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GEP521S - GASTROINTESTINAL AND ENDOCRINE PHYSIOLOGY - 2ND OPP - JAN 2023 |
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n Am I BIA u n IVERs ITY
OFSCIEnCEAno TECHn OLOGY
FACULTYOF HEALTH,APPLIEDSCIENCESAND NATURAL RESOURCES
DEPARTMENT OF HEALTH SCIENCES
QUALIFICATION: BACHELOR OF HUMAN NUTRITION
QUALIFICATION CODE: 08BOHN
COURSE NAME: GASTROINTESTINAL
AND ENDOCRINE PHYSIOLOGY
SESSION: JANUARY 2023
LEVEL: 5
COURSE CODE: GEP521S
PAPER: THEORY
DURATION: 3 HOURS
MARKS: 100
SUPPLEMENTARY/SECOND OPPORTUNITY QUESTION PAPER
EXAMINER:
MS RIANA PICK
MODERATOR: DR ELZABE VAN DER COLF
INSTRUCTIONS
1. Answer ALL the questions in the answer book provided.
2. Write clearly and neatly.
3. Number the answers clearly.
PERMISSIBLE MATERIALS
NONE
THIS QUESTION PAPER CONSISTS OF 10 PAGES (Including this front page)
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SECTION A
QUESTION 1
(20 MARKS)
Evaluate the following statements in each numbered section and select the most appropriate
answer from the given possibilities. Write the appropriate letter next to the number of the
statement/phase in the ANSWER BOOK. {Each question carries 1 mark.)
1.1
A 23-year-old man consumes a meal containing 30 percent protein, 15 percent fat,
and 55 percent carbohydrate. At which of the locations depicted in the below figure
are bile salts most likely to be absorbed by an active transport process:
A) A
B) B
C) C
D) D
E) E
A
B
C
D
E
1.2
Which ion has the highest concentration in saliva under basal conditions:
A) Bicarbonate
B) Chloride
C) Potassium
D) Sodium
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1.3
The proenzyme pepsinogen is secreted mainly from which of the following
structures:
A) Acinar cells of the pancreas
B) Ductal cells of the pancreas
C) Epithelial cells of the duodenum
D) Gastric glands of the stomach
1.4
Which hormone is released by the presence of fat and protein in the small intestine
and has a major effect in decreasing gastric emptying:
A) CCK
B) GLIP
C) Gastrin
D) Motilin
E) Secretin
1.5
Which manometric recording in the below figure illustrates normal function of the
oesophagus at midthoracic level before and after swallowing (indicated by the
arrow): The dotted lines represent a pressure of O mm Hg.
A) A
B) B
C) C
A 0 ---+--
B 0 -------+------
D) D
E) E
C 0 -------------
+
D 0 ·--------.-..--------+~
·-·---
E 0 --------
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1.6
A 62-year-old man with dyspepsia and a history of chronic gastric ulcer has
abdominal pain, with his endoscopy showing a large ulcer in the proximal gastric
body and biopsies positive for H. pylori. Which substances are used clinically for
treatment of gastric ulcers of various aetiologies:
Antibiotics
NSAIDs
H2 Blockers
Proton Pumi:1Inhibitors
A) No
No
Yes
Yes
B) Yes
No
No
Yes
C) Yes
No
Yes
Yes
D) Yes
Yes
Yes
Yes
E) No
Yes
Yes
Yes
1.7
Cystic fibrosis (CF) is an inherited disorder of the exocrine glands affecting children
and young people. A primary disruption in the transfer of which ion across cell
membranes occurs in CF, leading to decreased secretion of fluid:
A) Calcium
B) Chloride
C) Phosphate
D) Potassium
E) Sodium
1.8
A 45-year-old woman with type 1 diabetes has an early feeling of fullness when
eating, often nauseous after a meal and vomits about once each week after eating.
Glucose-induced damage to which structure is most likely to explain her
gastrointestinal problem:
A) Celiac ganglia
B) Enteric nervous system
C) Oesophagus
D) Stomach
E) Vagus nerve
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1.9
An 89-year-old man has a cerebrovascular accident (stroke) in the medulla and pons
that completely eliminates all vagal output to the gastrointestinal tract. Which
function is most likely to be totally eliminated in this man:
A) Gastric acid secretion
B) Gastrin release
C) Pancreatic bicarbonate secretion
D) Primary oesophageal peristalsis
E) Secondary oesophageal peristalsis
F) None of the above
1.10 Cystic Fibrosis (CF) is the most common cause of pancreatitis in children. Which
option best explains the mechanism of CF-induced pancreatitis:
A) Activation of enterokinase
B) Activation of trypsin inhibitor
C) Autodigestion of pancreas
D) Excessive secretion of CCK
E) Gallstone obstruction
1.11 Which of the following is both synthesized and stored in the hypothalamus:
A) ADH
B) Thyroid-stimulating hormone (TSH)
C) LH
D) Somatostatin
E) Somatomedin
1.12 By which mechanism do LH and FSHreturn to baseline levels:
A) LH surge
B) Negative feedback on gonadotropin-releasing hormone (GnRH) by
progesterone
C) Negative feedback on GnRH by oestradiol
D) Negative feedback on GnRH from testosterone
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Match each of the patients described in Questions 1.13 and 1.14 with the correct
set of plasma values listed in the table below, considering normal values for: plasma
aldosterone concentration, 10 ng/dl; plasma cortisol concentration, 10 mg/di; and
plasma potassium concentration, 4.5 mEq/L.
