⓐ SSK Ⓑ Somatostatin
28. Gastrointestinal epithelial cells renew occur in within ☛ 2-7 days Ⓒ Gastrin / Glucogon Ⓓ Secretin
(~5 days life cycle)
Ⓒ ✪ Hypoglycemia ☛ ↑ Gastrin ➜ ↑ Glucagon➜ ↑ blood glucose.
GIT Hormones ✪ Somatostatin ☛ worth a therapeutic trial in severe idiopathic
postprandial hypoglycemia.
Gastrin
✦ Sceincedirect Elsevier, Pg. ✦ Ganong, Pg. 443, 445, 329
1. most potent release of gastrin is due to? (Radio 29 Aug 2021
8. Patient presented with symptoms of mid-epigastric pain
(A.N) +7 in past) - ID: 15737
that is relieved by meal and antacids. Showed
Ⓐ Carbohydrates Ⓑ Fats Ⓒ Proteins hypersecretion of acid. What is cause of hypersecretion?
(Med 24 May 2023 (A.N) +2 in past) - ID: 36636
Ⓒ ● Proteins in Bolus ➜ Antrum G Cells ➜ Gastrin Realease ➜
Ⓐ Secretin Ⓑ Gastrin Ⓒ CCK
HCL Production
✦ Guyton, Pg. 823
Ⓑ Zollinger-Ellison syndrome ☛ Gastrinomas ➜ ↑
2. If Antrum of stomach is removed, it would result in ? Gastrin ➜ Hypersecretion of HCL ➜ severe peptic ulceration
(Med 15 Feb 2022 (A.N) +4 in past) - ID: 3854 ✦ Robbins, Pg. 784

Ⓐ Decrease Compliance Ⓑ Increase acid output 9. Gastrin secretion increased by ☛ Stomach distention
Ⓒ Increased Gastrin Ⓓ Decreased Gastrin 10. Gastrin secretion not affected by ☛ Antrum distension
11. Increased gastrin secretion by ☛ Alkaline antrum
Ⓓ ✔ Entire Gastrin secretion is from G Cells of Antrum
✔ Body of stomach lies between upper Fundus and lower Pyloric 12. Decrease PH in stomach will decrease ☛ Gastrin
Antrum and it plays major role in compliance. 13. Comparison of Gastrin and CCK given ☛ Gastrin increased in ZE
✦ Guyton, Pg. 802, 823 Syndrome
3. Which of following stimulates Gastric motility, 14. Similarity of Gastrin and CCK ☛ Have same 5 carboxyl terminal
Secretions and Emptying by activation of pyloric pump, (Terminal 5 amino acids )
relaxation of pylorus, and increased lower esophageal 15. Main Action of gastrin is to ☛ Increase HCl and pepsin secretion
sphincter Pressure ? (CPSP Demo +16 in past) - ID: 34819 (Parietal cells )
Ⓐ Gastrin Ⓑ Ach 16. Cause of increased insulin released from pancreas includes ☛ GIP
Ⓒ Secretin Ⓓ Somatostatin ＞ CCK (primary role)
Somatostatin
Ⓐ ◉ Gastrin ☛ Released In response to
✦ Stretching of stomach ✦ ↑ stomach pH ✦ Proteins 17. What is action of chemical somatostatin in pancreatic
Stimulates fistula? (Med 17 Aug 2022 (A.N) +11 in past) - ID: 8941
✦ Gastric mucosal growth ✦ Gastric motility
✦ HCL secretion ✦ ECL cells ➜ histamine release Ⓐ Inhibit enzymes Ⓑ Inhibit secretions
Sphincters Ⓒ Relieve pain Ⓓ All of
✦ Increases LES Tone ✦ Relaxes Pylorus
✦ Ganong, Pg. 471 Ⓑ Somatostatin ☛ Inhibits Pituitary, Pancreatic and GIT hormones
Octreotide ( somatostatin analog ) ☛ used to treat Pncreatic fistula,
4. Lower esophageal Sphincter tone increased by (Med 18 Pitutary adenoma, Carcinoid syndrome, and Variceal bleeding
Nov 2022 (A.N) +2 in past) - ID: 36491 ✦ Ganong, Pg. 144 ✦ First Aid, Pg. 371

Ⓐ Anticholinergic Ⓑ Omeprazole Ⓒ Gastrin 18. Potent insulin inhibitor (Radio 30 Nov 2021 (A.N) +7 in past) -
ID: 16269
Ⓒ Gastrin ☛ hormone that stimulates acid production in stomach ➜
acid production also causes an increase in LES tone ➜ prevents acid Ⓐ Growth hormone Ⓑ Epinephrine
reflux into esophagus. Ⓒ Somatostatin Ⓓ Oxytoxin
Anticholinergic, medications more commonly decrease GI motility,
and do not directly increase LES tone as gastrin does. Ⓒ Somatostatin ☛ secreted by D cells of islets of Langerhans and is
a potent inhibitor of both insulin and glucagon.
5. Gastrin is inhibited by ? (Med 18 Nov 2022 ( M) +6 in past) - ✦ Researchgate, Pg.
ID: 20999
CCK
Ⓐ Enterokinase Ⓑ Bile
Ⓒ Proteins Ⓓ Somatostatin 19. Hormone causes contraction of gall bladder ? (Radio 24th
Nov 2020 (M) +4 in past) - ID: 25087
Ⓓ Somatostatin is antagonist to insulin, glucagon as well as gastrin Ⓐ GIP Ⓑ Vip Ⓒ CCK

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 Medi Call FCPS – 1 | Physiology - GIT

