Fast Track Merge PDF - Practice Questions on Cell Types, Lymphoid Organs, and Inflammation

SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. MODULE 16 1. Which of the following cell types is bone formation, making the most abundant in red bone marrow a...

SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. MODULE 16 1. Which of the following cell types is bone formation, making the most abundant in red bone marrow appear more fluid- marrow? like a. Osteocytes d. the presence of yellow b. fibroblasts bone marrow, such as c. myocytes absence of any d. hematopoietic stem cells hematopoietic activity 2. Which of the following histological 5. limb from which of the following features is associated with yellow parts of the body does not enter bone marrow? into the systemic circulation a. Fine vascularization through thoracic duct b. dominance of a. limb from the right arm. hematopoietic stem cells c. Adipocyte rich tissue 6. lymph from the right lymphatic duct d. presence of enters the circulation at what megakaryocytes point? a. the junction of the right 3. Which factor stimulates subclavian vein and the mesodermal cells to become jugular vein. hematopoietic stem cells? b. - a. fibroblast growth factor 2 c. - b. platelet-derived growth d. - factor c. vascular endothelial growth 7. What is true regarding lymph node factor drainage? d. transforming growth factor a. axillary lymph nodes drain or TGF beta into the subclavian vein and external jugular veins. 4. a 50-year-old patient undergoes an b. lymphatics in the axilla imaging study revealing a normal drain into the inguinal trabecular network of bone. nodes. However, the bone narrow c. lymphatics in the throat appears more fluid-like and less drain to the anterior rigid. What is the most likely cervical chain. explanation for this finding? d. lymphatics in the left lower a. the bone marrow is extremity drain into the composed of Gelatinous abdominal lymph nodes. bone marrow, which lacks the rigidity of bone 8. Which of the following is not a b. patient has osteopenia, function of the spleen? causing abnormal structure a. Filtering and removing cold of the bone marrow, which or damaged red blood is not right cells. c. trabeculal network is b. Storing platelets in white displaced by excessive blood cells. SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. c. Producing red blood cells 14. This lymphoid organ has a thin in adults under normal paracortical region between its conditions. cortex and medulla, containing d. Helping to mount an high endothelial venues. immune response against Answer: lymph nodes bloodborne pathogens. 15. This lymphoid organ consists of 9. What is the primary antibody white pulp and red pulp. produced by plasma cells in Answer: spleen MALT? Answer: IgA (b) 16. You are a pathologist studying 10. What is the primary function of the samples of tissue taken from thymus during _ cell development? patients at the operating room. To a. Production of B your annoyance, the intern on duty lymphocytes got some of the slides mixed up b. filtration of lymphatic fluid and you must identify the organ c. Activation of maturity cells from its microscopic appearance. d. Induction of central One set of slides labeled only tolerance lymphoid tissue shows a distinct cortex and medulla, but no 11. What is the key role of _ cells on lymphoid nodules. This sample is _? likely from which lymphoid organ? a. Secretion of IgA Answer: thymus b. Production of T cells c. Phagocytosis of bacteria 17. Which of the following is a d. Uptake and transfer of granulocyte characterized by a antigens to immune cells multi-lobe nucleus, three to five lobes, and is typically the first 12. A 10-year-old child presents to the leukocyte to arrive at the site of clinic with a history of recurrent infection? sore throats. Difficulty swallowing Answer: neutrophil and bad breath over the past year. The parents report the child has 18. Which white blood cell missed multiple days of school due differentiates into macrophages to illness. Physical examination upon entering tissues? reveals enlarged erythematous Answer: monocytes. tonsils with visible crits containing white debris.He was diagnosed 19. Which of the following is the most with chronic tonsillitis. What is a numerous type of a granulocyte in common result of chronic tonsillitis normal blood smears with a in children? lifespan that can vary from days to Answer: formation of years depending on its specific adenoids (c.) function? Answer: C. lymphocyte 13. This lymphoid organ has hassel corticosomes in its medulla. 20. A 12-year-old patient presents with Answer: thymus frequent sneezing and dark pigmentation under the eyes. SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. Blood work is likely to reveal an a. Autoimmune response elevation in which white blood cell b. Bacterial infection type and what role does it play in leading to neutrophil the patient's condition? infiltration. Answer: eosinophils c. Focal infection d. Allergic reaction 21. Which of the following statements describes inflammation? 25. What differentiates the effects of a. vasoconstriction of local CC and CXC, chemokines, and blood vessels with immune cell migration? increased local blood flow. a. CC chemokines primarily b. clotting of fluids in the attract neutrophils while interstitial spaces due to CXC chemokines attract increased amounts of monocytes. fibrinogen. b. CC chemokines attract c. cellular shrinkage. monocytes and d. decreased permeability of lymphocytes while CXC capillaries to facilitate chemokines primarily diabetes. attract neutrophils. c. CC chemokines activate 22. Which of the following is not a integrins while CXC classic sign of inflammation? chemokines activate Answer: PALOR selectins. d. CXC chemokines primarily 23. Which of the following cytokines is induce cytokine release most closely associated with the whereas CC chemokines initiation of the inflammatory enhance phagocytosis. response? Answer: tumor necrosis factor A 26. What is the role of chemokines scavenging receptors and 24. A 45-year-old man presents to the controlling inflammation? clinic with a swollen, painful area a. they amplify chemokine on his left thigh that has been gradients for faster developing over the past three leukocyte recruitment. days. He reports the area has b. they degrade excess become increasingly red, warm, chemokines preventing and tender and that he noticed a overstimulation of small yellowish discharge coming leukocytes. from the center of the swelling.He c. they enhance signaling has a fever and feels generally pathways to prolong unwell. The patient has a history of leukocyte survival. poorly controlled diabetes mellitus. d. they inhibit integrin On physical examination, there is a activation of leukocytes. fluctuant mass in the center of the swelling which is tender to touch. 27. Why do neutrophils exhibit faster What is the most likely cause of chemotactic responses compared the formation of pus in this to monocytes? patient's condition? SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. a. neutrophils have a higher c. Lysozyme affinity for selectins than d. NPO, myeloperoxidase monocytes. b. CXCR1 and CXCR2 31. Which of the following is the first signaling in neutrophils step in the respiratory burst triggers rapid mechanism? polarization. a. Superoxide conversion to c. monocytes are restricted to hydrogen peroxide tissue migration only. b. Formation of hypoallose d. neutrophils rely solely on acid integrin-independent c. NADPH oxidase migration mechanisms. activation d. Catalysis of the enzyme 28. Which of the following would most myeloperoxidase. likely disrupt leukocyte migration 32. Which prognostic factor would be towards a chemokine gradient? considered as high risk for a a. decreased RhoA activation. patient with acute lymphoblastic b. increased production of leukemia? nitric oxide. a. Age of 11 years old c. reduced calcium influx b. WBC count of 48,000 cells within leukocytes. per cubic millimeter d. upregulated adhesion c. Female sex molecule expression. d. Remission response within 2 weeks of chemotherapy. 29. Which of the following statements is true of phagocytosis? 33. which of the following is the a. if the surface of a certain primary role of macrophage in the structure is smooth, the skin and subcutaneous tissue? likelihood of phagocytosis a. Production of collagen is increased. b. Phagocytosis of b. neutrophils can usually pathogens and cellular phagocytize as many as debris 100 bacteria before they c. Secretion of histamine for die. inflammatory responses c. macrophages can d. Synthesis of melanin phagocytize, digest, and pigment. function for many months. 34. which of the following is a major d. neutrophils are capable of cytokine secreted by macrophages phagocytizing particles in the lymph nodes that helps much larger than bacteria. mediate the immune response? a. Interleukin 1 30. Which enzyme of the granules of b. Tumor Necrosis Factor phagocytic leukocytes is Alpha, responsible for the green color of c. Interleukin 5. pus? d. All of the above a. NADPH oxidase b. Lactoferrin SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. 