Aldosterone
Cortisol
Potassium
Concentration
Concentration
Concentration
A) 10.0
2.0
4.5
B) 2.0
2.0
6.0
C) 40.0
30.0
2.0
D) 40.0
10.0
4.5
E) 40.0
10.0
2.0
1.13 A patient with Conn's syndrome
1.14 A patient consuming a low-sodium diet
1.15 A patient has an elevated plasma thyroxine (T4) concentration, a low plasma TSH
concentration, and her thyroid gland is smaller than normal. What is the most likely
explanation for these findings:
A) A lesion in the anterior pituitary that prevents TSH secretion
B) The patient is taking propylthiouracil
C) The patient is taking thyroid extract
D) The patient is consuming large amounts of iodine
E) Graves' disease
1.16 A patient has nephrogenic diabetes insipidus. Of the following options, which
outcome would be expected, or which intervention would be suggested:
A) Expected outcome: decreased plasma sodium concentration
B) Expected outcome: increased secretion of ADH from the supraoptic and
paraventricular nuclei
C) Expected outcome: high urine osmolality
D) Suggested intervention: water restriction
E) Suggested intervention: ADH antagonists (vaptans)
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1.17 A patient presenting with tachycardia and heat intolerance, is suspected of having
Graves' disease. Which of the following is not consistent with suspected diagnosis:
A) Increased total and free T4
B) Suppressed plasma [TSH]
C) Exophthalmos
D) Goitre
E) Decreased thyroid radioactive iodine uptake
1.18 A 56-year-old woman who completed menopause 3 years ago is found to have low
levels of FSH in her blood, when during the first few years after menopause, FSH
levels are normally extremely high. What is the best explanation for this finding:
A) She has been receiving hormone replacement therapy with oestrogen and
progesterone since she completed menopause
B) Her adrenal glands continue to produce oestrogen
C) Her ovaries continue to secrete oestrogen
D) She took birth control pills for 20 years before menopause
1.19 A patient has hyperthyroidism due to a pituitary tumour. Which set of physiological
changes would be expected:
Thtroglobulin Stnthesis
Heart Rate
Exo12hthalmos
A) Increase
Increase
Positive
B) Increase
Increase
Negative
C) Increase
Decrease
Positive
D) Decrease
Decrease
Positive
E) Decrease
Decrease
Negative
F) Decrease
Increase
Negative
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1.20 Which finding is most likely in a patient who has myxedema:
A) Somnolence
B) Palpitations
C) Increased respiratory rate
D) Increased cardiac output
E) Weight loss
QUESTION 2
(20 MARKS}
Assess the following statements and decide whether they are true or false. Write only the
number of the question and next to it indicate your answer as true or false in the ANSWER
BOOK. {Each question carries 1 mark)
2.1 Squamous stratified epithelium lines the oral cavity.
2.2 Carbohydrates and minerals encompass the nutrients obtained from food.
2.3 'Peristalsis' is a voluntary muscle movement which moves food along the digestive tract.
2.4 Mostly mechanical digestion occurs in the mouth.
2.5 Chemical digestion occurs in the oesophagus.
2.6 Proportion and gastric juices differentiate 'chyme' from a 'bolus.'
2.7 Parietal (oxyntic) cells release intrinsic factor.
2.8 Intrinsic factor helps the gut absorb minerals.
2.9 The function of the peritoneum: Provide a protective, lubricating surface for abdominal
organs.
2.10 The segments of the small intestine encompass the duodenum, ileum and colon.
2.11 The small endocrine gland located in the centre of the "brain" is known as the pineal
gland.
2.12 The "beta" cells of the pancreas are responsible for the production of glucagon.
2.13 Secondary male characteristics are influenced by hormones known as "androgens."
2.14 The development of T-lymphocytes is regulated by hormones known as
"mineralocorticoids."
2.15 The parathyroid hormone acts in a manner that is antagonistic to the activity of
"calcitonin."
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2.16 Both thyroxin and triiodothyronine increase the rate of "metabolism" in the body.
2.17 Contractions of the uterus may be stimulated by the hormone "vasopressin."
2.18 The hormone ACTH is produced by the "adrenal gland," and it regulates the activity of
the adrenal cortex.
2.19 The follicle stimulating hormone is a product of the" posterior" pituitary gland that acts
on the ovaries and testes.
2.20 Swelling of the thyroid glands due to a lack of iodine is referred to as "goitre."
QUESTION 3
SECTION B
3.1 Explain the following concept:
3.1.1 Primary function of the endocrine system
{22 MARl<S)
(2)
3.2 Using the anatomical figure below, name and state the function of
organ:
(10}
The Digestive
System
3.3 Complete the table below by naming the histological (structural) gastrointestinal layers
1-4 in order, and matching the correct function A, B, C, D, or E to each histological layer
(10}
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Layer
1 ....
2 ....
3 ....
4 ....
Functions
A. Nourishes gut epithelium
B. Layer of connective tissue that provides a structural network of blood
vessels, nerve, ducts of exocrine glands
C. Break up food, Mix food with digestive enzymes, Control gut motility
D. Provides a m icrovascu latu re network which coordinates intestinal
absorption & secretion
E. Transports products of digestion
QUESTION 4
{18 MARKS)
4.1 Name the three mechanisms by which endocrine glands are stimulated to
synthesize and release hormones?
(3)
4.2 Name the five main types of cells which make up the Langerhans islets, and
an example of a peptide hormone released by each of these cell types?
(10)
4.3 Define 'dysphagia'. What causes dysphagia?
(5)
SECTION C
QUESTION 5
(20 MARKS)
5.1 Classify intestinal neoplasms?
(3)
5.2 What are the clinical features of hypothyroidism?
(5)
5.3 Describe the normal anatomy and functions of the pituitary, thyroid, parathyroid
glands, and adrenals?
(12)
GOOD LUCK!!!