Ⓒ CCK ☛ most potent stimulus for gallbladder contractions Ⓐ Fatty acids in duodenum Ⓑ Amino acids in
✦ Guyton, Pg. 829 duodenum
Ⓒ PH less than 7.4 Ⓓ PH Less than 4.5
20. Stomach emptying is most importantly inhibited After
eating Fatty diet by which of following strongest stimulus? Ⓓ Gastric HCL ( pH ＜ 4.5 to 5.0 ) ➜ Only Potent stimulus ➜ Acts on
(Med 18 Nov 2022 (A.N) +41 in past) - ID: 13113
"S Cells" in Mucosa of duodenum and jejunum ➜ Activates and Release
Ⓐ CCK Ⓑ Insulin Secritin from Prosecritin ➜ Acts on Pancreas ➜ produces HCO3 ➜
Ⓒ Glucagon Ⓓ Gastrin Neutralize Acid
✦ Guyton, Pg. 827
Ⓐ CCK ☛ Mainly in response to fat and fatty acids ➜ secreted by “I”
29. Gastric Motility and Acid secretion is inhibited after
cells in mucosa of duodenum and jejunum
Fatty meal by ? (Surg 16 Aug 2022 (A.N) +10 in past) - ID: 24811
Inhibitors of Gastric Motility ☛ Delays Emptying ➜ CCK ( most potent Ⓐ Motilin Ⓑ Histamine
) , Secretin , GIP , Glucagon , Too much Chyme already in Ⓒ Gastrin Ⓓ Secretin
intestine , Acidic or Fatty Chyme in duodenum
Stimulants of Gastric Motility ☛ Speed up Emptying ➜ Gastrin , GRP , Ⓓ Secretin ☛ In response of Acid and Fat ➜ Secreted by S cells of
Motilin , Histamine duodenum, jejunum and ileum
✦ Guyton, Pg. 812,802,, 812,802, ◉ Stimulates ☛ ✦ Pepsin secretion ✦ Pancreatic bicarbonate
✦ Biliary bicarbonate ✦ Growth of exocrine pancreas
21. Small Gut Intestine Motility is Increased By (Med 23 Feb
2023 (M) +14 in past) - ID: 12709 ◉ Inhibits ☛ Gastric Motility and Acid secretion
✦ Guyton, Pg. 802, 812
Ⓐ CCK Ⓑ Bile
30. Secretin (Inc pancreatic HC03) release In response to ☛ HCL in
Ⓒ VIP Ⓓ Metoclopramide
duodenum
Ⓐ Intestinal Enhancers ☛ Gastrin , CCK , Insulin , Motilin , 31. Secretin is secreted by ☛ Small Intestine
Serotonin , Parasympathetic stimulation G.I.P , V.I.P
Intestinal Inhibitors ☛ Secretin , Glucagon , Sympathetic
Stimulation 32. Relaxation of GIT smooth muscles by which putative
Metoclopramide ☛ Blocks dopamine ➜ ↑ stomach motility ( mainly ) inhibitory neurotransmitter (Med 30 Sep 2020 (A.N) +6 in past) -
and intestinal ID: 12699
✦ Guyton, Pg. 813
Ⓐ GIP Ⓑ CCK Ⓒ Gastrin Ⓓ VIP
22. Fatty food and protein increase secretion (Radio 15 Nov
2022 (M)) - ID: 78413 Ⓓ VIP ☛ found in Myenteric Plexus of GIT ( not itself a hormone but an
inhibitory peptide )
Ⓐ CCK Ⓑ Gastrin
Functions :
Ⓒ Polypeptide Ⓓ Aminoacids
◉ Relaxation of intestinal smooth muscle and sphincters
◉ Dilation of peripheral blood vessels
Ⓐ Fatty food and protein ☛ increase secretion of
◉ Inhibition of gastric acid secretion
cholecystokinin.Gastrin, ☛ primarily stimulated by peptides
◉ stimulates pancreatic HCO3 secretion
in stomach. ✦ Ganong, Pg. 447 ✦ Guyton, Pg. 800
✦ Guyton, Pg. 812,802,, 812,802,
33. Which of following neurotransmitter decreases
23. Which of following increases pancreatic secretion and
contraction of stomach and gallbladder? (Surg 16 Aug 2022
releases Calcium from sarcoplasm? (Gynae 22 Feb 2023 (A.N) +6 (M)) - ID: 84145
in past) - ID: 31239
Ⓐ Substance P Ⓑ VIP
Ⓐ CCK Ⓑ Secretin
Ⓒ CCFC Ⓓ Secretin Ⓔ Motilin t
Ⓒ Gastrin Ⓓ Soma tomedian
Ⓑ Vasoactive intestinal peptide ☛ acts as neurotransmitter ➜
Ⓐ CCK ☛ Stimulates secretion of pancreatic Enzymes ( amylase,
reduces contraction of stomach and gallbladder ➜ slowing passage of
lipases, proteases ) and Bicarb
food through digestive system.
CCK ☛ Raised Intracellular Calcium
Substance P ☛ known to increase gut motility, contrary to function
✦ BRS Physiology, Pg. 212
described in question.
24. True about CCK ☛ Dec gastric emptying and Acts on muscarinic
34. Hormone that increases intestinal secretions of electrolytes and
receptors
H2O, relaxes smooth muscle, dilates peripheral blood vessels, and
25. In cholecystitis, hormone responsible for pain ☛ Cholecystokinin inhibits gastric secretions ☛ Vasoactive intestinal peptide (Inhibitory
26. CCK ☛ Causes gall bladder to contract (Pancreatic secretion) peptide)
Secretin 35. Rise in Insulin secretion is seen when GIP is actively secreted in
response to ☛ Oral glucose (↑ Insulin release )
27. Hormone which stimulates release of HCO3 from
36. Oral glucose/ carbohydrate load increases ☛ GIP hormone (Upper
Pancreas without stimulating pancreatic enzyme
small intestine)
secretions ? (Med 16 June 2021 (E) +4 in past) - ID: 3799
37. Release of Insulin from pancreas is caused by ☛ GIP (Upper small
Ⓐ CCK Ⓑ Secretin intestine)
Ⓒ Gastrin Ⓓ Acetylcholine
-----
Ⓑ Acetylcholine and Cholecystokinin ☛ stimulate acinar cells 38. Infant passes stools after each feed rapidly due to
of pancreas ➜ ↑ production of pancreatic enzymes But Less Water and hyperfunction of ? (Surg 22 Feb 2023 (A.N) +11 in past) - ID:
Bicarb 19786
Secretin ☛ Only ↑ HCO3 secretion ➜ neutralize gastric acid in
duodenum ➜ allowing pancreatic enzymes to function. Ⓐ Diarrhoea Ⓑ Celiac disease
✦ Guyton, Pg. 826 Ⓒ Release of metabolic mediators
Ⓓ Gastrocolic reflex
28. Stimulus for secretin to be released is ? (Med 19 Sep 2019
(M) +4 in past) - ID: 21513
Ⓓ Gastrocolic Reflex ☛ Presence of food in stomach increases
motility of colon and increases frequency of Mass movements.
✦ BRS Physiology, Pg. 203

