Urinary & Digestive Systems
An erection is under _____________________ (PANS/SANS) control, whereas ejaculation is under ______________________ (PANS/SANS) control.
"Point to Shoot" Erection = parasympathetic Ejaculation = sympathetic
Describe the pathway of sperm.
"SEVEN UP"
What is hydronephrosis?
"Water in the kidney" Kidney obstruction and distension/dilation of the renal pelvis and calyces
An intestinal hormone that stimulates the gallbladder to release bile is; > Serotonin. > Secretin. > Cholecystokinin. > GIP. > Gastrin.
Cholecystokinin. > Released by enteroendocrine cells in the duodenum
How do low levels of ADH affect the DCT and collecting ducts? How does this alter the urine concentration?
LOW levels = DCT and collecting ducts become impermeable to water despite the high osmotic gradient. Urine becomes dilute (100mosm/L, below isosmotic level)
Identify the proton pump inhibitor from the following drugs: > Bismuth > Omeprazole > Cimetidine > Celecoxib
Omeprazole. > Most effective treatment > Also used to Tx ulcers
Which of the following is an anti-emetic that works by blocking the 5-HT3 receptor? > Ondansetron > Scopolamine > Ipecac > Dronabinol
Ondansetron (anti-emesis). > Scopolamine (antimuscarinic) > Ipecac (pro-emesis) > Dronabinol (cannabinoid)
In the GI system, the muscularis externa is composed of 2 layers. A 3rd layer is found only in the _______________ and it is called the ________________ muscle.
Stomach. Oblique muscle
Which of the following is a predominant bacteria in the urethra? > Lactobacilli > S. faecalis > P. gingivalis > S. mutans
Streptococcus faecalis
All of the following are bacteria causing GI disease for the preformed toxins EXCEPT: > S. aureus > S. mutans > C. perfringens > B. cereus
Streptococcus mutans
Esophageal glands are located in which layer of the mucosal lining? - Mucosa - Lamina propria - Mucularis mucosa - Submucosa - Muscularis externa
Submucosa
Which of the following arteries supplies the distal portion of the duodenum, jejunum, ileum and proximal 2/3 of the transverse colon? > Branches of the celiac trunk > Superior mesenteric a. > Inferior mesenteric a. > Common hepatic a.
Superior mesenteric a. > Inferior supplies distal 1/3 of transverse colon and remainder of the large intestine
This class of diuretics is the most widely used class and works on the distal tubule of the nephron: > Thiazides > Loop diuretics > K+ sparing diuretics > Aldosterone antagonists
THIAZIDES. > Hydrochlorothiazide > Chlorothiazide > Chlorthalidone
Nephrogenesis is completed by birth in humans. TRUE or FALSE?
TRUE.
The genital eminence consists of genital tubercles, folds and swellings. What do each of these become in the male? In the female?
TUBERCLE: penis / clitoris FOLDS: fuse in male / labia minora SWELLINGS: scrotal pouch / labia majora
In the male reproductive system, what is the function of the cremaster muscle?
Temperature control (along with the dartos muscle) of the scrotum via. lifting and lowering the testes.
What is plasma clearance?
The ability of the kidneys to "clear" the plasma of substances in a specific length of time (ml/min)
What is achlorhydria?
The absence of hydrochloric acid (HCl) secretion
Chlamydia trachomatis, a gram -ve obligate is associated with which of the following pathologies: > Cystitis > Glomerulonephritis > Urethritis > Gonorrhea
Urethritis. > Along with N. gonorrheae
Which type of nephritis is the result of various diseases that cause slow progressive loss of renal function? - Acute post-infectious glomerulonephritis - IgA nephropathy - Chronic glomerulonephritis - Rapidly progressive glomerulonephritis
Chronic glomerulonephritis.
Which of the following drugs acts as an H2 receptor antagonist? > Bismuth > Omeprazole > Cimetidine > Celecoxib
Cimetidine. > Histamine stimulates parietal cells to secrete H+ > Used to Tx ulcers
What are plicae circulares?
Circular folds of mucosa in small intestine which contain villi and microvilli
Identify the anti-emetic that works as a cannabinoid receptor agonist: > Cimetidine > Dronabinol > Ondansetron > Scopolamine
Dronabinol. > Cimetidine (Tx for ulcers) > Ondansetron (5-HT3 antagonist) > Scopolamine (anti-muscarinic)
Which of the following pathogens is the most associated with urinary tract infections? > E. coli > Klepsiella spp. > Proteus spp. > P. aeruginosa
E. coli
Which cells secrete histamine? > Parietal cells > G cells > ECL cells > Chief cell
ECL (Enterochromaffin-like) cells
Compare/contrast the internal and external anal sphincters.