35. macrophages in the lungs are d. Acid nature of the gastric primarily located in which of the mucosa following structures? Answer: (A.) alveolar 39. Which of the following structures spaces contain dendritic cells? a. white pulp 36. a 34-year-old female presents to b. bone trabeculae the clinic with a three-week history c. cords of bilroth of a red, swollen, and painful area d. space of bees (?) on her right lower lip. The swelling 40. A 60-year-old male presents with is localized to the subcutaneous fatigue, pallor, and jaundice. His tissue and she reports mild fever. laboratory results revealed anemia A skin biopsy shows infiltrating with an elevated reticulocyte count immune cells in the dermis and and increased bilirubin levels. His subcutaneous tissue with medical history includes chronic numerous large phagocytic cells alcoholism, and a physical containing engulfed debris and examination reveals spenomena. bacteria. Which of the following is Ultrasound of the abdomen the primary macrophage type confirms enlarged spleen, and a responsible for the observed bone marrow biopsy shows immune response in the dermis increased erythropoiesis. Given and subcutaneous tissue of this the patient's clinical presentation patient? and lab findings, which of the a. alveolar macrophages in following is responsible for the lungs. metabolizing the remnants of dead b. sinus macrophages in the RBC? lymph nodes. a. White pulp of the spleen c. dermal macrophages in b. liver stellate the skin and macrophages. subcutaneous tissue. c. Pulse d. Langerhans cells in the d. static medullary cells. epidermis. 41. leukopenia refers to a condition in 37. Which of the following is a which the number of white blood phagocyte in the liver? cells is abnormally low. Which of a. hepatic stellate cells the following is the most likely to b. reticuloendothelial cells cause leukopenia? c. dendritic cells. a. increased production of d. Hepatocytes white blood cells in the bone marrow. 38. Which of the following structures b. decreased destruction of is most effective at efficiently white blood cells in the cleansing the blood from the spleen. gastrointestinal tract before they c. decreased production of enter systemic circulation? white blood cells in the a. Kupffer cells bone marrow. b. Payer’s patches c. Dendritic cells SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. d. increased release of white 45. What differentiates chronic blood cells from the lymph leukemia from acute leukemia? nodes. a. Chronic leukemia involves only red blood cells, which 42. leukopenia is commonly is wrong because characterized by a low white blood apparently your white blood cell count. Which of the following is cells are affected in a common cause of leukopenia? leukemia. a. Bacterial infection b. Chronic leukemia b. Viral infection progresses slowly and c. High blood sugar involves more mature d. High RBC count white blood cells. c. Chronic leukemia is more 43. What is the main characteristic of common in children. leukopenia? d. Chronic leukemia has no a. Low red blood cell count. systemic effects. b. Low white blood cell count 46. Which of the following best c. High platelet count describes myelogenous leukemia? d. High white blood cell count. a. Derived from bone marrow cells that form lymph 44. A patient with severe leukopenia nodes. presents with recurrent infractions b. Derived from bone in a history of chemotherapy. marrow cells that form Laboratory tests reveal a low white granulocytes and other blood cell count, particularly a non-lymphoid cells. reduction in neutrophils. Which of c. Limited to lymph nodes. the following mechanism is most d. Exclusively involves mature likely responsible for the patient's white blood cells. conditions? a. Increased red blood cell 47. What is the primary effect of count due to increased leukemia in the bone marrow? release of neutrophils from a. Hyperplasia of healthy the bone marrow due to blood cells. granulocyte colony b. Suppression of normal stimulating factor or GCSF blood cell production. inhibition. c. Increased production of b. Disruption of normal functional immune cells. hematopoiesis due to d. Decreased fat content in damage to the bone the marrow. marrow's formal cells. c. Increased destruction of 48. A 55-year-old man presents with neutrophils in the spleen fatigue and splenomegaly. Blood due to hyperstolism. tests reveal a high white blood cell d. Impaired granulocyte count with a predominance of differentiation due to myeloid precursors. And reduced availability of IL-3. (inaudible) 922 chromosomal translocation, which is your SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. Philadelphia chromosome. What is the most likely diagnosis? a. CML b. AML c. CLL d. ALL 49. Which of the following best describes the role of eosinophils in parasitic infections? a. they parasitize the parasites directly. b. they release enzymes and reactive oxygen species to kill parasites. c. they produce antibodies against the parasites. d. they help neutrophils in phagocytosis. 50. In a patient with asthma, eosinophils accumulate in the perifroncial tissues due to the release of chemotactic factors by mast cells and basophils. How might targeting this chemotactic signal help in treating asthma exacerbations? a. by reducing the number of eosinophils in the lungs, thereby preventing airway inflammation. b. by increasing the production of histamine to remove bronchoconstriction. c. by enhancing the migration of neutrophils to the site of inflammation. d. by stimulating the production of cytokines that inhibit eosinophil migration.  EPISODE 17: RIGHT TRACK QUESTIONS CHOICES KEY RATIONALE 1. Which of the following fragments A. C initiates chemotaxis of neutrophils and B. macrophages, causing migration of C. C5a phagocytes? D. 2. What process refers to the activation A. of phagocytosis by neutrophils and B. Opsonization B macrophages, causing these cells to C. engulf bacteria, where the antigen- D. antibody complexes are attached? 3. A 25-year-old woman presents with A) The absence of C5 prevents the A recurrent bacterial infections, formation of the membrane attack particularly with Neisseria species such complex, impairing the ability to lyse as Neisseria gonorrhoeae and Neisseria bacteria. meningitidis. Despite receiving appropriate antibiotics, her infections are difficult to treat, and she has a history of meningitis. Lab tests show deficiency in complement protein C5. What is the most likely explanation for her recurrent infections? 4. How do CD3 molecules contribute to B) By transmitting activation signals via B T-cell receptor signaling? ITAMs and ZAP-70. (not ma hear well) 5. What structural feature of MHC Class I B) Alpha helices flanking the peptide- B molecules ensures peptides specificity? binding groove. 6. Which of the following APCs C) Follicular Dendritic Cells C specializes in presenting unprocessed antigen directly to Beta cells? 7. Which APC subset is most effective in C) Conventional Dendritic Cells C cross-presentation? 8. Which of the following is inactivated or A) CD4+ Cells A destroyed by the Human Immunodeficiency Virus (HIV)? 9. Which of the following cytokines D) IL-4 D stimulates IgA production? 10. Which of the following cytokines is D) IL-17 D responsible for the recruitment of neutrophils? 11. An AIDS patient was diagnosed with C) Less than 200 cells/µL C Pneumocystis jirovecii pneumonia. What is probably the patient’s CD4+ count? 12. A three-year-old child is vaccinated B) Active Immunity B against Measles, Mumps, and Rubella (MMR). Which of the following best describes the type of immunity the child develops after receiving the vaccine? 13. Which of the following distinguishes A) Active immunity requires previous A active immunity from passive exposure or vaccination, while passive immunity? immunity does not. 14, Which of the following is a key T-cell mediated immunity feature of a delayed-type hypersensitivity reaction? 15. Which cytokine is most involved in a B) Tumor Necrosis Factor-Alpha (TNF-α). B delayed hypersensitivity reaction 16. Which of the following is true A) It is characterized by edema in the A regarding the pathology of urticaria? dermis and subcutaneous tissues. 17. What is the treatment of choice for A) Epinephrine A anaphylaxis? 18. Which of the following is the first line a. Antihistamine D treatment in patients having bronchial b. Inhaled corticosteroid asthma and acute exacerbation? c. Systemic corticosteroid d. Salbutamol 19. Dyspnea and rashes 30 minutes after TYPE 1 the administration of penicillin. On exam, her BP is 90-60, heart rate of 110, generalized cardiac ortho cardia, and wheezing on auscultation. What's the type of hypersensitivity? 20. What is the typical protein 4g/dL concentration (24:42) in lymph within deep nodes (24:44) along the nasopharyngeal arteries? VII.IX  EPISODE 17: RIGHT TRACK 21. Which of the following is typically a. Chylomicron C absent in a normal composition of b. Fibrinogen lymph? c. Erythrocyte d. Vitamin A 22. Which of the following actions most Prevents lymphatic capillaries from accurately describes the anchoring collapsing under increased pressure filaments of the lymphatic capillaries? 23. A 32-year-old woman presents the Enhanced entry of larger molecules like clinic with localized swelling in her right aldehyde and immune complexes leg following a recent insect bite. She reports increasing redness and warmth around the bite site with mild pain and stiffness in the affected area. On exam, the area around the bite is erythematous, edematous, and visibly swollen. Which of the following is most likely to occur within the lymphatic capillaries in this scenario? 