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 Medi Call FCPS – 1
39. Most imp sec of Gastric mucosa (Dent 16 Nov 2022 (M)) - ID:
83574
Ⓐ Pepsin
Ⓐ EXPLANTION
40. Motility of saliva due to (Med 21 Feb 2023 (A.N)) - ID: 83307
Ⓐ VIP Ⓑ Motilin
Ⓒ Acetylcholine Ⓓ Norepinephrine
Ⓐ VIP ☛ stimulates secretion of water and electrolytes in salivary
glands as well as increases blood flow ➜ increased production and
secretion of saliva.
Motilin ☛ stimulates GI motility and production of pepsin BUT no
significant role in salivation
41. Enterogastric reflex is stimulated by ☛ chyme in duodenum,
Presence of acids in duodenal chyme and Hypotonic chyme (Not by
pancreatic secretions)
42. Migrating Myoelectric complexes in intestine is increased by ☛
Motilin (↑ GIT Motility )
43. Hormone effecting both body weight and growth ☛ Leptin
(Anorexigenic neurons)
44. GIT hormones ☛ Substance P, Neurotensin, Guanylin, Galanin,
Somatostatin, GRP, CCK, Enkephalins. (Melatonin: pineal gland )
45. GIT motility ☛ not dependent on hormones only
46. Release of acid from stomach is mediated through ☛ H2 receptor
(Histamine)
47. Satiety is mediated by ☛ Impulses from GIT
G.I Motility
Swallowing
1. Regarding pharyngeal phase of deglutition which is
appropriate? (Med 23 Feb 2023 (A.N) +19 in past) - ID: 14872
Ⓐ Vocal cords strongly approximate
Ⓑ Larynx moves downward
Ⓒ Esophageal sphincter is contracted
Ⓓ Esophagus is Closed
Ⓐ Vocal cords are strongly approximated
Larynx is pulled upward and anteriorly by neck muscles
PharyngoEsophageal Sphincter Relaxes ➜ Esophagus opened
✦ Guyton, Pg. 808
2. Which cranial nerve combination has role in pharyngeal
phase of swallowing and leads to difficulty in swallowing
when damaged? (Radio 21 Feb 2023 (A.N) +2 in past) - ID: 82360
Ⓐ CN V Ⓑ CN VII IX, X
Ⓒ CN V, IX,X,XII Ⓓ CN VII, VI, V, IX
Ⓒ 2nd Phase ☞ Pharyngeal Involuntary ➜ lasts ＜ 2 seconds.
Deglutition Center ☞ Areas in Medulla and Lower Pons
Nerves involved ☞ CN V3, IX, X, XII, ansa cervicalis, RLN
Soft palate ☛ Pulled upward to close posterior nares
Palatopharyngeal folds ☞ on each side Pulled Medially
Glottis ☞ Closed and Respiration inhibited
Vocal cords ☞ are strongly Approximated
Larynx ☞ pulled upward and anteriorly
✦ Guyton, Pg. 808
3. Difference between primary and secondary peristaltic wave ☛
Primary has oropharyngeal phase (Motor function )
4. Deglutination phases ☛ Upward movement of larynx during
pharyngeal phase prevent food aspiration
5. 3rd Part of deglutition ☛ Vagally stimulated (Peristaltic activity )
6. 2nd Phase of swallowing ☛ Center located in Medulla and lower
pons (Pharyngeal Involuntary )
7. Long-term smoker feeling difficulty in swallowing with solids ☛
Damage to neurons
8. During swallowing ☛ Larynx moves upward and anterior
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| Physiology - GIT
Peristalsis
9. Slow waves of stomach begin from (Med 17 Aug 2022 (E) +2
in past) - ID: 79482
Ⓐ Intestinal cells of Kajal Ⓑ Myenteric plexus
Ⓒ Smooth muscle in longitudinal layer
Ⓓ Smooth muscle in circular layer
Ⓐ Slow wave activity ☛ generated and propagated by interstitial
cells of Cajal in stomach wall ➜ confer a fundamental level of control
over gastric motility ➜ initiating and coordinating peristalsis
10. Migratory motor complexes in stomach and duodenum
are controlled by (Med 23 Feb 2023 (M)) - ID: 72963
Ⓐ CCK Ⓑ Gastin
Ⓒ Motilin Ⓓ Secretin
Ⓒ Motilin, activates MMCs which transport undigested food from small
to large intestine.
CCK also affects gastrointestinal motility but primarily does so by
stimulating contraction of gallbladder and slowing gastric emptying.
11. Secondary peristalsis occurs in response to ? (Dent 29
Sep 2020 (E) +5 in past) - ID: 20062
Ⓐ Food in pharynx Ⓑ Distention of Esophagus
Ⓒ Fatty food Ⓓ Acidic food
Ⓑ Secondary peristalsis ☛ After weak primary peristaltic wave ➜
Remaining bolus causes distension ➜ Vagal reflex ➜ Enforces peristaltic
activity
✦ Guyton, Pg. 809
12. True Regarding gastroesophageal sphincter ? (Med 15
Aug 2022 (A.N) +3 in past) - ID: 10392
Ⓐ It's a true anatomical sphincter
Ⓑ Its pressure increases in pregnancy
Ⓒ Its pressure decreases in achalasia
Ⓓ It relaxes during swallowing
Ⓓ ● No True anatomic sphincter exists at lower end of esophagus ➜
Circular layer of smooth muscle in this region serves physiologic
sphincter
● “Receptive Relaxation” of Lower Esophageal Sphincter occurs
ahead of peristaltic wave
● LES Contraction ( Vagal control ) ➜ ➊ Augmented by Gastrin
__➋ Relaxed by Pregnancy Hormones, Secretin, CCK and Glucagon
● Achalasia ☛ incomplete relaxation due to failure of Myenteric plexus
✦ Guyton, Pg. 809 ✦ SNELL, Pg. 170 ✦ N.I.H USA, Pg.
13. Contraction and motility in GIT muscle is due to ? (Med
17 May 2022 (A.N) +4 in past) - ID: 2356
Ⓐ Spontaneous stimulation by Ca+
Ⓑ Hormone and slow waves Ⓒ Neuronal and Slow
waves
Ⓓ Neuronal and action potential
Ⓐ Smooth Muscle Contraction ☛ Always self excitatory ➜ Always due
to Ca+ entry
✪ Slow Waves ☛ created by pacemaker cells controling Na+
◉ Slow wave Do Not cause Ca to enter smooth muscle
◉ Slow wave only cause entry of sodium ions
◉ Slow waves themselves DO NOT cause contraction
◉ Slow waves just Initiate Action Potential
✪ Spike potentials ☛ generated at peaks of slow waves ➜ Calcium
ions enter fibers ➜ Contraction.
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14. Waves in stomach ☛ High amplitude in cranial than caudal (Mixing
waves )
15. Electrical activity of Slow Waves in Duodenum occurs at frequency
of ☛ 12/min (＞ Ileum)
16. Lower esophageal constrictor will open ☛ Before peristaltic wave
52
 Medi Call FCPS – 1 | Physiology - GIT

17. Acid in duodenum ☛ Decreases gastric emptying (CCK) Ⓐ Substance P ☛ a neuropeptide ➜ acts as a neurotransmitter ➜
18. Resection of duodenum results in ☛ Increased gastric emptying stimulates cholinergic as well as SP specific receptors ( Tachykinin NK-1
receptors ) ➜ ↑ Saliva flow
19. Electrical activity of Slow Waves in stomach occurs at ☛ 3/min
Acetylcholine ＞ VIP ＞ Sub P
( Ileum = 9/min)
20. Gastro Intestinal rotation is clockwise around ☛ 270 degree ✦ N.I.H USA, Pg.
21. wave generated in esophagus to propel bolus is ☛ Primary 3. Salivary enzyme kill bacteria and prevents iron
peristalsis utilization by bacteria: (Med 23 Feb 2023 (M) +10 in past) - ID:
22. Time taken by food to reach large intestine from pylorus is ☛ 4hrz 2527
(1 cm/min)
Ⓐ Iron binding lactoferrin Ⓑ Inhibiting protein synthesis
23. Peristalsis ☛ Aided by outer longitudinal and inner circular muscles Ⓒ Rupture of membranes Ⓓ Salivary amylase
constriction
24. If large bolus is stuck after eating ☛ Secondary peristalasis will be Ⓐ Lectoferrin ☛ An iron-binding globular protein ➜ Secreted by
generated by intrinsic nervous system to remove it (Myenteric plexus exocrine glands ( such as Lacrimal and Salivary ) ➜ deprive bacteria of
and vagus) a source of iron.
✦ BRS Microbiology, Pg. 244
25. Rate of passage of food in esophagus depends upon ☛
Gravitational Force (Peristalsis) 4. Saliva helps in digestion. Which induces saliva
26. Intestinal peristalsis ☛ Involves contraction of smooth muscles, production from salivary gland? (Med 17 Nov 2022 (A.N) +7 in
past) - ID: 37731
arranged in two layers, circular and longitudinal
27. Secondary peristalsis is induced by ☛ Myenteric Plexus (Enforces Ⓐ VIP Ⓑ Motilin
movement) Ⓒ Vagus nerve Ⓓ Trigeminal nerve
28. Peristalsis depends on ☛ Food in lumen
Ⓐ ● Parasympathetics ☛ Mainly Control salivary glands ➜ via M1 and
29. Contractions of GIT which move downward and coz increase M3 Muscarinic Ach receptors
pressure behind bolus are called ☛ Peristalsis contractions ● Sympathetics ☛ also increase salivation but much less than
----- parasympathetic
● VIP ☛ Potentiates action of acetylcholine in salivary glands
30. Which of following effects gastric motility (Anesth 15 Nov Acetylcholine ＞ VIP ＞ Sub P
2022 (M) +1 in past) - ID: 72481 ✦ Ganong, Pg. 431, 447 ✦ N.I.H USA, Pg. ,

Ⓐ Metoclopramide Ⓑ H2 antagonists Ⓒ Dopamine agonist 5. Which of following Increases salivary secretions: (Surg 15
Aug 2022 (E) +6 in past) - ID: 1669
Ⓐ Metoclopramide ☛ enhances rate of gastric emptying by
(1) augmenting esophageal peristalsis, gastric antral contractions, and Ⓐ Secretin Ⓑ VIP
small intestine transit time Ⓒ Motilin Ⓓ Acetylcholine Ⓔ Substance P
(2) increasing resting pressures of lower esophageal and pyloric
sphincters. Ⓓ ● Parasympathetics ☛ Mainly Control salivary glands ➜ via M1 and
✦ Katzung, Pg. 1097 M3 Muscarinic Ach receptors
● Sympathetics ☛ also increase salivation but much less than
31. slow waves in small intestinal smooth muscle cells parasympathetic
are? (Med 17 Aug 2022 (E) +3 in past) - ID: 79485 ● VIP ☛ Potentiates action of acetylcholine in salivary glands
Acetylcholine ＞ VIP ＞ Sub P
Ⓐ Action potentials Ⓑ Phasic contractions
✦ Ganong, Pg. 431, 447 ✦ N.I.H USA, Pg. ,
Ⓒ Tonic contractions
Ⓓ Oscillating resting membrane potentials 6. Eating dry fruit saliva from parotid gland is (Med 15 Feb
Ⓔ Oscillating release of choiecystokinin 2022 (A.N)) - ID: 72556

