MMM.txt

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emm64
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146851
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MMM.txt
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2012-04-10 18:11:36
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Systems MMM
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Systems 2 MMM
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  1. Which of the following organs is matched incorrectly with its function
    • a) Pancreas: secretes enzymes to digest carbs, fats, nucleic acids and proteins
    • b) Gall Bladder: production of bile
    • c) Sphincter of Oddi: regulate secretions from common bile duct and pancreatic duct
    • d) Large intestine: stores and concentrates undigested matter
    • e) Ileum: recycling of bile acid
  2. B
  3. A patient presents with a deficiency in the membrane-bound enterokinase found in the epithelial cells of the lumen of the small intestine. Which of the following enzymes would remain unaffected?
    • a) Trypsin
    • b) Carboxypeptidase
    • c) Chymotrypsin
    • d) Lipase
  4. D
  5. Which of the following molecules does not need to be absorbed using secondary active transporter coupled to sodium?
    • a) Glucose
    • b) Short di/tripeptides
    • c) Free Amino acids
    • d) Galactose
  6. B
  7. Which of the following does NOT inhibit gastric emptying?
    • a) Presence of fats in the duodenum
    • b) Low pH detected in the duodenum
    • c) Increased CCK release
    • d) Hypotonic solution in the duodenum
  8. D
  9. What are the portions of digestion under voluntary control?
    • a) Initiation of the swallowing reflex
    • b) Conctriction/relaxation of the anal sphincter
    • c) Gastric motility and emptying
    • d) The closure of the lower esophageal sphincter
    • e) A and B
    • f) A and C
  10. E
  11. Which is NOT true of control of acid secretion
    • a) In the cephalic phase, enteric neural activity leads to the release of gastrin, histamine, and acetylcholine
    • b) Low acid stimulates the secretion of somatostatin, which stimulates acid production
    • c) Fats in the duodenum will inhibit release of H+ in the stomach
    • d) Distention of the duodenum will inhibit acid secretion in the stomach
    • e) High levels of acid secretion will result in higher levels of bicarbonate in the blood
  12. B
  13. The substance needed to bind to vitamin B12 is produced in the _____ cells of the stomach and B12 is recycled in the _____ of the small intestine.
    • a) Parietal, duodenum
    • b) Chief, jejunum
    • c) Parietal, ileum
    • d) Chief, ileum
    • e) G, duodenum
  14. C
  15. 8) Once fatty acids are absorbed into the enterocyte of the small intestine, they are immediately re-esterified and placed into chylomicrons. Why is this done?
    • a) To renew the free fatty acid to allow for more simple diffusion of fatty acids into the enterocyte
    • b) To allow for effective transport of the FA in an aqueous environment
    • c) To allow for packaging of vitamins A, D, E, and K for transport as well
    • d) Facilitate passage into the lacteals and eventually into the venous system near the heart
    • e) All of the above
  16. E
  17. 1) Which of the following ulcer therapies functions by lowering the levels of cAMP present in the parietal cell, thus inhibiting the action of the H+/K+ ATPase?
    • a) Omeprazole (proton pump inhibitor)
    • b) Cimetidine (H2 antagonist)
    • c) Sucralfate
    • d) Calcium Carbonate
    • e) A and B
  18. B
  19. 2) Which of the following drugs requires special consideration when used with antibiotics in a drug regimen treating H. Pylori induced gastric ulcers?
    • a) Bismuth Salicylate
    • b) Sucralfate
    • c) Misoprostol (prostaglandin analog)
    • d) Bran (bulk-forming agent)
    • e) Cimetidine (H2 antagonist)
  20. B
  21. 1) Traveler’s diarrhea is most commonly associated with what organism?
    • a) Listeria Monocytogenes
    • b) EAEC
    • c) Clostridium difficile
    • d) ETEC
  22. D
  23. 2) A 30 year old male recently died from dehydration due to hypersecretion of fluids and water. Furthermore, the stool before death was noted to have a “rice-water” appearance. What is the most likely culprit?
    • a) Y. Enterocolitica
    • b) Vibrio Cholerae
    • c) Salmonella
    • d) Campylobacter jejuni
    • e) B. Cereus
  24. B
  25. 1) A first-time patient enters your office for a full diagnostic and it is noted that there is significant erosion of the mandibular teeth. After the medical history, it is confirmed that he uses multiple pillows to sleep comfortably at night. It seems pretty clear that he is suffering from certain GI disorder. To confirm your diagnosis, you must order a diagnostic test. Which of the following would be useful in confirming the diagnosis?
    • a) Endoscopy
    • b) Ambulatory 24 hr pH testing
    • c) Stool sample
    • d) A and B
    • e) All of the above
  26. D
  27. 2) A patient is suffering from epigastric pain that no longer is alleviated by antacids. The patient furthermore noticed that his stool lately has had a black, tarry appearance. Which of the following is NOT a predisposing factor for his condition?
    • a) H. Pylori Infection
    • b) Zollinger-Ellison Syndrome
    • c) Chronic, persistent use of NSAIDs
    • d) Chronic therapy using prostaglandin analogues
    • e) Smoking
  28. D
  29. 3) A patient sits down in your chair and you immediately notice a markedly yellow appearance of the sclera and oral mucosa. Recognizing this as a potentially dangerous health situation you immediately order a blood test and send him to his physician. The blood test showed elevated levels of both conjugated and unconjugated Bilirubin. Which is the MOST LIKELY cause of this condition?
    • a) An obstruction preventing transport of Bilirubin from blood into the liver
    • b) Cholelithiasis
    • c) Hemolysis
    • d) Liver Failure (due to Hepatitiis, etc.)
    • e) None of the above