24. Which of the following factors Increased interstitial fluid colloid increases the interstitial fluid pressure pressure that also increases lymph flow? 25. A newborn male with George's Deletion of self-reactive helper and syndrome presents with recurrent cytotoxic T lymphocytes in the thymus is infections. Which of the following the basis for the central immune statements best describes the role of the intolerance thymus in T cell maturation and selection? 26. Which of the following types of cells Tumor cells can natural killer lymphocytes recognize and destroy? 27. What is the key feature of adaptive Memory of specific pathogens for faster immunity? feature responses 28. Which of the following statements It involves chemical and cellular about innate immunity is correct? mechanisms to protect the body 29. A vaccinated healthcare worker Natural killer cells targeting virus- develops mild COVID-19 symptoms after infected cells exposure to a variant strain of the virus. Which component of the innate immune system would most likely help control the infection in this scenario? 30. What is the primary role of humoral Producing antibodies that target immunity? pathogens 31. Which cells are primarily responsible B-cells for producing antibodies in humoral immunity? 32. Which molecule is essential for Major histocompatibility complex (MHC) antigen presentation to T-cells during cell-mediated immunity? 33. In cell-mediated immunity, helper T Antigens presented to MHC class 2 cells are activated by? molecules 34. What is the role of beta lymphocytes Producing antibodies in immunity? 35. How do T-lymphocytes develop a. Exposure to bacterial antigens C specificity? b. Preprocessing in lymph nodes c. Preprocessing in the thymus d. Random genetic mutations 36. What ensures that T-lymphocytes do a. Phagocytosis in the spleen not react against cell antigens? b. Migration to the lymph nodes c. Destruction during thymus preprocessing d. Secretion of antibodies by beta lymphocytes. 37. A 12-year-old boy is brought to the a. His B lymphocytes are unable to B clinic with recurrent bacterial infections. migrate to the thymus for preprocessing. Lab tests reveal an abnormally low level b. His immune system lacks diversity in of B lymphocytes. Based on the role and antigen reactivity due to a deficiency in characteristic of lymphocytes, which of beta-lymphocytes. the following best explains why the c. B lymphocytes are insufficient for patient's immune system is failing to mounting an immune response to respond adequately to bacterial bacterial antigens. infection? d. His B lymphocytes are responsible for direct antigen destruction which is impaired. 38. Preprocessing of B lymphocytes Bone Marrow occurs in this organ. 39. Preprocessing of T lymphocytes Thymus occurs in this organ. VII.IX  EPISODE 17: RIGHT TRACK 40. Lymphocytes originate from this Bone Marrow organ. 41. A 30-year-old male comes in for a T lymphocytes routine checkup. A chest X-ray is done which shows a suspicious mass in the anterior medial sphincter. A possible cause for an anterior medial sphincter mass could be a tumor or a cyst of a structure involving the preprocessing of which immune cell? 42. Which type of B cells divide at a rate a. Plasma blasts once every 10 hours for about 9 b. Lymphoblasts commissions just before producing c. Plasma cells mature cells? d. Memory cells 43. In a particular study, high fighters of a. Kidney antibodies against smallpox have been b. Spinal Cord detected in the blood of people c. GALT vaccinated with B lymphocytes. With d. MALT your knowledge about beta cells, in which organ will you expect high concentrations of these antibodies? 44. Each plasma cell produces around 2k how many gamma globulin antibodies per second? 45. Which of the following is true a. In a scan of 4 days, lymphoblasts divide regarding the attributes of the B rapidly and produce around 500 cells lymphocyte system? foreach original lymphoblast. b. After recognizing the foreign antigen, macrophages are presented to both B Cells and T cells. c. Plasma cells continue to secrete antibodies into the circulating blood for several years d. Pre-exposure of B and T cells to the same antigen will cause a slower and less potent antibody response since more beta cells are in lactose 46. As a first-year medical student, FAB, Disulfide bonds understanding the structure of antibodies is essential for comprehending the role in immune responses. Which part of an antibody is responsible for antigen —? 47. Which immunoglobulin is the most IgG crosses the placental barrier into the abundant in the blood, and what is its fetal circulation distinguishing feature that sets it apart from other antibody classes? 48. Which of the following best describes a. Crosses the placental barrier to provide B the primary function of an antibody that immunity to the fetus constitutes 5-10% of blood b. First antibody produced in initial immunoglobulin and can often exist in a immune response definite form? c. Destroys parasitic worms d. Protects the mucosa 49. A 5-year-old child is evaluated for Dimeric form in which the heavy chains of frequent respiratory and two monomers are united by a gastrointestinal infections. Lab testing photocatalyst shows low levels of an antibody class typically found in mucosal secretions. What best describes the antibody involved in this case? 50. Statements describe the mechanism The molecular complex soluble antigen by which an antibody activates the and antibody becomes so large and invading agents. precipitates VII.IX  SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. MODULE 18 1. Which of the following are the 2 Ans: C (determining blood groups) main ?? (sorry) Ans: B type (a & b) 10. What does hemolysis referred to? ?? Di kayo ma dungan hehe Ans: C (breakdown of RBC) 2. Which factor is primarily is 11. A 25 yr old woman visits a clinic responsible for determining an that determines her blood type in individual blood group preparation for blood donation, a Ans: C (presence of antigen on the blood technician adds specific surface of RBC) antigens A & B antibodies to separate samples of her blood, 3. A laboratory technician mixes a after some time clotting is sample of type a blood with observed in the sample treated antibody during a blood typing test with the anti B antibody, while no what is the expected outcome of clotting is observed in anti A, this interaction? based on the observation what is Ans: D (no reaction occur does not the patient likely blood type? target type a blood) Ans: B (type B) 4. Which of the following is the main 12. A 25 yr old female comes to the function of antibody to the immune clinic complaining of palpitation system? and SOB on exertion, it was Ans: B (recognize and neutralize mentioned before onset of specific antigens) symptom she had untreated throat infection, after workup she is 5. Which of the following is not a diagnose with rheumatic heart characteristic of IGM antibodies? disease, which of the ff best Ans: C (it is the highest binding among describes the immune response to all antibodies) the case? Ans: A (allernigenesity)? 6. In the ABO blood group system which agglutinins are present in 13. A 40 yr old male comes to the the person with type O blood? clinic with symptoms of fever, Ans: C (both anti A & B) jaundice and body weakness, workup shows that his hbsg? 7. Which of the following statements Positive, is diagnose with acute about agglutinins is false? hepa B which of the ff best Ans: B (agglutinins are always specific describes the immune response to to carbohydrate antigens) the hepa B virus in this case? Ans: B (immunogenisity) 8. What does the term agglutination mean? 14. Which of the ff is the ability of the Ans: B (the clotting of particles) immune system to repel a exoginous antigen into fight an 9. In what content is agglutination infection? commonly use? Ans: B (immunologic defense) DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION.  SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. type is unknown and 15. The antigens of the ABO blood crossmatching cannot be done due groups are made up of which of to the urgency of case, which of the ff? the ff blood types should the Ans: B (carbohydrates) attending physician order for the transfusion to minimize the risk of 16. Where are antigens located in the infection? RBC? Ans: B (blood type with anti A & B Ans: A (extracellular surface) agglutinins) 17. How many blood groups antigens 23. Which of the ff best describes the where identified in 1984? role of agglutinins in the immune Ans: A (410) system? Ans: B (enhance the process of 18. Which of the ff statements is true? phagocytosis) Ans: B (IV blood pathogenic blood antigens comprises less than 1%) 24. Agglutinins are primarily found in which of the ff immune system 19. Which of the ff statements most component? accurately describes the whole Ans: C (plasma cells) characteristics of agglutinogens of the ABO blood group systems 25. Which type of agglutinin is most Ans: B (inherited people may have commonly involve in the blood either of them or not at all) typing process? Ans: C (IGM) 20. A 30 yr old pt with a blood type AB undergoes genetic testing to 26. A 35 yr old woman presents in the confirm their blood group, the clinic for a routine check up, she result show the inherited both A reports no significant medical and B alleoles of the parents, base history and has no symptoms of on this information, which of the ff illness, during her blood work the reciepents could receive blood lab technician finds a positive from a AB blood type donor result for the presence of without triggering an immune agglutinins the physician orders response? further test in concludes to the Ans: only type AB recipient patients agglutinins are of the anti A type this findings suggest to the 21. Which of the ff statements patients immune systems has accurately describes the relative development antibodies RBC with frequencies of ABO blood types on the type A blood group, which of the global population? the ff is the most likely cause? Ans: B (the genotype with no antigens Ans: ?? is the most prevalent) ?? nag chikka si doc ni skip ra 22. A 45 yr old pt presents in ER during a severe car accident, is 27. What happens to RBC that hypotensive and requires an undergo agglutination during immediate blood transfusion, blood transfusion reaction? DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION.  SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. Ans: B (destroyed by the immune the most likely cause in the system) complications of pregnancy? Ans: no sensitization of Rh positive 28. Which of the ff antibodies causes blood (no letter) agglutination in a person with RH negative blood when given Rh 34. What is the primary cause in positive blood? erythroblastosis fetalis? Ans: B (Type Rh antibodies) Ans: A (Rh incompatibility with the mother and fetus) 29. Which of the following is the consequence of agglutination 35. Which of the ff population has a during transfusion reaction? greater risk for developing Ans: C (kidney failure and erythroblastosis fetalis due to Rh gastrointestine infection) incompatibility? Ans: C (infants born to Rh negative 30. A 50 yr old woman with a history of mothers) multiple pregnancies presents her blood typing before surgery, her 36. Which of the ff is the blood type is confirm as Rh characteristics with severe negative what does this indicate erythroblastosis fetalis? about her Rh antigen? Ans: B (jaundice after first 24 hrs after Ans: D (she lacks the b antigen but has birth) other Rh antigens) 37. A 30 yr old Rh negative woman 31. A patient with O negative blood Ravida Inpara what is the most type receives a transfusion with O important management of this positive blood initially there is no point to prevent complications with reaction, however 2 weeks later pt the current fetus? experience delayed blood reaction Ans: A (Give Rogam) which of the ff explains why there is delayed reaction? Di nako ma sabot hehehe Ans: B (negative however pt developed Rh antibodies) 38. Which of the ff is a possible cause for acute kidney failure ff a 32. A lab technician conducts a test on transfusion reaction? a pt blood sample and identifies Ans: A (release of toxic substances) the presence of the Rh B antigen with the presence of C, D, a 39. Which o f the ff is false regarding antigens. However pt Rh type be acute kidney failure after a classified? transfusion reaction? Ans: B (Rh positive) Ans: B (regardless the amount in can cause blockage) 33. A 24 yr old Rh negative woman comes to the ER after receiving a 40. A 32 yr old male with a genotype Rh positive blood she has no type OA is transfuse with blood immediate reaction however later from a pt which is agglutinogen she experience complications in with a blood type B, which of the ff subsequent pregnancies, what is is least likely to occur in this pt? DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION.  SAFE KEEP THIS DOCUMENT. DO NOT PRINT OR REPRODUCE. DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION. Ans: D (jaundice) 41. Which of the ff is a primary advantage of autographs over allographs? Ans: A (autographs has a lower risk of infection) 42. Which of the ff best describes an isograph? Ans: (species who are identical, no letter stated) 43. Which of the ff statements is true regarding allographs? Ans: B (graphs with the same species) 44. Which of the ff best describe a xenograph? Ans: D (transplant with individuals with different species) 45. What category of immunosuppressant drug is frequently employed in allograph transplant? Ans: C (corticosteroids) 46. What is the primary goal of immunosuppressive drugs administered after transplantation? Ans: B (prevent the reciepients body from rejecting the transplanted tissue) DO NOT USE THIS DOCUMENT AS BASIS OF ANY CORRECTION.  EPISODE 19: RIGHT TRACK QUESTIONS CHOICES KEY RATIONALE 1. Which structure primarily receives A) Axon C most of the incoming signals in a neuron B) Synapse C) Synapses and dendrites D) Synaptic branches and axons 2. What is the characteristic feature of A) Signals propagate bidirectionally C synaptic signal transmission? between neurons B) Signals bypass the nucleus directly C) Signals predominantly travel in a unidirectional forward manner D) Signals that require synaptic connections for transmission 3. Which process explains the perception D) Activation of facilitated synapses by D of experiencing original sensations in the signals generated within the brain absence of external sensory input? 4. What unique function do synapses A) Creating new neural pathways that B perform in addition to transmitting bypass the brain signals? B) Selectively blocking, amplifying, and directing signals C) Eliminating all weak signals 5. After repeated exposure to a particular A) Facilitation of synapses related to A melody, a musician finds they can hear auditory signals the tune in their head even when it is not playing. What neural mechanism explains this response? 6. The phrenic nerve, which innervates B) C3 to C5 B the diaphragm, originates primarily from which spinal cord level? 7. A lesion at the T10 spinal cord level B) Sensation to the umbilical region B would most likely result in loss of which of the following functions or sensations? 8. Which subcortical structure is critical A) Amygdala C for consolidating declarative memories B) Basal ganglia and spatial navigation? C) Hippocampus D) Thalamus 9. The subcortical structures are A) Complex decision-making B primarily responsible for which of the B) Basic sensory processing and motor following functions? control C) High-level reasoning and language comprehension 10. The left hemisphere of the cerebral A) Language processing A cortex is typically dominant for which of B) Spatial navigation the following functions in most C) Motion recognition individuals? D) Face recognition 11. Inhibitory post-synaptic potentials A) Depolarization of the postsynaptic B (IPSPs) play a key role in regulating membrane neuronal activity. Which of the following B) Hyperpolarization of the postsynaptic accurately describes the effect of an IPSP membrane on a post-synaptic neuron? C) Neutralization of the post-synaptic potential D) Increased neurotransmitter release 12. In an experiment, a neuron is B) Reduced likelihood of reaching exposed to a substance that prolongs the threshold duration of inhibitory post-synaptic potentials (IPSPs). What effect would this prolonged IPSP have on the neuron's ability to integrate signals via spatial and temporal summation? 13. Temporal summation plays a key role A) The simultaneous activation of B in the integration of signals over time in multiple synapses neurons. Which of the following best B) Successive subthreshold excitatory describes temporal summation? inputs C) Inhibition of postsynaptic firing D) Reduced sensitivity to further stimuli 14. A 28-year-old male presents to the A) Increased sodium influx into the B emergency department after sustaining postsynaptic neuron, causing a head injury. Upon examination, he is depolarization; GCS 12 able to open his eyes spontaneously, B) Chloride influx or potassium influx, appears confused, and responds to pain causing hyperpolarization of the by localizing it. Neurological testing postsynaptic membrane; GCS 13 reveals diminished reflexes and reduced C) Increased calcium influx into the responsiveness in certain neural circuits. postsynaptic neuron, enhancing Further analysis indicates enhanced neurotransmitter release; GCS 14 VII.IX  EPISODE 19: RIGHT TRACK inhibitory synaptic activity, leading to D) Decreased ion permeability, hyperpolarization of the post-synaptic neutralizing the post-synaptic potential; membranes in the affected neurons. GCS 15 Based on this information, which of the following mechanisms best explains the observed effect of inhibitory synapses on the post-synaptic membrane, and what is the patient's Glasgow Coma Score (GCS)? 15. A 45-year-old male patient presents A) Excessive presynaptic inhibition of A to the clinic with symptoms of muscle excitatory neurons, leading to decreased weakness, decreased reflexes, and neurotransmitter release difficulty maintaining balance. His B) Hyperactivation of NMDA receptors, medical history reveals a long-standing causing excitotoxicity and neuronal death issue with muscle control and C) Increased acetylcholine release at coordination. Blood tests indicate an neuromuscular junctions, leading to imbalance in GABAergic activity, and excessive muscle contraction further electrophysiological studies D) Reduced potassium channel activity, show reduced excitatory input to motor leading to prolonged depolarization of neurons and a significant delay in action motor neurons potential generation. Based on this clinical presentation, which of the following mechanisms most likely explains the patient’s condition? 