Ⓓ Slow waves ☛ Undulating changes in RMP Ⓐ Predominantly serous Ⓑ Predominantly mucinous Ⓒ Mixed
✦ Guyton, Pg. 798
Ⓐ Parotid gland ☛ Serous
32. Iron tablets when to take ☛ Empty stomach (Best absorbed) Sublingual gland ☛ Mucous
33. Feces is passed by defecation through ☛ Mass movement Submandubular gland ☛ Mixed
34. Intestinal motility is due to ☛ Spontaneous stimulation of slow 7. Which of following is True regarding Saliva ? (Patho 25 Feb
waves by Ca 2020 +4 in past) - ID: 367
35. Increased Gut motility is by ☛ Acetylcholine (strong contraction of Ⓐ Normally acidic in ph
circular muscles) Ⓑ Predominantly mucoid in normal conditions
G.I Secretion Ⓒ Has Na and K less than plasma
Ⓓ Normally alkaline in P.h Ⓔ Hypertonic
Saliva
Ⓐ ✪ Saliva formed by ☛
1. Bacterial cell wall breakdown is caused by which __➊ Parotid ( Serous only and major role )
component of saliva? (Dent 23 May 2023 (A.N) +10 in past) - ID: __➋ Submandibular ( Mix )
15399
__➌ Sublingual glands ( Mix )✪ PH☛ b/w 6.0 and 7.0 ( slight Acidic )
Ⓐ Lysozyme Ⓑ Peroxisome ➜ favorable range for digestive action of Ptyalin✪ while passing
Ⓒ Glyoxisome Ⓓ Neutrophils through ducts ➜ Reabsorb NaCl and Secrete K+ and HCO3 ➜
__✦ High ➜ K+ and HCO3-
Ⓐ Lysozyme ☛ Salivary proteolytic enzyme ➜ attack bacteria and aid __✦ Low ➜ Na+, Cl- and TonicityNOTE: In Ganong (pg 431) it is
thiocyanate ions in entering bacteria where these ions in turn become mentioned that Saliva is Alkaline but im following Guyton here.
bactericidal
✦ Guyton, Pg. 820 ✦ Guyton, Pg. 819

2. Increase salivary flow occurs by (ENT 23 May 2023 (M) +4 in 8. Salivary enzyme is? (Surg 16 Feb 2022 (E) +2 in past) - ID:
past) - ID: 2272 35818

Ⓐ Substance P Ⓑ Prosta glandins Ⓐ Amylase

Ⓒ Sleep Ⓓ Anticholinergic

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 Medi Call FCPS – 1 | Physiology - GIT

Ⓐ EXPLANATION 25. Gastrin secretion occurs from which part of stomach

9. PH of fresh secreted saliva Is ☛ Slightly less than 7.0
10. Salivary gland receptors ☛ Cholinergic Muscarinic
11. Parotid gland secretion in unstimulated condition contains ☛
Increase k
12. Saliva ☛ Hypotonic (Conc. ECF.)
13. K is higher in concentration in ☛ Saliva
14. Short term intake of food is affected by ☛ Saliva
15. Salivation controlled by ☛ Salivary center located in medulla
16. Saliva is increased by ☛ Cholinergic drugs
17. In Xerostomia salivary pH is: ☛ Low (Inc mouth acidity)
18. Oligosaccharide in saliva to which microbes adhere and get
attached to mucosa ☛ Mucin (Protects GIT )
19. Controlled by Parasympathetic supply ☛ Increased salivation
(Sympathetic ( minor ))
Gastric Secretions
20. Most important enzyme present in gastric juice is ?
(Dent 29 Sep 2020 (E) +6 in past) - ID: 20755
Ⓐ Trypsinogen Ⓑ Pepsinogen
Ⓒ Enterokinase Ⓓ Lipase
Ⓑ Oxyntic Glands ☛ secrete HCL, Pepsinogen, intrinsic factor mucus
Pyloric Glands ☛ secrete mainly Mucus and Gastrin
✔ HCL converts inactive Zymogen Pepsinogen into Active Enzyme
Pepsin
✦ Guyton, Pg. 821
21. Gastric HCI from parietal cells is needed for ? (Med 31
August 2021 (A.N) +9 in past) - ID: 2658
Ⓐ Conversion of Pepsinogen into Pepsin
Ⓑ Intrinsic factor activation Ⓒ Extrinsic factor activation
Ⓓ Conversion of trypsinogen to trypsin
Ⓐ ➊ Rate of Release of Pepsinogen is Directly proportional to HCL
➋ Inactive Pepsinogen ➜ When Mixes with HCL ➜ Activated into Pepsin
➜ Proteolytic enzyme Active only in a highly acidic medium ( pH 1.8 to
3.5)
✦ Guyton, Pg. 822, 823
22. Parietal cell release which of following? (Surg 16 May 2022
(A.N) +6 in past) - ID: 24487
Ⓐ Intrinsic factor and HCl Ⓑ Intrinsic factor and Pepsinogen
Ⓒ Only Intrinsic Factor Ⓓ Only HCL
Ⓐ ✪ Fundus and Body ( Oxyntic Glands )
✦ Parietal Cells ➜ HCL, Intrinsic Factor
✦ Chief Cells ➜ Mucus, Pepsinogen, Lipase
✦ Guyton, Pg. 821, 821
is: (Med 25 May 2023 (A.N) +3 in past) - ID: 78430
Ⓐ Antrum Ⓑ Granular
Ⓒ Costal Ⓓ None
Ⓐ Proteins in bolus ➜ Antrum of stomach ➜ "G Cells" of Pyloric
glands ➜ Entire production of Gastrin ➜ Stimulates ECL cells ➜
Release Histamine ➜ stimulate Parietal cells of Oxyntic glands ➜ 3
main roles :
__➊ HCL Production ( Main Role )
__➋ ↑ Growth of mucosa ➌ ↑ Gastric Emptying
✪ HCl converts pepsinogen to pepsin
✦ Guyton, Pg. 802,811,823, 802,811,823, 802,811,823, 802,811,823 ✦
Sceincedirect Elsevier, Pg.
26. Which of following secretion has lowest pH in GIT?
(Dent 23 May 2023 (A.N) +3 in past) - ID: 3438
Ⓐ Intestinal Ⓑ Oral
Ⓒ Gastric Ⓓ Pancreatic
Ⓒ Gastric juice has lowest / acidic pH = 0.8
✦ Guyton, Pg. 821
27. Highest potential difference in wall of stomach is when ☛ Mucosa
intact with NO HCl (↑ Potential Difference)
28. Gastric secretion is increased by ☛ H2 receptors
29. Enzyme stable at acidic pH ☛ Pepsin (pH 1.8 to 3.5)
30. Intrinsic factor ☛ Is a glycoprotein (B12 absorption)
31. Do not causes Acid secretion ☛ Acidic Antrum (Somatostatin)
32. Protection of stomach from acid ☛ Mucus (Protective barrier)
33. Area of stomach affected in pt with megaloblast cells ☛ Fundus
34. Action of Prostaglandins on stomach ☛ Inhibit HCL Secretion from
Parietal Cells
Pancreatic Secretions
35. At high flow rate,Pancreatic secretions are rich in ?
(Ophth Nov 2018 +5 in past) - ID: 19774
Ⓐ Cl Ⓑ Lipase
Ⓒ Amylase Ⓓ HCO3
Ⓓ ➊ CCK and Acetylcholine ➜ Acts on Pancreatic Acinar ➜
Stimulates Release of Juice and Zymogen Granules having Enzymes ➜
Low volume Rich in Enzyme Juice
✦ HCO3 is secreted in small ducts and it is reabsorbed in large ducts in
exchange for Cl ➋ Secretin ➜ Acts on Pancreatic Ducts ➜ Raise
secretion flow ➜ ↓ HCO3 ⇄ Cl Exchange ➜ ↑ HCO3 conc ➜ High
Volume High Alkaline and Low in Enzymes Juice
✦ Ganong, Pg. 436
36. Which of following is not present in pancreatic
secretions (Med 17 May 2022 (E) +3 in past) - ID: 24324

