Question 1: A certain type of sandwich has caused severe indigestion in those wh
ID: 51361 • Letter: Q
Question
Question 1:
A certain type of sandwich has caused severe indigestion in those who eat it. The sandwich seemingly remains in the consumer’s stomach for over 7 hours before completely moving into the small intestine. Which of the following organs/systems/processes could the sandwich potentially be affecting? Select ALL that could potentially cause this problem.
The sympathetic nervous system
The parasympathetic nervous system
The enteric nervous system
The central nervous system
The gastroesophageal sphincter
The pyloric sphincter
Water reabsorption by the small intestine
Water reabsorption by the large intestine
Absorption of chyme through the stomach lining
Acid production in the gastric gland
Question 2:
Which of the following tests could be appropriate to help determine the cause of this problem (Select all that apply)? Select ALL that could potentially cause this problem.
Measure Gastrin content of chyme in the duodenum
Measure fat content of chyme in the duodenum
Measure pH of chyme in the duodenum
Measure protein content of chyme in the duodenum
Determine if the patient is experiencing abnormally high stress levels
Measure activity of the vagus nerve
Measure water content in the patient's faeces
Give the patient tequila and determine if it is absorbed through the stomach lining
Question 3:
You determine that the pH of chyme in the duodenum is extraordinarily low, potentially due to excessively acidic chyme emptying from the stomach. Vagal nerve activity is normal. How could this be causing food to remain in the stomach for such a long period of time (Select THE MOST appropriate answer)?
High acid content in the stomach is slowing gastric motility, thus slowing the release of contents into the duodenum.
High acid content in the stomach is slowing protein digestion, which excites the pyloric sphincter and decreases the rate of gastric emptying.
High acid content in the duodenum is slowing gastric emptying by contracting the pyloric sphincter.
High acid content in the duodenum increases circulating levels of secretin, which decreases gastric motility.
Question 4:
What potential mechanisms could be responsible for the low pH in the chyme within the duodenum (Select all that Apply)?
Increased levels of gastrin being released from G cells.
Decreased levels of gastrin being released from G cells.
Increased levels of histamine being released from ECL cells
Decreased levels of histamine being released from ECL cells.
Increased levels of somatostatin being released from D cells.
Decreased levels of somatostatin being released from D cells
Inhibition of the H+/K+ pump in parietal cells.
Excess secretin release from the small intestine
Inhibition of cholecystokinin release from the small intestine
Excess cholecystokinin release from the small intestine
Blockage of pancreatic exocrine ducts
Blockage of gallbladder exocrine ducts
Question 5:
You run some blood tests and determine that pancreatic function is normal, and all circulating hormones are within a normal range with the exception of increased levels of secretin. Considering all the information you have been given so far, what must be the cause of this condition? (select all that apply)
Increased levels of gastrin being released from G cells.
Decreased levels of gastrin being released from G cells.
Increased levels of histamine being released from ECL cells
Decreased levels of histamine being released from ECL cells.
Increased levels of somatostatin being released from D cells.
Decreased levels of somatostatin being released from D cells
Inhibition of the H+/K+ pump in parietal cells.
Excess secretin release from the small intestine
Inhibition of cholecystokinin release from the small intestine
Excess cholecystokinin release from the small intestine
Blockage of pancreatic exocrine ducts
Blockage of gallbladder exocrine ducts
Explanation / Answer
1.
a. The sympathetic nervous system – it controls the contraction of sphincters in the GIT, acid secretion in the stomach.
b. The pyloric sphincter – it is a muscle cuff that lies between the pylorus of stomach and the duodenum. This allows passage of only small food particles to pass through it into the duodenum. If the sphincter does not relax properly, release of food from the stomach is delayed.
c. Acid production in the gastric gland: High gastric acids prevent the sphincter from opening so that too much acid does not enter the duodenum.
2.
Measure gastrin content of chyme, measure fat content of chyme, measure pH of chime, measure protein content of chime, measure activity of the vagus nerve, measure water content in the patient’s feces all helps to determine the cause of this problem.
3.
High acid content in the duodenum is slowing gastric emptying by contracting the pyloric sphincter.
4.
Increased levels of gastrin being released from G cells, increased levels of histamine being released from ECL cells
5.
Increased levels of gastrin being released from G cells and increased levels of histamine being released from ECL cells. These two led to increase in the secretion of stomach acid. The decreased pH at the duodenum is counteracted by secretion of SECRETIN. This hormone stimulates the pancreas to release bicarbonates which neutralize the stomach acid in the duodenum.
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