    D
  30. 4) A patient recently had a blood test and it was determined that he had chronic case of Hepatitis B that has not been cleared. Which antibodies or antigens will NOT be present in the blood sample?
    • a) IgM-Anti HBc
    • b) IgG-anti-HBc
    • c) IgG-anti-HBs
    • d) HBs-Ag
    • e) All of the above will be found in the blood sample
  31. C
  32. 1) Which of the following disorders can result in hyperchylomiconemia?
    • a. LPL deficiency
    • b. Uncontrolled type I diabetes
    • c. Increase Expression of LDL receptors
    • d. A and B
    • e. A and C
  33. D
  34. 2) Statins
    • a. Block the synthesis of LDL receptors
    • b. Inhibit the uptake of cholesterol via endocytosis of LDL by LDL receptors
    • c. Affect LPL activity
    • d. Inhibit cholesterol synthesis from Acetyl CoA, depleting the cholesterol pool
    • e. None of the above
  35. D
  36. 3) Which is the primary molecule regulating the transfer of Fatty acyl CoA into the mitochondria for Beta Oxidation?
    • a. Fatty acyl CoA
    • b. Malonyl CoA
    • c. Insulin
    • d. ACC (Acetyl CoA Carboxylase)
    • e. All of the above
  37. B
  38. 4) During the fed state, the levels of the above molecule(s) will _______, causing a(n)________ in the rate of transfer into the mitochondrion for Beta oxidation.
    • a. Increase, increase
    • b. Increase, decrease
    • c. Decrease, decrease,
    • d. Decrease, increase
  39. B
  40. 5) In the fasted state, the levels of all of the following are lower than usual EXCEPT
    • a. LPL
    • b. Chylomicron formation
    • c. Epinephrine
    • d. Blood Insulin
    • e. Dietary lipids
  41. C
  42. 6) Which of the following is NOT an effect of elevated levels of ketone bodies due to starvation or uncontrolled Diabetes I?
    • a. Lowering of blood pH
    • b. Ketonuria
    • c. Sweet-smelling breath
    • d. Compromised liver function
    • e. Maintenance of proper function in the brain despite lower glucose levels
  43. D
  44. 1) The Biosynthesis of Cysteine requires all of the following factors EXCEPT
    • a) Pyridoxal phosphate (Vitamin B6)
    • b) The Essential amino acid methionine
    • c) ATP
    • d) Tetrahydrobiopterin
  45. D
  46. 2) Both B12 and Folate are needed for the successful conversion of homocysteine to methionine. Deficiencies in Folate and B12 are associated with heart disease
    • a) Both statements are true
    • b) True and then false
    • c) False and then true
    • d) Both are false