23. Which of following is associated with complete gastric Ⓐ Trypsin Ⓑ Chymotrypsin

resection? (Med 17 May 2022 (A.N) +13 in past) - ID: 36026 Ⓒ Corboxypeptidase. Ⓓ Pepsin

Ⓐ IDA Ⓑ Vitamin B12 deficiency Ⓓ added later

Ⓒ Folic acid deficiency Ⓓ Sideroblastic anemia
37. Most common cells in islets of Langerhans that secrete
Ⓑ Gastrectomy ☛ Loss of Parietal Cells ➜ ↓ Intrinsic factor insulin and Amylin are? (Med 31 Aug 2021 (M) +4 in past) - ID:
Production ➜ ↓ Vitamin B12 21137
✦ Guyton, Pg. 822
Ⓐ Alpha cells Ⓑ Beta cells Ⓒ Delta cells
24. Intrinsic factor is secreted from which part of stomach
? (Surg 17 Nov 2022 (M) +11 in past) - ID: 1232 Ⓑ ✪ Beta cells :
✦ 60% of all Islets cells ✦ Secrete Insulin and Amylin
Ⓐ Gastric fundus Ⓑ Gastric Cardia ✪ Alpha cells :
Ⓒ Gastric Pyloric Ⓓ None of above ✦ 25% of all cells ✦ Secrete Glucagon
✪ Delta cells :
Ⓐ ✪ Fundus and Body ( Oxyntic Glands ) ✦ 10% of all cells ✦ Secrete Somatostatin
✦ Parietal Cells ➜ HCL, Intrinsic Factor ✦ Guyton, Pg. 983
✦ Chief Cells ➜ Mucus, Pepsinogen, Lipase✪ Antrum and Pylorus (
Pyloric Glands ) 38. Which hormone inhibits action of hormone-sensitive
✦ G Cells ➜ Gastrin ✦ Mucus Cells ➜ Mucus, Pepsinogen lipase ? (Med 16 Aug 2022 (E) +4 in past) - ID: 8346
✦ Guyton, Pg. 821 ✦ BRS Physiology, Pg. 207
Ⓐ Insulin Ⓑ Cortisol
Ⓒ Glucagon Ⓓ Thyroxine

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 Medi Call FCPS – 1 | Physiology - GIT

Ⓐ Insulin ☛ inhibits Hormone-sensitive Lipase ➜ ↓ hydrolysis of Ⓐ Lactase (Brush border enzyme ) ➜ breaks down lactose
triglycerides already stored in fat cells ➜ ↓ Release of fatty acids from If deficient ➜ Lactose Intolerance
adipose tissue
✦ Guyton, Pg. 987 50. Enzyme secreted by brush border epithelial cells of small intestine
☛ Lactase (Lactase ＞ Enterokinase)
39. Enzyme not present in pancreatic secretion is ? (DENTAL
16 Aug 2022 (A.N) +11 in past) - ID: 19630
51. Columnar epithelium of Intestine secretes ☛ Peptidase, Sucrase,
Maltase, Lactase, Lipase, Enterokinase (Brush Border Enzymes )
Ⓐ Trypsin and Lipase Ⓑ Amylase and ELastase 52. Large Intestine ☛ Dont secrete Acid or Any Enzyme (Dont have
Ⓒ Zymogen and Aminopeptidase Villi )
Ⓓ Carboxypeptidase and Phosphilipase A2
53. Trypsinogen in duodenum will be activated by Enterokinase in ☛
Ⓒ ● Aminopeptidase is secreted by Small intestinal Mucosa Acidic pH (pH 5.2-6.0 )
● Zymogen Granules are storage organelles for P. Enzymes Bile
● All other mentioned are Pancreatic Enzymes
54. Bile from liver is different from that from Gallbladder?
(Dent 25 Feb 2020 (A.N) +5 in past) - ID: 10407
Click to view Full Table in MediCall Application
✦ Ganong, Pg. 437, 437 Ⓐ Has more HCO3- Ⓑ Has more mucous and pigments
40. Secretions having highest pH are present in ? (Surg 17 Ⓒ Has Less Na and Cl Ⓓ Has less water
Nov 2022 (A.N) +11 in past) - ID: 19751
Ⓐ ✪ Bile HCO3 ✦ Liver ( 28 ) ＞ GB ( 10 )
Ⓐ Stomach Ⓑ Pancreatic ✪ Bile Water ✦ Liver ( 97 ) ＞ GB ( 92 )
Ⓒ Saliva Ⓓ Duodenum ✪ Bile Salts ...✦ Liver ( 1 ) ＜ GB ( 6 )
✔ Remember ☛ Water, Sodium and HCO3 ➜ Additionally secreted
Ⓑ Pancreatic juice is alkaline in nature due to high concentration of
in Liver by Secretin and Added to Bile
bicarbonate ions. Bicarbonate is useful in neutralizing acidic gastric ✦ Guyton, Pg. 829, 828
acid, allowing for effective enzymic changes.PH of pancreatic juice is
highest(pH= 8.0-8.3) 55. Fat digestion is done by: (Med 17 Nov 2022 (M) +1 in past) -
ID: 83919
41. Secretions that is most isotonic, has high HCO3,
inhibited via vagotomy? (Med 16 Aug 2022 (E) +1 in past) - ID: Ⓐ Emulsification of Fats by Bile salts
82354 Ⓑ Bile salt Ⓒ Lipase Ⓓ HCO3

Ⓐ Bile Ⓑ Pancreatic secretion Ⓐ Bile salts ☛ mediates first step for digestion of fats. ➜ act as
Ⓒ Gastric secretion Ⓓ Bowel secretions emulsifiers, breaking down large fat globules into smaller droplets ➜
increases surface area for enzymes
Ⓑ Vagotomy causes a substantial reduction of pancreatic exocrine
secretion ( Rich in HCO3) 56. Bile ☛ Bound to glycine and taurine (Form Bile Acids )
Pancreatic juice is isotonic solution containing Na+, Cl−, K+, and 57. Bile acids are absorbed in ☛ Terminal ileum (Taken up by liver)
HCO3− (in addition to enzymes).
58. Meissner's plexus of GIT is attributed to which of
42. hormone that causes glycogenolysis (glucagon)
following functions? (Med 16 May 2022 (E)) - ID: 78403
release from which pancreatic cells: (Radio 23 May 2023 (A.N)
+2 in past) - ID: 71001 Ⓐ Secretion of neurotransmitters
Ⓐ Alpha cells Ⓑ Mucous cells Ⓑ Controlling motility of GIT
Ⓒ Beta cells Ⓓ D cells Ⓒ Controlling GIT reflexes
Ⓓ Controlling of secretions andblood flow
Ⓐ Pancreas alpha cells ☛ produce glucagon ➜ raises blood sugar Ⓔ Contraction of gall bladder