(1) INTERNAL: smooth muscle, involuntary (2) EXTERNAL: skeletal muscle, voluntary
Compare/contrast the internal and external urethral sphincters.
(1) INTERNAL: thickening of detrusor muscle, smooth muscle, involuntary (2) EXTERNAL: portion of urogenital diaphragm, skeletal muscle, voluntary
List the following in order of anterior to posterior location: > Vagina > Urethra > Clitoris > Anus
(Ant) Clitoris Urethra Vagina (Post) Anus
What two components make up the renal corpuscle?
- Glomerulus - Glomerular (Bowman's) capsule
Name 3 vitamins produced in the large intestines.
- Vitamin K - Biotin - Vitamin B5
Name some drugs that may have interactions with diuretics.
> Antidiabetic drugs > Corticosteroids > Digoxin > Lithium > NSAID's
Branches of which arteries supply the small intestine?
> Celiac trunk (proximal duodenum) > Superior mesenteric (distal duodenum, jejunum, ileum)
When referring to rotational anomalies, what is a volvulus?
A hyper-rotation, or kink, in the rotating intestine that results in an obstruction
What is the normal reabsorption rate of glucose?
1 mg/ml
Glomerular filtrate must pass through 3 distinct layers. What are they?
1. Capillary endothelium (fenestrations) 2. Basement membrane (collagen type IV) 3. Podocytes (& pedicels)
What are 4 types of diabetes insipidus?
1. Central/Cranial: injury to posterior pituitary 2. Nephrogenic: problem with AQP or receptors 3. Dipsogenic: hypothalamus malfunction 4. Gestational: during pregnancy
What are the 3 phases of gastric activity regulation?
1. Cephalic phase 2. Gastric phase 3. Intestinal phase
Place the following in order of the flow of urine to the urethra: > Renal pelvis > Major calyx > Urinary bladder > Minor calyx > Collecting duct > Ureter
1. Collecting duct 2. Minor calyx 3. Major calyx 4. Renal pelvis 5. Ureter 6. Urinary bladder
Put the following layers of the digestive tract wall in order from the lumen to the deepest layer: > Lamina propria > Submucosa > Serosa > Muscularis externa > Digestive epithelium > Muscularis mucosae
1. Digestive epithelium 2. Lamina propria 3. Muscularis mucosae 4. Submucosa 5. Muscularis externa 6. Serosa
What are the 3 major functions of the nephron?
1. Glomerular filtration 2. Tubular reabsorption 3. Tubular secretion
What are the 3 types of nephrosis?
1. Minimal change disease 2. Focal segmental 3. Membranous
Where does ADH act? (2 correct answer). > Blood vessels > Proximal tubule > Loop of Henle > Distal tubule > Collecting duct
> Blood vessels. > Collecting duct Also called "vasopressin" because it is a vasoconstrictor.
Which portions of the large intestine (colon) are intraperitoneal?
> Cecum > Transverse colon > Sigmoid colon > Rectum (1st part)
List the following in the correct order for renal system development: > Mesonephros > Metanephros > Pronephros
1. Pronephros 2. Mesonephros 3. Metanephros
What are 3 types of nephric systems observed during embryonic development?
1. Pronephros 2. Mesonephros 3. Metanephros
What are the 3 functions of the urinary system?
1. excretion 2. elimination 3. homeostatic regulation
What is a normal range of pH state?
7.35 - 7.45
Roughly how many sperm are produced each day? Roughly how many sperm does an average ejaculation contain?
100-200 million / day 200-500 million / ejaculation
What are the normal plasma levels of sodium?
135-145 > Hypo/Hypernatremia
The duodenum has 4 parts. 3 are retroperitoneal but 1 is intraperitoneal. Which one is the exception? > 1st part (superior) > 2nd part (descending) > 3rd part (inferior) > 4th part (ascending)
1st part, superior part.
What is the normal range of bicarbonate (HCO3) in the body?
22 - 26 > Increase causes alkalosis > Regulated by the kidneys
What is the average length of the menstrual cycle? What are the phases of the cycle?
28-days. > Follicular phase > Ovulation (day 14) > Luteal phase
Which part of the duodenum does the pancreas, liver and gall bladder drain?
2nd part, descending part.
The major and minor duodenal papillae are located in the ____________ (#) part of the duodenum, which is _______________ (intra/retroperitoneal).