16. Which of the following changes in A) Increased excitatory neurotransmitter B synaptic function is most likely to occur release in response to acidosis? B) Decreased action potential propagation C) Enhanced synaptic vesicle recycling D) Increased synaptic efficacy 17. Which of the following is most likely C) Decreased synaptic efficacy C to occur as a result of synaptic fatigue? 18. What effect does the accumulation of A) Enhances synaptic function by C potassium ions in the extracellular space increasing sodium influx during prolonged synaptic activity have B) Prolongs action potential duration, on synaptic transmission? leading to increased neurotransmitter release C) Reduces the driving force for neurotransmitter release, impairing synaptic function D) Facilitates the recovery phase of neuronal excitability 19. A 65-year-old male presents to the A) Increased sodium influx, leading to B emergency department after being found sustained depolarization unconscious in his home. What is the B) Disruption of calcium ion influx, primary mechanism by which hypoxia is impairing neurotransmitter release affecting synaptic transmission in this C) Increased NMDA receptor activation, patient? leading to excitotoxicity D) Enhanced inhibitory post-synaptic potentials (IPSPs), reducing neuronal excitability 20. A 45-year-old woman presents to the A) Inhibition of voltage-gated sodium B clinic with complaints of severe muscle channels, preventing action potential weakness, dry mouth, and blurred vision. initiation Which of the following mechanisms most B) Blockade of muscarinic receptors, likely explains the effect of the drug on leading to decreased parasympathetic synaptic transmission? activity C) Enhancement of dopamine release, leading to overstimulation of motor pathways D) Increased release of glutamate, causing excitotoxicity 21. Which sensory receptor type utilizes A) Mechanoreceptors C transient receptor potential (TRP) B) Nociceptors channels for signal transduction? C) Thermoreceptors D) Chemoreceptors 22 In the context of the labeled line B) Activation of separate sensory B principle, which of the following best pathways for sweet and salty tastes demonstrates this concept? 23. Which of the following best A) Respond continuously to sustained C describes the role of rapidly adapting pressure mechanoreceptors in sensory B) Detect changes in temperature perception? C) Respond only at the onset and removal of a stimulus D) Transmit pain signals over prolonged periods VII.IX  EPISODE 19: RIGHT TRACK 24. Which of the following neuronal A) Reverberating circuits C circuits is most effective in preventing B) Diverging circuits overstimulation of neural pathways? C) Lateral inhibition circuits D) Converging circuits 25. Which receptor is associated with C) Mechanoreceptors C detecting stretch in the gastrointestinal (GI) tract? 26. What is the primary cause of the B) Opening and closing of ion channels B change in membrane potential during receptor excitation? 27. Which ion primarily contributes to C) Sodium (Na⁺) C the receptor potential in the Pacinian corpuscle? 28. What happens when the receptor B) It generates an action potential B potential exceeds the threshold in a sensory receptor? 29. Which ion plays a major role in C) Sodium (Na⁺) C generating the receptor potential of sensory nerve endings? 30. Given that the Pacinian corpuscle A) Ability to detect changes in pressure or A adapts rapidly to sustained pressure, vibration which of the following would be most affected if a person had an impaired Pacinian corpuscle function? 31. Which of the following is responsible A) Type C fibers A for dull, aching pain transmission? 32. Which of the following sensory nerve A) Type I neuro fiber A fibers is responsible for proprioception? 33. Which tactile receptor is responsible A) Meissner’s corpuscles (but the answer A for detecting light touch and tapping? in the ratio was Pacinian) 34. A 45-year-old man presents to the A) Meissner’s corpuscles A clinic complaining of numbness and difficulty sensing fine touch in his fingertips. Which of the following tactile receptors is most likely impaired? 35. When a pain signal enters the spinal B) Thalamus B cord, it synapses with interneurons that terminate in which of the following structures? 36. When walking on uneven ground, D) Through large myelinated fibers D your ankle detects subtle changes in foot position. How is this sensory information transmitted? 37. Which of the following structures is C) Spinothalamic tract C NOT involved in transmitting proprioceptive information? 38. When a fine touch signal enters at a C) Medulla C specific level of the spinal cord, where does its neuron decussate (cross over)? 39. A 70-year-old woman with a history B) Itch of diabetes presents with loss of balance, difficulty detecting vibration in her feet, and trouble sensing the position of her toes. MRI shows a lesion at the T6 spinal cord level. Based on this information, which sensory modality is most likely intact? 40. Which statement about the C) Highly organized somatotropic C somatosensory area I is true? representation VII.IX  EPISODE 19: RIGHT TRACK 41. What is a key difference in a D) Area II receives input from both sides somatosensory area 1 and 2 of the body 42. Which body part occupies the largest B. Fingers area in the somatosensory Area I 43. What is the effect of lateral inhibition B) enhancing spatial contrast and in the dorsal-column pathway sharpening localization of sensory stimuli. 44. A 45-year-old man presents with A. Somatosensory Area I A difficulty distinguishing textures with his right hand. The neurological exam shows impaired vibratory sense and fine touch on the right hand, but intact pain and temperature sensations. Which part of the brain is most likely affected? 45. What pathway is responsible for D. Anterolateral pathway D transmitting sensory signals that do not require highly discrete localization at the single source and do not require discrimination of fine gradations of intensity? 46. The spinal cord lateral fibers B. Lamina II (Substantia Gelatinosa) B originate mainly in the following dorsal horn laminae levels, except: 47. Most pain signals terminate in the C. Reticular nuclei of the brainstem C 48. Most pain signals terminate in which A) Interlaminar nuclei C of the following? B) Ventrobasal complex C) Reticular nuclei of the brainstem D) None of the above 49. In addition to somatosensory signals B. They are almost entirely inhibitory. B transmitted from the periphery to the brain, corticofugal signals are transmitted in a backward direction from the cerebral cortex to lower sensory relay stations such as the thalamus. What is the function of these corticofugal signals? 49. Dermatome in the level of the T10 umbilicus 50. Which of the following is the best A) A specific zone of skin innervated by a A definition of a dermatome? single spinal nerve. B) A single nerve responsible for motor function. C) A collection of multiple nerves that work together. D) A nerve plexus that innervates the limbs. VII.IX  EPISODE 21: RIGHT TRACK QUESTIONS RIGHT CHOICE KEY RATIONALE 1. Which anatomical structure is most Haustra directly related to the function of large D intestine absorbing water and electrolytes. 2. In which of the following situations, Intra-abdominal infection might have paracolic gutters play a B significant clinical role? 3. Which of the following anatomical Retroperitoneal and lies between C relations is true to ascending colon? the liver and right kidney 4. Which of the following is form by the Marginal Artery of Drummond A anamastomosis of the SMA and IMA? 5. A surgeon is about to perform IVb and 5 B cholecystectomy. The gall bladder can be localized within which segment of the liver? 6. A pediatric surgeon is resecting a Left Umbilical Vein C possible malignant mass from the liver of an unit. The surgeon divides the round … surgery. Which of the following fetal vessels is appeared? 7. A 45 year old male, patient with a Segment V D history of chronic alcohol use presents with severe abdominal pain, hepatomegaly and jaundice. A CT scan reveals significant cirrhosis with the evidence of portal hyperplesia. Upon further investigation, the doctor notes that the patient has an obstruction in the right hepatic duct. Which of the following number segments is most likely to be affected. In this case due to its close association with the right hepatic duct? 8. The artery that gives rise to terminal Subclavian artery D branches which supplies the upper central area of interior abdominal wall is the direct branch of which of the following? 9. The posterior intercostal veins drains Azygous vein directly to which of the following? 10. Which of these nerve crosses the Both iliohypogastric and B anterior surface of the quadratus ilioinguinal nerve pass (cross) lumborum throughout its course? the anterior surface of the … 11. A 1 year old boy was brought to the Indirect hernia D ER by her mother to a pedritician due to unusual bulge to his left scrotum. An ultrasound was done and the patient is referred to a surgeon. Which of the following is true about the patient’s condition? 12. The superior mesenteric vessels Neck of the pancreas C pass posteriorly to which part of the pancreas? 13.Which of the following borders of the Inferior part of the Liver A Triangle of Calot is the most superior? 14.The uncinate process of the Ventral bud A pancreas is formed by which of the following embryological structures? 