43. Enteropeptidase enzyme def causes unavailability of enzyme in Ⓓ ✪ Outer plexus ➜ between longitudinal and circular muscles ➜
intestine during digestion ☛ Trypsin (Activates trypsinogen) Myenteric or Auerbach’s ➜ Controls Movement
44. To prevent Autodigestion of pancreas pancreatic enzymes are ☛ ✪ Inner plexus ➜ Submucosal or Meissner’s ➜ controls secretion
Secreted in Inactive form. (Activated by trypsinogen) and local blood flow.
✦ Ganong, Pg. 472
45. Alpha 2 macroglobulin inhibits ☛ Endoproteases ( Pepsin, Trypsin,
Chymotrypsin, Elastase ) (Liver) 59. Gland of upper duodenum that secrete a bicarbonaterich solution ☛
Brunner's glands
46. Alpha and Beta cells of pancreas are derived from ☛ Endoderm
60. Following acid secretion from stomach ☛ Increase in plasma HC03
47. Exocrine pancreas insufficiency ☛ Decreased Trypsin in Duodenum
levels
(Protease)
Intestinal Secretions Digestion and Absorption
48. Activation of pancreatic enzyme Trypsinogen into Protein Digestion
trypsin in Duodedum occur by? (Med 19 Nov 2022 (A.N) +37 in
past) - ID: 23148
1. most important enzyme for protein digestion present in
pancreas is ? (Med 17 June 2021 (E) +5 in past) - ID: 22759
Ⓐ Enterokinase Ⓑ Ph less than 7
Ⓒ Bicarbonates Ⓓ Gastrin Ⓐ Lipase Ⓑ Amylase
Ⓒ Trypsin Ⓓ Pepsin Ⓔ Chymotrypsin
Ⓐ Mucosal Lining of Duodenum secrete ➜ Enteropeptidase (
enterokinase ) ➜ Activates Pacreatic Trypsinogen into Trypsin in Ⓒ ● Trypsin ➜ most important, most abundant Proteolytic Enzyme
duodenum ➜ Trypsin further activates other pacreatic enzymes ● Amylase ➜ digests Carbs ● Lipase➜ digests Fats
✦ Guyton, Pg. 825
✦ Ganong, Pg. 437

49. Deficiency of enzymes produced by brush border will 2. In normal person decreased acid secretion causes? (Med
1st Dec 2021 (E) +5 in past) - ID: 3249
cause? (Radio 23 May 2023 (A.N) +4 in past) - ID: 36986
Ⓐ Decrease protein digestion Ⓑ Increase gastrin
Ⓐ Lactose intolerance Ⓑ Steatorrhea
secretion
Ⓒ Inability of micelle formation
Ⓒ Abnormal fat digestion
Ⓓ Decrease absorption of triglycerides

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 Medi Call FCPS – 1 | Physiology - GIT

Ⓐ HCL + Inactive Pepsingogen ➜ Active Pepsin ( Proteolytic enzyme Ⓐ Secretory diarrhea Ⓑ Decreased Micelles formation
Active only in a highly acidic medium - pH 1.8 to 3.5 )
Gastrin is Increased by Protein in food or by stretch. Ⓑ Bile Salts ☛ Form Micelles with Lipids ➜ ↑ Absorption
✦ Guyton, Pg. 822 ✪ Malabsorption of bile salts and their retention ➜ extract water into
lumen ➜ Osmotic Diarrhea
3. Protein digestion starts in ? (Surg 15 Aug 2022 (E) +6 in past) ✦ Guyton, Pg. 829
- ID: 15392
11. Patient with pancreatitis has developed steatorrhea
Ⓐ Mouth Ⓑ Esophagus
due to deficiency of ? (Med 25 May 2023 (M) +8 in past) - ID: 2518
Ⓒ Stomach Ⓓ Duodenum
Ⓐ Enterokinase Ⓑ Peptidase
Ⓒ Stomach ☛ Pepsin ➜ Starts Protein digestion ➜ 10% Proteolysis Ⓒ Amylase Ⓓ Lipase
Upper Small Intestine ☛ Pancreatic Enzymes ➜ 90% Proteolysis
Click to see Digestion Flow Chart on MediCall App Ⓓ Pancreatitis ➜ Loss of Lipase ( major enzyme for Fat digestion ) ➜
✦ Guyton, Pg. 835, 835 ↓ Fat digestion and absorption ➜ fatty, bulky, clay-colored stools
(steatorrhea)
4. Which of following increase gastric secretion (Dent 23 May
2023 (A.N) +3 in past) - ID: 38770
● Amylase ➜ digests Carbs ● Trypsin ➜ digests Proteins
✦ Guyton, Pg. 825
Ⓐ Ingestion of protein Ⓑ Increase in gastric acidity
12. Absorption of fat soluble vitamins requires ☛ Bile (Emulsify)
Ⓒ Secretin secretion
13. Fat metabolism is facilitated by ☛ Pancreas and liver (Lipase and
Ⓐ Proteins in bolus ➜ Antrum of stomach ➜ "G Cells" of Pyloric Bile)
glands ➜ Entire production of Gastrin ➜ Stimulates ECL cells ➜ 14. Absorption of Iong chain fatty acids is greatest in ☛
Release Histamine ➜ stimulate Parietal cells of Oxyntic glands ➜ 3 Jejunum (Micelle)
main roles :
15. Chylomicrons synthesized in: ☛ Small intestine (Micelles)
__➊ HCL Production ( Main Role )
__➋ ↑ Growth of mucosa ➌ ↑ Gastric Emptying 16. Total pancreatectomy causes ☛ Weight loss (↓ Insulin )
✪ HCl converts pepsinogen to pepsin 17. Dec digestion of fat d/t ( most common cause) ☛ pancreatic
✦ Guyton, Pg. 802,811,823, 802,811,823, 802,811,823, 802,811,823 ✦ insufficiency (Cystic fibrosis)
Sceincedirect Elsevier, Pg.
Carbs Digestion
5. Congenital absence of Enterokinase ☛ Protein
assimilation (Activates trypsin) 18. 2 years old boy was presented with c/o diarrhea. Stool
PH was acidic And Brush border of his intestine was lost
Fat Digestion
what enzyme is deficient in this patient? (Gynae 30 Aug 2021
6. Lipids after metabolism absorbed and transfer in plasma (M) +4 in past) - ID: 15573
In form of (Surg 16 Feb 2022 (E) +2 in past) - ID: 34141 Ⓐ Protease Ⓑ Amylase
Ⓐ VLDl Ⓑ Chylomicron Ⓒ Lactase Ⓓ Lipase
Ⓒ LDL Ⓓ Conjugate with albumin
Ⓒ Lactase (BB Enzyme) Deficiency
Ⓑ Fat digestion ☛ TGs ➜ Monoglycerides and Fatty acids ➜ ◉ Malabsorbed lactose ➜ fermented by intestinal bacteria ➜ produce
Chylomicrons ➜ Absorb Gas and organic Acids ➜ bloating, flatulence and abdominal pain ( after
✦ Guyton, Pg. 863 ingestion of milk )
◉ Nonmetabolized lactose and organic acids ➜ increase stool
7. Bile salts help in which of following ? (Med 15 Feb 2022 (A.N) osmotic load with fluid loss ➜ Osmotic Diarrhea
+4 in past) - ID: 24307 ✔ Diagnosis confirmed by hydrogen breath test.
✦ CMDT, Pg. 649
Ⓐ Absorption of lipid Ⓑ Digestion of lipid
Ⓒ Hydrolysis of lipid Ⓓ Released in response to carb 19. Carbohydrates malabsorption is due to deficiency of ?
(Radio 29 Sep 2020 ( A.N ) +11 in past) - ID: 21648
Ⓐ Bile Salts function :
➊ Form semisoluble Micelles with Lipids ➜ ↑ Absorption Ⓐ Intestinal Lipase Ⓑ Intestinal lactase
➋ Emulsify Fats ➜ ↓ surface tension ➜ Break Easily Ⓒ Intestinal Amylase Ⓓ Maltase
✦ Guyton, Pg. 829
Ⓑ Pancreatic Amylase ☛ Major Role in Carb Digestion
8. Regarding fat metabolism more appropriate (Surg 23 Feb Sucrase ☛ splits Sucrose into Fructose and Glucose.
2023 (M) +2 in past) - ID: 34261 Lactase ☛ splits Lactose into Galactose and Glucose
Ⓐ Mucus, lipase, bile salt Ⓑ Mucus, lipase, bicarbonate Lactase is BB Enzyme and deficiency causes Lactose Intolerance
✦ Guyton, Pg. 834
Ⓒ Mucose, bicarbonate, bile salt
Ⓓ Amylase, lipase, bile salt 20. Digestion of Carbohydrate/ starch begins in mouth
with enzyme (Surg 16 Feb 2022 (E) +5 in past) - ID: 15369
Ⓐ Fat digestion ➤ Mouth ➜ Stomach by gastric lipase ➜ Small
intestine ➜ Fat emulsified by bile ( Bile salt) ➜ Pancreatic lipase ➜ Ⓐ Lipase Ⓑ Salivary Amylase Ⓒ Protease
Fatty acid + Diglyceride ➜ Monoglyceride ➜ Glycerol ➜
✦ Guyton, Pg. 825, 829 Ⓑ Ptyalin ( α-amylase ) ☛ secreted mainly by parotid glands
➜ hydrolyzes starch into disaccharide maltose and other small
9. Regarding insulin's action on adipocytes? (Med 16 May 2022 polymers of glucose
(E) +7 in past) - ID: 16442 ✦ Guyton, Pg. 834
Ⓐ Promotes glycogenolysis Ⓑ Activates lipoprotein lipase 21. One year old child presented with diarrhea after 1 yr.
Ⓒ Hormone sensitive lipase Ⓓ Act as anabolic History of some milk intake.? Doctor asked her to stop
giving milk to baby. Cause (Med 16 May 2022 (E)) - ID: 79212
Ⓑ Insulin ☛ Acts on Adipose tissue ➜ Activates Lipoprotein lipase ➜
which splits triglycerides into fatty acids ➜ absorbed into Adipose cells Ⓐ Spru disease Ⓑ Lactose intolerance
➜ converted again to triglycerides ➜ Stored. Ⓒ Hirshsprung disease Ⓓ Celiax disease
✦ Guyton, Pg. 987
Ⓑ Lactose intolerance ☛ unable to fully digest lactose in milk ➜
10. Deficiency of bile salts after ileal resections causes?
diarrhea, gas and bloating after eating or drinking dairy products.
(Med 25 May 2023 (A.N) +4 in past) - ID: 28680