2nd, retroperitoneal
What are the normal plasma levels of potassium?
3.5 - 5.0 > Hyper/Hypokalemia
What is the normal isotonic osmolarity of body fluids?
300 mosm/liter > Reaches 1200-1400 at the deepest regions of the medullary
What is the normal range of CO2 in the body?
35 - 45 > Increase causes acidosis > Regulated by respiration
What is the transport maximum (Tm) for glucose?
375 mg/min > Concentration of transported molecules needed to saturate the carriers.
The stomach is first seen during ______________ week of development.
4th week. > Expansion of the foregut
Substances smaller than _______ Molecular Weight (MW) can freely become part of the GF: > 50,000 > 60,000 > 70,000 > 80,000
60,000
Which of the following forms of diabetes insipidus is vasopressin effective in treating (2 answers): > Central or cranial > Dipsogenic > Nephrogenic > Gestational
> Central/Cranial (Neurogenic) > Gestational Dipsogenic (hypothalamus) and Nephrogenic (AQP) have malfunctions that can't be resolved with hormone replacement therapy.
What are the 3 major anions of the body?
> Chloride (Cl-) > Bicarbonate (HCO3-) > Phosphorous-Phosphate (PO3-)
What are the two types of erectile tissue in the penis?
> Corpus cavernosa (2) > Corpus spongiosum (1)
Describe the structure of the glomerular capsule.
> Double walled > Squamous epithelium > Outer layer continuous with PCT > Inner layer composed of podocytes
What are the 3 regions of the small intestine in order? Which region is the smallest?
> Duodenum (smallest) > Jejunum > Ileum
Each kidney is protected by these 3 concentric layers of connective tissue...
> Fibrous capsule > Perinephric fat capsule > Renal fascia
What 3 parts collectively make up the "genital eminence"?
> Genital tubercle > Genital folds > Genital swellings
What influences glomerular filtration rate?
> Glomerular blood pressure and flow > Size of filtration slits and pores
What are the 3 components of the hepatic portal triad?
> Hepatic artery > Hepatic portal vein > Bile duct
Which of the following arteries supply the lesser curvature of the stomach? > Left & right gastric a. > Left & right hepatic a. > Short gastric a. > Left & right gastroepiploic a.
> Left gastric a. (branch off celiac trunk) > Right gastric a. (branch of common hepatic a.)
What are the 3 phases of the 28-day uterine cycle?
> Menstrual phase > Proliferative phase > Secretory phase
What are the 4 basic layers of the digestive tract?
> Mucosa (epithelium, lamina propria, muscularis mucosae) > Submucosa > Muscularis Externa > Serosa or Adventitia
What are the 3 regions of the pharynx? Which is NOT part of the digestive system?
> Nasopharynx (not part of the respiratory system) > Oropharynx > Laryngopharynx
What are the accessory digestive organs?
> Pancreas > Liver > Gallbladder > Salivary glands
What are the 3 regions of the male urethra?
> Prostatic urethra > Membranous urethra > Spongy urethra
What are the 4 major cations of the body?
> Sodium (Na+) > Potassium (K+) > Calcium (Ca+) > Magnesium (Mg+)
What are the bacterial and viral origins of hepatitis?
> TB, secondary to Syphilis > Hepatitis A, B & C
What is the spermatic cord?
A bundle of tissue that contains the ductus deferens, blood vessels, nerves and lymphatics that serve the testis
What is a diverticulosis?
A condition in which the mucosa/submucosa herniates through muscle wall. > Occur in the sigmoid colon
What is Fanconi syndrome?
A disease of the proximal tubules associated with loss of reabsorption. May be inherited or acquired. Urine and blood have altered levels of excreted molecules
What is diabetes insipidus?
A disorder caused by inadequate amounts of ADH which causes excessive water loss
With regards to the GI system, what is segmentation?
A form of mechanical digestion. Mixing and churning of food in the small intestine
Compare/contrast respiratory acidosis and alkalosis.
ACIDOSIS: CO2 is too high (>45). Hypoventilation. Kidneys compensate by conserving bicarb. ALKALOSIS: CO2 is too low (<35). Hyperventilation.
Compare/contrast metabolic acidosis and alkalosis.
ACIDOSIS: Loss of bicarb, lungs compensate by increasing respirations ALKALOSIS: Loss of acid ions or too much conservation of bicarb. Decreased respiration or excretion of bicarb via. kidneys.
ADH causes the insertion of ______________ into the ________________ of the nephron.