15.Where are gallstones most Part of which that contains D commonly repeated within the mucosal stones and continuous gallbladder? with cystic duct (Hartmann’s pouch) 16. A 45 year old male presents to the Transverse Colon B ER after a stabbing injury to the abdomen. The patient reports that the stab wound was localized from the upper abdomen and affected the body of the pancreas. Imaging reveals that the pancreas has been impacted but not penetrated. Which of the following organ is most likely injured to be injured as well? 17. Which artery supplies blood to the Splenic Artery C spleen? 18. Which of the following is a paired Inferior phrenic artery A VII.IX  EPISODE 21: RIGHT TRACK branch of the abdominal aorta? 19. Which of the following is NOT a Stomach C retroperitoneal organ? 20. A 60-year-old woman presents with Retroperitoneal, superior to the B back pain and a palpable mass in her left kidneys flank. Imaging reveals a tumor arising from the adrenal gland. Which of the following best describes the location of the adrenal glands? 21. A 38-year-old woman presents with Common bile duct D abdominal pain radiating to her back. CT imaging shows inflammation around the head of the pancreas. Which of the following retroperitoneal structure is most likely to be compressed? 22. This refers to a collection of cell Prevertebral ganglia C bodies located anterior to the abdominal aorta. 23. Which of the following is correct The prevertebral ganglia are B regarding prevertebral ganglia? comprise of the celiac, aorticorenal ganglia, superior, and inferior mesenteric ganglia 24. This structure marks the end of the Ganglion impar D two sympathetic chains and is the only unpaired autonomic ganglion in the body. 25. RK, a first-year medical student forgot *not mentioned/inaudible* B to set his alarm and was already late for his modular exam. Upon arriving at school, he noticed that he was not able to urinate since this morning despite drinking around 2 liters of water. Which of the following is the correct course of nerve impulse involved in his body's response? 26. Which layer of the abdominal wall Scarpa’s fascia C provides a membranous structure beneath the fatty layer? 27. Which of the following represents the Skin C correct sequence of abdominal wall layers from outermost to the innermost? 28. Which muscle is encountered during a Rectus abdominis C Pfannenstiel incision? 29. A surgeon is preparing for an open Linea semilunaris D appendectomy and needs a McBurney’s incision at the lateral border of the rectus abdominis. Which anatomic feature serves as a key landmark for identifying this lateral border? 30. Which of the following best describes It is a superficial fatty layer of the B camper’s fascia in the context of the abdominal wall continuous with abdominal wall anatomy? superficial fascia of the thigh and peritoneum 31. Which of the following is NOT a Its fibers from primarily A correct statement about the external superiomedial *inaudible* oblique muscle? direction 32. Which of the following statements A) Conjoint tendon is form by the D regarding the conjoint tendon is NOT fusion of the aponeurosis of the true? internal oblique and transverse abdominis B) It plays a critical role in forming the posterior wall of the inguinal canal C) Conjoint tendon is located anterior to the superficial inguinal vein D) It is a weakening of the quadrate tendon lead to indirect inguinal hernia 33. The transversus abdominis muscle Compression of the abdominal C primarily contributes to which of the contents following functions? 34. Which of the following is true about It provides a free curved lower D the arcuate line in relation with the rectus order, where the posterior wall of sheath? the rectus sheath ends. 35. What forms the inguinal ligament? The reinforced free period C (inaudible) edge of the external oblique muscle's aponeurosis 36. Which ligament is formed by the fibers Pectineal ligament B extending along the pecten surface? 37. What structure/s form the posterior The aponeurosis of the C VII.IX  EPISODE 21: RIGHT TRACK wall of the rectus sheath in the upper tranversus of abdominis and half three-quarters of the rectus abdominis of the internal oblique muscle? aponeurosis 38. A 28-year-old brought to the ER with Skin, superficial fascia, deep A a stab wound. Upon examination, finds fascia, anterior rectus sheath, the ends single paramedial stab wounds rectus abdominis, transversalis on left side of the abdomen below the fascia, and extraperitoneal fat umbilical region and at the lower fourths rectus abdominis area. You assess the injury. Which of the following layers is most likely to be traversed by the stab wound? 39. Which of the following best describes A layer that forms to the posterior C the transversalis fascia? wall of the rectus sheath below the arcuate line. 40. Which of the following statements It represents a potential site for C correctly describes the Hesselbach's herniation due to weakness in the Triangle? abdominal wall. 41. Which of the following statements The organs in the intraperitoneal A accurately describes the abdominal cavity are completely surrounded cavity? by the visceral peritoneum. 42. A patient presents with epigastric pain The affected organ, except for its B radiating to the back described as a tail, is located in the boring pain. Which of the following retroperitoneal space (Pancreas). statements most accurately describes the organ likely involved? 43. A 32-year-old female presents with The rounded, blind- C severe pain in the right upper quadrant ended*inaudible* organ lies at the radiating to her right shoulder. Which of level of the ninth costal cartilage the following statements accurately (Gallbladder) describes the affected organ? 44. Which statements best describe the Mucous-secreting glands are C esophagus? found in the lamina propria and submucosa 45. Which of the following statements is It pierces the diaphragm slightly to C true about esophagus the left and enters the stomach on the right side. 46. Which of the following arteries is Inferior thyroid artery A primarily responsible for supplying blood to the upper part of the esophagus? 47. A 50-year-old female with history of Lower esophageal sphincter (LES) chronic GERD presents with sharp chest pain, occasional regurgitation, and sore throat. She has been experiencing these symptoms more frequently in the past few months. Which of the following is the anatomic structure responsible for preventing reflux of gastric contents into the esophagus? 48. A 45-year-old male for Esophageal branches from the D esophagectomy due to early-stage aorta esophageal cancer. The surgeon plans the approach surgery and considers vascular supply. Which artery primarily supplies blood to the middle third of the esophagus during esophagectomy? 49. Which of the following is a distinctive Taenia coli C feature of the large intestine muscular layers, especially part … *inaudible*? 50. The epiploic appendages are most Cecum A commonly found in which part of the large intestine? Legend: red font = inaudible VII.IX  DO NOT REPRODUCE THIS FILE. DO NOT USE THIS FILE FOR ANY CORRECTIONS. SAFE KEEP THIS FILE. MODULE 22 1. Which layer of the intestinal wall is the outermost? Answer: c. serosa 2. Which of the following vests describes the function of the intestinal cells of Kajal in the G.I.T.? Answer: It is to act as pacemaker cells generating slow waves of _ motility 3. Which of the following factors depolarizes the gastrointestinal smooth muscle membrane, making it more excitable? a. release of norepinephrine from adrenergic nerve endings. b. stimulation by acetylcholine. c. activation of the prevertebral ganglia. d. effect of adrenaline on the fiber membrane. 4. A three-year-old pediatric patient is diagnosed with Hirschsprung's disease, a condition characterized by the absence of ganglion cells in the part of the colon, leading to a normal peristalsis. The child presents with symptoms such as abdominal distension, constipation,and failure to pass meconium on the first few days of life. In Hirschsprung's disease, the absence of ganglion cells in specific areas of the gastrointestinal tract leads to dysfunction in the myenteric plexus and submucosal plexus. Which of the following best explains the roles of the myenteric and submucosal plexuses in the gastrointestinal function? a. The myenteric plexus regulates blood flow and secretion in the intestines, while the submucosal plexus controls motility along the entire length of the gut. b. The myenteric plexus controls motility and muscle activity along the entire length of the gut, while the submucosal plexus controls local secretion and absorption within the mucosa. c. The myenteric plexus regulates local secretion and absorption, while the submucosal plexus controls motility and peristalsis. d. The myenteric plexus controls nutrient absorption in the small intestine, while the submucosal plexus regulates blood flow in the gastrointestinal tract. 5. Which of the following gastrointestinal reflexes is primarily responsible for triggering increased motility in the colon after food enters the stomach? Answer: gastrocolic reflex [rationale: Gastrocolic reflex is a physiological response where the stomach distension caused by food intake triggers increased colonic motility, often leading to bowel movement.] 6. Which of the following gastrointestinal hormones inhibits gastric acid secretion and stimulates insulin release? Answer: GIP [rationale: G-I-P, also known as gastric inhibitory peptide, is secreted by K- cells, K-cells, in the duodenum and jejunum, and it has two major functions. It inhibits gastric secretion and stimulates insulin release.] 