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 Medi Call FCPS – 1 | Physiology - GIT

22. Enzymes which cause malabsorption of carbohydrates are present Ⓐ Malnutrition Ⓑ Dirrohea
in ☛ Brush border Ⓒ Infection Ⓓ Nutrient and fluid deficiency
Gut Absorption
Ⓓ Small Intestine absorbs ☛ ◉ 80% electrolytes ◉ 90% water ◉
23. A 61 yo man underwent a surgery in which terminal Most of Nutrients
ileal resection had been done. He complains of fatigue, Proximal Colon absorbs ☛ ◉ Remaining Water ◉ Electrolytes ◉
headache, and heart racing. Labs: MCV=108fL, Some nutrients from Indigestible food
Hgb=8.9g/dL. What is most likely dx? (Med 25 May 2023 (A.N) ☢ Remember ☛ Nutrient Absorption is Not major role of Colon so if
+50 in past) - ID: 22932 Nutrients and Electrolytes given in option, choose that as major
function
Ⓐ Vitamin B12 Deficiency Ⓑ Vitamin B9 Deficiency ✦ N.I.H USA, Pg.
Ⓒ Vitamin B 6 Deficiency Ⓓ Iron deficiency Anemia
30. Patient underwent abdominal surgery, after which he
Ⓐ Terminal Ileum ☛ Site for Vitamin B12 and Bile Salts absorption repeatedly required fluid resuscitation due to water and
✦ CMDT, Pg. 649 electrolyte loss. He does not remember which part of
intestine was operated. (Med 17 Aug 2022 (A.N) +5 in past) - ID:
24. Vibrio cholera cause diarrhea via ? (Med 17 Nov 2022 (A.N)
34705
+8 in past) - ID: 13240
Ⓐ Jejunum Ⓑ Rectum
Ⓐ Dec. NaCl absorption Ⓑ Inc. Cl Secretion
Ⓒ Ileum Ⓓ Colon
Ⓒ CAMP Inhibition Ⓓ Dec. H2O absorption in colon
Ⓔ Duodenum
Ⓑ Cholera toxin ➜ Stimulates cAMP ➜ Opens Chloride channels ➜
Ⓒ ✪ Jejunum Resection ➜ ileum compensates Major function
Na+ go along Cl ions ➜ Loss of NaCl causes extreme Osmosis ➜ Rapid
✪ Ileal Resection ➜
flow of water with Salt ➜ Fatal Dehyderation if untreated
➊ ↑ ↑ Motility ➋ ↑ ↑ Intestinal transit ➌ Malabsorption
✦ Guyton, Pg. 840
➤ Colon receives ↑ ↑ Fluid + ↑ ↑ Electrolytes + ↑ ↑ Bile salts ➜
25. Which of following increases absorption of iron in gut? Unable to absorb all ➜ Large Volume Secretory Diarrhea☢ ↑ ↑ Bile
(Med 17 Aug 2022 (M) +11 in past) - ID: 33962 Salts ➜ Stimulates Colon ➜ cause Secretory Diarrhea ( but its One of
reasons along with others )
Ⓐ Green vegetables Ⓑ Citrus fruit
☢ Osmotic Diarrhea ➜ Only due to presence of
Ⓒ Chocolates Ⓓ Apple
Malabsorbed osmotically active agents e.g Carbohydrates (esp Lactose)
✦ Bailey and Love, Pg. 283 ✦ CMDT, Pg. 600
Ⓑ Citrus fruits ☛ contain vitamin C ➜ shown to enhance iron
absorption ➜ captures non-heme iron and stores it in form that's more 31. Active absorption of sodium occurs in ? (Med 2 Dec 2021
easily absorbed by body. (A.N) +7 in past) - ID: 20096

26. Most of dietary iron is absorbed in (Dentistry Aug 2021 (E) Ⓐ Colon Ⓑ Jejunum
+8 in past) - ID: 1659 Ⓒ Rectum

Ⓐ Stomach Ⓑ Duodenum Ⓐ Sodium Gut Absorption

Ⓒ Lower part of small intestine Secondary Active ☛ in jejunum Cotransport with glucose, Na+, amino
Ⓓ Upper part of colon acid and H+ exchange
Active Transport ☛ in Colon by sodium channels
Ⓑ Duodenum ☛ place for almost all Iron absorption ✦ Guyton, Pg. 839 ✦ Ganong, Pg. 51 ✦ N.I.H USA, Pg.
➤ Liver ➜ secrete Apotransferrin into Bile ➜ in duodenum it binds with
free iron and iron compounds to make Transferrin ➜ it binds with 32. Maximum Water and electrolytes are absorbed from
receptors in epithelial cells ➜ pinocytosis ➜ Absorbed which part of gut? (Med 17 June 2021 (A.N) +6 in past) - ID: 22664
✦ Ganong, Pg. 459 ✦ Guyton, Pg. 451
Ⓐ Ileum Ⓑ Colon
27. Ileal resection more than 100 cm will cause (Med 19 Nov Ⓒ Jejunum Ⓓ Duodenum
2022 (E) +14 in past) - ID: 9538
Ⓒ Small intestine ☛ Leaky junctions + Brush border ➜ ↑ permeablity
Ⓐ Dec Absorption of Bile Salts
and large surface area ➜ ● 80% electrolytes ● 90% water and most
Ⓑ Increased water content of stool
absorption of carbohydrates ( specifically jejunum )
Ⓒ Decreased Fat absorption
Colon ☛ Tight junctions ➜ ↓ water and electrolytes absorbed
✪ Water Absorption :
Ⓐ Over 95% of bile acids are absorbed in terminal ileum . Large ileal
Jejunum : 5500 ml ＞ Ileum : 2000 ml ＞ Colon : 1300 ml
resections (>100 cm) can lead to luminal bile salt deficiency resulting in
fat malabsorption and colonic secretion. 90% water absorption takes
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place throughout small intestine as well as large intestine. ( Ref :
✦ Ganong, Pg. 441 ✦ BRS Physiology, Pg. 217
Guyton + NCBI USA )
33. Terminal ileum resection most important feature: (Med
28. Patient with fluid loss now show metabolic acidosis 15 Feb 2022 (E) +1 in past) - ID: 26826
with hypokalemia. Most fluid loss will be through (Gynae 22
Feb 2023 (M) +14 in past) - ID: 2903 Ⓐ Jaundice Ⓑ Steatorrhea
Ⓒ Constipation Ⓓ Pernicious anemia
Ⓐ Colon Ⓑ Stomach
Ⓔ Iron deficiency anemia
Ⓒ Duodenum Ⓓ Jujenum
Ⓑ Terminal Ileal Resection ( ＞ 100 cm ) ☛ Steatorrhea
Ⓐ Enteritis ➜ Intense irritation of Colon ➜ Mucosa screte Extra Large
quantities of Water + Electrolytes ➜ Diarrhea with Loss of alot of 34. Patient with fatigue , dec RBC and abnormal size and shape of RBC,
electrocytes including K+ ➜ Dehyderation + Hypokalemia ➜ Metabolic GIT malabsorption, lesion in ☛ Ileum (B12 defeciency)
Acidosis
35. Chenoxycholic acid decrease turnover in ☛ Ileal resection (Bile
Remember ☛ Site for Most Water and Electrolyte Absorption is
acids malabsorption )
Jejunum but here specifically severe Loss is asked which is not just due
to Malabsorption but a particular pathology. 36. Complete removal of colon causes ☛ Electrolyte imbalance
✦ Guyton, Pg. 832 (Impaired absorption )
37. Increased water content In fecaes is due to damage to ☛ Ileum
29. Colon resection will cause (Radio 15 Nov 2022 (A.N) +3 in
past) - ID: 15394 (Water Absorption 2000 ml)