    A
  47. 2) Urea contains ammonia from which source(s)
    • a) Carbamoyl synthetase
    • b) Free Ammonia
    • c) Ornithine
    • d) Aspartate
    • e) A and C
    • f) B and D
  48. F
  49. 3) In a patient suffering from PKU, there is a deficiency that disallows the successful catabolic breakdown from the amino acid ______ to the amino acid _____.
    • a) Homocysteinemethionine
    • b) TyrosinePhenylalanine
    • c) MethionineHomcysteine
    • d) PhenylalanineTyrosine
    • e) HomocysteineCysteine
  50. D
  51. 4) A non-diabetic person was placed in the hospital as a result of trauma. It was soon found out that his chart was mixed with his roommate, who is a type I diabetic. The hospital staff realized their mistake almost immediately and wants to offset this input before it affects his normal functioning of Glycolysis and the TCA cycle. Which of the following would be an inappropriate measure to use to help offset the effect of insulin given to the patient with regard to glycolysis and the TCA cycle?
    • a) Increase glucagon levels
    • b) Increase Calcium levels
    • c) Increase levels of Acetyl CoA
    • d) Increase phosphorylation of PFK-2
    • e) Increase NADH concentration
  52. B
  53. 5) Gluconeogenesis and Glycolysis represent two important metabolic functions that are reciprocally regulated. Which of the following is true regarding the regulation of these cycles?
    • a) Both cycles can be functioning simultaneously in the same cell
    • b) Fructose 1,6 Bisphosphatase is the key regulatory step in glycolysis
    • c) Citrate will inhibit glycolysis while stimulating gluconeogenesis
    • d) Phosphofructokinase-1 is the key regulatory step in glucaneogenesis
    • e) AMP and Fructose-2,6 bisphosphate will stimulate glucaneogenesis and inhibit glycolysis
  54. C
  55. 6) Glycogen synthesis and breakdown are likewise heavily regulated pathways. Which is true of glycogen breakdown in the liver?
    • a) Glycogen breakdown is facilitated by the phosphorylated glycogem synthase
    • b) It is facilitated by the dephosphorylated glycogen phoshorylase enzyme
    • c) Glucagon will facilitate the phosphorylation to activate glycogen phosphorylase, thereby stimulating breakdown
    • d) Epinephrine will facilitate the phosphorylation to activate phosphorylase, stimulating breakdown
    • e) C and D
  56. C
  57. 7) What is the hormone present in high amounts in the FED state? This hormone will cause all of the following processes to increase EXCEPT:
    • a) Glucose uptake
    • b) Ketogenesis
    • c) Liver glycolysis
    • d) Glycogen synthesis
    • e) Fat synthesis
  58. B
  59. 8) Which of the following is NOT true of both type I and early type II diabetes?
    • a) Genetic predisposition plays a role
    • b) Chylomicrons and VLDL accumulate in peripheral tissues
    • c) Glycerol and amino acids indicate a state of “starvation” because they are gluconeogenic precursors
    • d) C peptide is present in the blood
    • e) Adipocytes breakdown triglycerides to fatty acids and glycerol
  60. D
  61. 9) Disorders in which of the following would decrease insulin secretion?
    • a) GLUT 2 transporter
    • b) Voltage-sensitive Ca channels on the pancreatic beta cell membrane
    • c) Glucose Kinase
    • d) A and C
    • e) All of the above
  62. E
  63. Parietal Cells stain pink while chief cells stain blue.
    Which is the only correct statement regarding this finding?
    A. Parietal cells are eosinophilic due to the large
    amounts of RNA in the cytoplasm
    B. Parietal cells are basophilic due to large
    amounts of protein in the cytoplasm
    C. Chief cells are basophilic due to large amounts
    of RNA in the cytoplasm
    D. Chief cells are eosinophilic due to large
    amounts of protein in the cytoplasm
    C
  64. Which of the following is NOT a component of the villi or found in the Crypt of Lieberkuhn?
    • a. Lacteal Duct
    • b. Enterocytes
    • c. Panneth Cells
    • d. Brunner’s Glands
    • e. Neuroendocrine Cells








    D
  65. Which of the following is NOT true regarding chron’s Disease and Ulcerative colitis
    • a. They are both Idiopathic inflammatory bowel
    • diseases
    • b. Chron’s Disease features skip lesions, while UC
    • does not
    • c. Crohn’s disease is associated with NON-caseating
    • granulomas
    • d. UC features lesion with sharp, demarcated border











    D
  66. Which of the following organs feature stratified squamous epithelium?
    • a. The esophagus
    • b. The stomach
    • c. The large intestine
    • d. The Rectum/Anus
    • e. A and D
    • f. All of the above













    E
  67. 1) Cells found in the core of the Islets of Langerhans perform what function in the body?
    • a) Increase blood glucose levels
    • b) Decrease blood glucose levels
    • c) Inhibit insulin and glucagon release
    • d) Stimulate gastrin secretion
    • e) Inhibits intestinal motility
  68. B
  69. 2) In the portal triad shown above, blood flows from ____ and ____ in the direction of the ____

    • a) 1, 2, central vein
    • b) 1, 3, portal vein
    • c) 2, 3, central vein
    • d) 3, 4, portal vein
    • e) 1, 3, central vein
  70. A
  71. 3) Which of the following is NOT correct of the disse space?
    • a) This is a lymphatic space
    • b) Found between the hepatocyte and the fenestrated endothelial cells
    • c) Ito cells in the Disse space may produce collagen during inflammation
    • d) Endocrine products are not secreted into this space
    • e) When bile ducts are obstructed, alkaline phosphatase is secreted into this space
  72. D
  73. 4) Portal Hypertension can result in all of the following except:
    • a) Esophageal varices
    • b) Secondary Hyperaldosteronism
    • c) Periumbilical medusae
    • d) Ascites
    • e) These all can be caused by portal hypertension
  74. E
  75. 5) This pathology is MOST LIKELY due to what disease?
    • a) Hepatitis A
    • b) Hepatitis B
    • c) Hepatitis C
    • d) Hepatocellular Carcinoma
    • e) Obstructive Jaundice
  76. C
  77. 6) Fat necrosis with possible calcification is very characteristic of what disease?
    • a) Hepatitis
    • b) Acute Pancreatitis
    • c) Chronic pancreatitis
    • d) Pancreatic adenocarcinoma
    • e) Liver failure











    B

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