7. Which of the following statements correctly describes the primary function of the migrating motor complex, or MMC (migrating motor complex), in the gastrointestinal tract? a. It facilitates the absorption of nutrients during the fed state. b. It prevents retrograde flow of intestinal contents by increasing ileocecal valve pressure. c. It promotes gastric emptying by enhancing antral contractions. DO NOT REPRODUCE THIS FILE. DO NOT USE FOR ANY CORRECTIONS. KEEP THIS FILE SAFE.  DO NOT REPRODUCE THIS FILE. DO NOT USE THIS FILE FOR ANY CORRECTIONS. SAFE KEEP THIS FILE. d. It clears residual food, bacteria, and secretions from the stomach and small intestine between meals. 8. Which of the following metabolic factors plays the most significant role in increasing intestinal or splenic blood flow during digestion? Answer: adenosine [rationale: adenosine is the key metabolic factor responsible for increasing gastrointestinal blood flow by promoting vasodilation in response to increased metabolic demand.] Other choices: endothelin 1, angiotensin-2, vasopressin- 3 [additional rationale: why not vasopressin-3; Vasopressin is a constrictor. The question is asking for a hormone that would increase gastrointestinal blood flow during digestion. So it wouldn't be, the vasopressin will not help in the dilation. If you have an increase in vasopressin, you'll have vasoconstriction, thereby decreasing the blood flow in your gut during digestion.Your vasopressin is released during sympathetic responses. Your adenosine is increased during parasympathetic,during rest and digestion.] 9. What initiates the chewing reflex? Answer: D. inhibition of jaw muscles when food enters the mouth. 10. What happens to the lower esophageal sphincter when a peristaltic swallowing wave approaches? Answer: A. It relaxes to allow the food to pass into the stomach. 11. How does increased intra-abdominal pressure affect the esophagus? a. It caves the esophagus inward, preventing reflux. b. It forces the lower esophageal sphincter to open, leading to reflux. c. It increases the secretion of digestive enzymes in the esophagus. d. It has no effect on the esophagus. 12. What triggers secondary peristalsis in the esophagus? Answer: The distention of the esophagus by the retained food. 13. a 45-year-old man presents to the clinic with a complaint of difficulty swallowing both liquids and solids. He mentions that the food often feels stuck in his chest after eating, and he has occasional chest discomfort. Further testing shows that the lower esophageal sphincter fails to relax properly during swallowing. What condition is most likely responsible for this patient's symptom? a. Achalasia b. - c. - d. - 14. The most potent hormone to inhibit gastric emptying is mainly secreted in the mucosa of which part of the gastrointestinal tract? Answer: CTK 15. For liquids, the principal determinant of rate of gastric emptying is? Answer: volume DO NOT REPRODUCE THIS FILE. DO NOT USE FOR ANY CORRECTIONS. KEEP THIS FILE SAFE.  DO NOT REPRODUCE THIS FILE. DO NOT USE THIS FILE FOR ANY CORRECTIONS. SAFE KEEP THIS FILE. 16. Danny, a 30-year-old call center agent, just has just finished eating his dinner, which is composed of one cup of rice, one serving of beef tips, and half serving of mixed vegetables. How soon will gastric emptying most likely commence? Answer: 13 minutes [rationale: 3 hours = stomach is already empty] 17. Increased food volume promotes increased gastric emptying. Which of the following is true? a. increased food volume stimulates the pylorus. b. increased food volume stretches the stomach wall, eliciting myoenteric reflex. c. increased food volume results in increased storage pressure in the stomach. d. increased food volume inhibits the activity of the pyloric pump. 18. Which is the primary reason why chloride concentrations slow in saliva? Answer: Sodium is reabsorbed, causing electrical negativity, which leads to passive reabsorption of chloride 19. Which area of the brain partially regulates salivation in response to taste and smell stimuli? Answer: Anterior hypothalamus. 20. What is the primary function of the reverse anterior gastric reflex? a. to increase gastric secretion when the small intestine is distended. b. to stimulate gastric motility when the stomach is empty. c. to inhibit gastric secretion and slow stomach emptying when the small intestine is full. d. to promote the absorption of nutrients from the small intestine. 21. A 30-year-old man is diagnosed with hyperchlorhydria and presents with stomach ulcers. Which of the following pH ranges is most favorable for Pepsi activity in the stomach? Answer: 1.8 to 3.5 pH [rationale: Pepsine has its optimum proteolytic activity at pH between 1.8 to 3.5.At higher pH levels, Pepsine becomes inactivated or inactive] 22. a patient is given an H2 receptor antagonist or acid reflux. What effect would this drug have on the stimulation of gastric acid secretion? Answer: B. It inhibits histamine-induced activation of adenylate cyclase in the parietal cell. 23. A six-year-old man diagnosed with achlorhydria following chronic gastritis. He reports difficulty digesting proteins and has signs of anemia. Which of the following explains the patient's symptoms related to protein digestion? Answer: Lack of chloric acid secretion to activate your pepsinogen 24. Which of the following conditions will decrease gastric secretion from G-cells? a. Distention of the stentule. b. Increased protein in the stomach. c. high gastric acidity of less than two pH [rationale: Gastric secretion is inhibited when the stomach pH drops below pH two as a feedback mechanism to prevent, to prevent.] d. Devagal stimulation. DO NOT REPRODUCE THIS FILE. DO NOT USE FOR ANY CORRECTIONS. KEEP THIS FILE SAFE.  DO NOT REPRODUCE THIS FILE. DO NOT USE THIS FILE FOR ANY CORRECTIONS. SAFE KEEP THIS FILE. 25. What molecular mechanism directly leads to the release of hydrogen ions by parietal cells? Answer: Hydrogen potassium ATPase pumps on the apical membrane of parietal cells actively exchange hydrogen ions for potassium driving acid secretion. 26. During the intestinal phase of gastric acid secretion, which hormone plays an inhibitory role? Answer: Secretin [rationale: secretin released in response to acidic time entering the duodenum inhibits gastric acid secretion to protect the intestinal lining.] 27. Which of the following is primary component of bile responsible for emulsifying fats in the small intestine? Answer: Bile acids [rationale: bile acids, primarily calling acid and kinodeoxycholic acid are the main components responsible for emulsifying dietary fats. Breaking them into smaller droplets to increase surface area for digestive enzymes. Licitin; Licitin also contributes to emulsification but is a secondary bile acid. So, what is your primary bile, your primary calling acid? It is your? Bile acid. But when the question asks for the secondary, it is your? Licitin.] 28. Which of the following is most closely associated with the secretion of bile? Answer: CCK [rationale: CCK is a key hormone that stimulates the construction of the gallbladder leading to bile release, especially after the ingestion of fatty food. But vagus nerve, there's a, yeah, the choice A is vagus nerve stimulation can also influence bile secretion but less directly than your CCK. So, more potent CCK.] 29. Which of the following directly influences the enterohepatic circulation of bile salts? a. secretion of secretin by the pancreas. b. reabsorption of bile salts in the ileum. [rationale: Rationally, the enterohepatic circulation involves the reabsorption of bile salts in the ileum. After the bile salts aid in fat digestion, they are absorbed back into the bloodstream, transported to the liver by the liver and resecreted into the bile.] c. release of CCK by the duodenum. d. the breakdown of cholesterol in the liver. 30. Which of the following best describes the role of CCK in the digestive process? a. It increases gastric acid secretion to aid in digestion. b. It stimulates the gallbladder to contract and release bile. [rationale: CCK is released in response to the presence of fats in the duodenum, stimulating the gallbladder to contract and release bile, which aids in fat digestion.] c. It inhibits the secretion of pancreatic enzymes. d. It reduces the bile secretion to prevent gallstone formation. 31. Which of the following best describes the relationship between liver cholesterol secretion and gallstone formation? a. Increased cholesterol secretion increases the risk of gallstone formation. [rationale:excess cholesterol secretion by the liver can lead to supersaturation of cholesterol bile, which may result in the formation of cholesterol gallstone.] 32. Which of the following GI hormones is secreted by your eye cells? Answer: CCK [rationale: CCK is produced by the eye cells in the, what part of your small intestine? The adenoma and ileo. So it is secreted in the entire tract of your, by the entire tract of your small intestine.] DO NOT REPRODUCE THIS FILE. DO NOT USE FOR ANY CORRECTIONS. KEEP THIS FILE SAFE.  DO NOT REPRODUCE THIS FILE. DO NOT USE THIS FILE FOR ANY CORRECTIONS. SAFE KEEP THIS FILE. 33. Which of the following GI hormone secretes insulin once it's stimulated? Answer: GIP [rationale: G.I.P. is produced by K-cells in the duodenum and jejunum. Its main stimuli are oral glucose and once stimulated, it secretes insulin.] 