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 Medi Call FCPS – 1 | Physiology - GIT

38. In an adult ilectomy and jeiunectomy has been done, he has Ⓐ Albumin ☛ Sentized by liver
diarhea and 15 -20 bowel sounds / min, cause of dec transit time in ✦ Ganong, Pg. 582
Intestine is ☛ Secretory and osmotic
4. Organ that regenerates on its own (Gyn 16 Aug 2022 (M) +4
39. Small Gut of a patient resected upto 100 cm is at risk of ☛ in past) - ID: 36016
Diarrohea (Unabsorbed Bile salts)
Ⓐ Liver Ⓑ Skeletal muscle
40. Increased dietary Potassium causes ☛ Decreased absorption in
Ⓒ Cardiac muscle Ⓓ Neuron
distal tubule
41. Iron absorption increased by ☛ Ferrous form Ⓐ Liver ☛ has unique capacity to regenerate itself after damage ➜ can
42. Absorptive surface of small intestine in m2 ☛ 250 (Tennis court) regrow to normal size even after up to 90% of it has been removed.

43. Level of lead in blood is estimated due to maximum absorption 5. Chylomicron Lipoprotein is made by liver where it is
through ☛ GIT (10-15% absorbed) released directly from hepatocytes? (Patho 15 Aug 2022 (M) +5
in past) - ID: 15618
44. In an adult, Lead passes unabsorbed in GIT by ☛ 90 % (50% in
children) Ⓐ Porta hepatis Ⓑ Portal triad
Ⓒ Sinusoids Ⓓ Space of disse
45. Stomach has some special cells that absorb ? (Med 17
Nov 2022 (A.N)) - ID: 82867 Ⓓ Liver ☛ Site for production of Most of ◉ Lipoproteins ◉ Cholesterol
Ⓐ Carbohydrates Ⓑ Alcohol ◉ Phospholipids ◉ Triglycerides
Ⓒ Triglyceride Ⓓ Chylomicrons Lipoprotein ☛ assembly and secretion involves space of Disse in
form of VLDL
Ⓑ Alcohol is swallowed ➜ it is not digested like food. First, a small ✦ Sceincedirect Elsevier, Pg.
amount is absorbed directly by tongue and mucosal lining of mouth ➜ 8. Basic nutritional assessment status of pt with h/o weight loss is
Once in stomach, alcohol is absorbed directly into your blood stream clinically determined by ☛ Serum albumin and iron
through tissue lining of stomach and small intestine.
9. Functions of liver ☛ Lipogenesis, detoxify toxic substances and
46. Total parenteral nutrition (TPN) is a method of feeding synthesizes Cholesterol and proteins like albumin (Globulin: Formed by
that bypasses gastrointestinal tract Fluids are given into a Plasma Cells )
vein to provide most of nutrients body needs. What fa tbe 10. Liver glycogen is not converted into glucose due to ☛ Enzyme
not a complication related to TPN? (Med 18 Nov 2022 ( M)) - ID: deficiency
58200
11. Functions of liver ☛ Lipogenesis, Albumin synthesis and Cholesterol
Ⓐ Fluid overload Ⓑ Hyperglycaemia synthesis (Globulin: Formed by Plasma Cells)
Ⓒ Abnormal liver functions Ⓓ Coagulopathies
12. Glucokinese is present in ☛ Liver (Activated by Insulin )
Ⓔ Vitamin deficiencies.
13. Maximum glycogen stored in ☛ Liver (5-6% of liver fresh weight)
Ⓓ TPN Complications ☛ 14. Plasma glucose level is determined by ☛ Glucostatic activity of
◉ Dehydration and electrolyte Imbalances. liver (Glycogenolysis and gluconeogenesis)
◉ Thrombosis ◉ Hyperglycemia
15. Functions of liver include ☛ Formation of anglotensinogens
◉ Hypoglycemia ◉ Infection.
◉ Liver Failure. ◉ Micronutrient deficiencies (vitamin and minerals) 16. BMR in resting condition maintained by ☛ Liver
17. Liver disease leads to decrease in ☛ Prothrombin (Made by Liver)
47. A 5 months old baby presents with vomiting, diarrhea
and lethargy for 12 hours. There is drooping of neck -----
muscles. On examination,he is dehydrated and hypotonic.
(Med 17 Nov 2022 (A.N)) - ID: 60701 1. A patient presented with fatigue, pallor, peripheral
neuropathy and generalized weakness. Labs show
Ⓐ Hypocalcemia Ⓑ Hyponatremia Macrocytes MCV 101 fl. Which of following is most
Ⓒ Hypokalemia Ⓓ Hyperkalemia common cause of pernicious anemia? (Radio 21 Feb 2023 (A.N)
+13 in past) - ID: 23343
Ⓑ Vomiting and diarrhea ☛ can lead to fluid and electrolyte loss ➜
result in dehydration + hyponatremia + hypokalemia Ⓐ Stomach Acidity
Hyponatremia ☛ affect CNS ➜ lethargy and muscle weakness + Ⓑ Autoimmune Atrophic Gastritis
hypotonia (drooping of neck muscles) in a baby Ⓒ Iron Deficiency Ⓓ Intestinal Resection
Hypokalemia ☛ typically present with muscle cramps, weakness, and
cardiac arrhythmias. Ⓑ Autoimmune Atrophic Gastritis ☛ autoantibodies directed against
parietal cells and/or intrinsic factor ➜ loss of parietal cells ➜ ↓ acid
48. Duodenum ☛ Secretes bile in response to a fatty meal secretion, ↑ serum gastrin ➜ pernicious anemia ( megaloblastic
49. Related to Food Intake ☛ Inhibit appetite by leptins secreted from anemia due to lack of intrinsic factor and B12 malabsorption ).Note ➤
adipocytes There are three causes of IF defeciency
➊ Autoimmune destruction
Liver Physiology ➋ As a result of gastrectomy
➌ Congenital defeciency
Only autoimmune loss is called pernicious anemia others don't
2. Gluconeogenesis takes place in which organ? (Surg 24 May ✦ Kaplan Pathology, Pg. 163
2023 (M) +5 in past) - ID: 78384

Ⓐ Kidney Ⓑ Liver
Ⓒ Lungs Ⓓ Spleen

Ⓑ Liver ☛ Glycogenolysis and gluconeogensis

✦ Ganong, Pg. 22

3. About plasma proteins (Med 17 Nov 2022 (A.N) +1 in past) - ID:

82852

Ⓐ Synthesized by liver Ⓑ Synthesized by Kidney

Ⓒ Synthesized by Immune system Ⓓ Synthesized by
Lymphocytes

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Medi Call FCPS – 1 | May 2023 Papers