34. Which of the following GI hormone inhibits gastric emptying? Answer: CCK [rationale: CCK is produced by the I-cell of the entire small intestine tract. Its main trigger is fatty acid.] 35. A 60-year-old male with a history of peptic ulcer disease is experiencing recurrent nausea, abdominal cramps, and diarrhea. He has also noticed unexplained weight loss and increased hunger. His doctor is suspecting Zollinger-Ellison syndrome characterized by gastric secreting tumor. What effect would the excessive gastric secretion have on his gastrointestinal system? It will increase gastric acid secretion. [rationale: Gastrin stimulates the parietal cells of the stomach to secrete gastric acid. In Zollinger-Ellison syndrome, excessive gastrin production leads to hypersecretion of gastric acid, which can contribute to peptic ulcers, nausea, abdominal discomfort, and diarrhea. Increased gastric acid secretion is a hallmark of this condition exacerbating gastrointestinal symptoms. In Zollinger-Ellison syndrome, excessive gastrin production leads to hypersecretion of gastric acid, which can contribute to peptic ulcers, nausea, abdominal discomfort, and diarrhea. The signs and symptoms presented by your patient. Increased gastric acid secretion is a hallmark of Zollinger-Ellison syndrome, which exacerbates gastrointestinal symptoms.] a. Inhibition of gastric acid secretion. b. Increased motility of the small intestine. [rationale: wrong; In Zollinger-Ellison syndrome, the problem is your gastric acid secretion. c. Excessive bile secretion. d. Increased gastric acid secretion. 36. Mucus secretion in the large intestine is primarily regulated by which of the following? a. Twice A is parasympathetic nervous system. b. Extreme emotional disturbances. c. Hormonal influence such glucagon-like peptide 1 and CCK. d. Local stretch and presence of luminal contents. [rationale: Mucose secretion in the large intestine is primarily regulated by local factors such as the stretch of the intestinal wall and the presence of the luminal contents.] 37. Where does the digestion of maltose primarily occur? Answer: jejunum [rationale: Your maltose is digested primarily in your jejunum. While maltose can be formed in the stomach and the mouth during starch digestion, the salivary amylase, the primary digestion of maltose into glucose, occurs in the small intestine, particularly in the jejunum. It can also be digested in your duodenum. Actually, duodenum and jejunum are the answers, but you don't have duodenum here.] 38. Which of the following carbohydrates must undergo a process involving water before it can be absorbed? Answer: sucrose. [ rationale: Sucrose is a disaccharide and requires enzymatic breakdown into its monosaccharide component, so it will become a glucose and a fructose by the enzyme sucrase before absorption occurs.] DO NOT REPRODUCE THIS FILE. DO NOT USE FOR ANY CORRECTIONS. KEEP THIS FILE SAFE.  DO NOT REPRODUCE THIS FILE. DO NOT USE THIS FILE FOR ANY CORRECTIONS. SAFE KEEP THIS FILE. 39. A 45-year-old male with poorly controlled diabetes presents with difficulty managing his blood sugar levels. Which of the following best describes the characteristic of the absorption mechanism in the lumen of the intestines that may be overexpressed in this patient? a. It allows transport against their concentration gradient. b. Directly uses ATP to move simple carbohydrates into cells. c. Is insulin dependent and functions via facilitated diffusion. d. A transporter that also transports sugar alcohol. 40. What is the primary role of the stomach's acidic environment in protein digestion? Answer: denatures proteins. 41. What are the end products of triglyceride digestion by pancreatic diabetes? Answer: mono-glycerides and pre-fatty acids. 42. Which enzyme is responsible for hydrolyzing triglycerides within chylomicrones in your bloodstream? a. pancreatic lipase. b. glycoprotein lipase. [rationale: Glycoprotein lipase is located in the endothelial surface of capillaries. It hydrolyzes triglycerides in chylomicrons into pre-fatty acids and glycerol, allowing their uptake by genes.] c. hormone-sensitive lipase. d. gastric lipase. 43. 40-year-old female presents with jaundice and steatorrhea. Imaging reveals a blockage in the common bile duct. Which aspect of the fat digestion is most likely impaired? a. secretion of pancreatic lipase. b. emulsification of fats. c. absorption of short-chain fatty acids. d. production of chylomicrons. 44. Digested fats form into monoglycerides and free fatty acids. These digestive end products first become dissolved in the central lipid portions of bland, which are soluble in kind? Answer: bile micelles [rationale: When fats are digested to form monoglycerides and free fatty acids, both of these digesting end products first become dissolved in the central lipid portions of the bile micelles. Because the molecular dimension of these micelles are only 3 to 6 nanometers in diameter, and because of their highly charged exterior, they are soluble in kind.] 45. Which of the following statement is correct regarding bile micelles? a. In the presence of bile micelles, about 97% of the fat is absorbed, whereas only 40 to 50% of fat can be absorbed in the absence of micelles. b. In the presence of bile micelles, about 40 to 50% of fat is absorbed, whereas as much as 97% of the fat can be absorbed in the absence of micelles. c. Bile micelles have a molecular dimension of 7 to 9 nanometers in diameter with a highly charged exterior. d. Bile micelles have a molecular dimension of 1 to 2 nanometers in diameter with a highly charged exterior. [rationale: Micelles perform a varying function that is highly important for fat absorption. In the presence of an abundance of bile micelles, about 97% of fat is absorbed. In the absence of bile micelles, only 40 to 50% can be absorbed.Because of the molecular dimensions of these micelles are only 3 to 6 nanometers in diameter, and because of their highly charged exterior, they are soluble in kind.] DO NOT REPRODUCE THIS FILE. DO NOT USE FOR ANY CORRECTIONS. KEEP THIS FILE SAFE.  DO NOT REPRODUCE THIS FILE. DO NOT USE THIS FILE FOR ANY CORRECTIONS. SAFE KEEP THIS FILE. 46. Small quantities of short and medium fatty acids are absorbed directly into the portal blood rather than being converted into triglycerides and absorbed by way of lymphatics.The reason for the direct absorption of short and medium chain fatty acids into the portal blood is due to: Answer: B. These fatty acids are more water soluble and most are not reconverted into triglycerides and endoplasmic reticulum. [rationale: small quantities of short and medium chain fatty acids such as those from butter fat are absorbed directly into the portal blood rather than being converted into triglycerides and absorbed by way of lymphatics. The cause of this difference between short and long chain fatty acid absorption is that the short chain fatty acids are more water soluble and most likely are not reconverted into triglycerides by the endoplasmic reticulum.] 47. Which of the following correctly explains the sequence of events that happened during absorption of fats? This is the sequence of events that happened during absorption of fats. Fats are digested to form monoglycerides and free fatty acids. Both of these digestive end products first become dissolved in the central lipid portions of bile micelles. In this form, the monoglycerides and free fatty acids are carried to the surface of the microvilli into the intestinal cell brush border and then penetrate into the recesses among the moving, agitating microvilli. Here, both the monoglycerides and the fatty acids diffuse immediately out of the micelles and into the interior of the epithelial cells, which is possible because the lipids are also soluble in the epithelial cell membrane. This process leaves the bile micelles still in the time where they function again and again to help absorb still more monosaccharides and fatty acids. After entering the epithelial cells, the fatty acids and the monoglycerides are taken up by the cells smoothed in the plasmic reticulum. Here, they are mainly used to form new triglycerides that are subsequently released in the form of chylomicrons through the base of the epithelial cell to flow upward through the thoracic lymph duct and empty into the circulating blood.] {You can read more on those on Chapter 66, Page 831 in your Guideline Edition 40th Edition.} 48. Most of the absorption in the large intestine occur in: a. Distal colon b. Proximal colon c. Transverse colon d. cecum 49. A.K. wanted to have a better lifestyle this year and decided to start running daily. After one of his morning sessions, he became thirsty but forgot to bring his water bottle. Since he only had spare change in his pocket, he brought water in a coin-operated machine at a nearby Sari-sari store. The following day, he had six episodes of loose watery stool. Which of the following statements best explain A.K.'s increase in bowel movement? a. The electrical potential gradient created by sodium absorption causes chloride absorption as well. b. The tight junctions between the epithelial cells of large intestinal epithelium are much tighter than those of the small intestine, therefore facilitating greater amounts of diffusion of fluids and electrolytes. c. Destruction of crypts in the large intestine causes