ADH causes the insertion of aquaporin 2 into the collecting duct of the nephron.
What is colloid pressure?
AKA oncotic pressure Plasma proteins (too large to pass through capillaries) in the intravascular space pull fluid back into the capillaries to maintain osmotic pressure. > Failure to do so can lead to acites
What hormone regulates the reabsorption of water in the DCT & collecting ducts? Where does it come from?
ALDOSTERONE (via. RAAS) > Produced and secreted by adrenal cortex
What is "acites"?
Abnormal build-up of fluid in the abdomen. Can result from a failure to maintain colloid (i.e. oncotic) pressure.
The functions of the oral cavity include all of the following, except; - Analysis of material before swallowing. - Mechanical processing of food. - Lubrication. - Absorption of fatty acids - Digestion of carbohydrates.
Absorption of fatty acids.
Which type of nephritis can occur 2-3 weeks after a strep infection? - Acute post-infectious glomerulonephritis - IgA nephropathy - Chronic glomerulonephritis - Rapidly progressive glomerulonephritis
Acute post-infectious glomerulonephritis. > Antigen-Ab complexes precipitate on glomerular membrane
The following pathogen has been associated with Traveler's diarrhea and infantile gastroenteritis? > S. aureus > E. coli > T. Forsythia
E. coli
Adenocarcinoma affects the ______________ (distal, middle, proximal) third of the esophagus, whereas SCC affects the ____________ (distal, middle, proximal).
Adenocarcinoma = distal 1/3 SCC = middle 1/3
Where is aldosterone synthesized? > Adrenal cortex > Adrenal medulla > Anterior pituitary > Posterior pituitary
Adrenal cortex. > Also secreted here.
Which of the following is a K+ sparing diuretic? > Amiloride > Furosemide > Hydrochlorothiazide > Bumetanide
Amiloride. > Along with Triamterene
Which of the following bacteria is found in the oral cavity and is associated with GI infections? > Campylobacter spp. > P. gingivalis > S. mutans
Campylobacter spp.
This pathogen is a gram negative bacteria, s-shaped and motile. It is found in infected poultry, unpasteurized milk and untreated water: > Shigella > Salmonella > Campylobacter > Escherichia coli
Campylobacter.
What is celiac sprue?
An autoimmune disorder of the small intestine caused by a reaction to gliadin (a gluten protein).
What is pyelonephritis?
An invasive bacterial infection of the kidneys usually ascending from a UTI. > E. coli, Proteus
What stimulates aldosterone production/secretion? > High b.p > Hypocalcemia > Hypokalemia > Angiotensin II binding it's receptor
Angiotensin II binding it's receptor.
Which of the following compounds acts simply as a pH buffer? > Omeprazole > Antacids > Cimetidine > Celecoxib
Antacids (Mg+, Ca+, Al salts)
At what vertebral level does the esophagus begin? At what level does it pierce through the diaphragm?
BEGINS: C6 (posterior to cricoid cartilage) ESOPHAGEAL HIATUS: T10
Roughly how many follicles are females born with? How many remain at puberty?
BIRTH: ~1.5 million PUBERTY: 400, 000
Compare/contrast prolactin and oxytocin.
BOTH are hormones produced by mammary glands. - Prolactin produces milk - Oxytocin ejects milk
Describe the three phases of deglutation.
BUCCAL: compression of bolus, elevation of soft palate and sealing off of nasopharynx PHARYNGEAL: bolus passes glottis by elevation of larynx, folding of epiglottis ESOPHAGEAL: contraction of pharyngeal muscles for bolus into esophagus. Involuntary. Peritalsis begins.
This bacteria is found in contaminated rice and soups and is associated with oral infections: > E. coli > Bacillus cereus > H. pylori
Bacillus cereus
All of the following are causative agents of balanitis except: > Coliforms > Streptococci > Bacteriodes spp. > Treponema pallidum
Bacteriodes spp. > Inflammation of the glans
Which of the following is associated with the replacement of squamous epithelium by columnar epithelium with goblet cells? > Mallory-Weiss Syndrome > Barrett Esophagus > Plummer-Vinson syndrome > Sjogren Syndrome
Barrett Esophagus > 30-100x risk of adenocarcinoma
Which of the following compounds is considered a "purgative"? > Bisacodyl > Dronabinol > Ondansetron > Scopolamine
Bisacodyl (irritant stimulant) > Dronabinol (cannabinoid) > Ondansetron (5-HT3 receptor antagonist) > Scopolamine (antimuscarinic)
In the renal system, the base of the allantois forms the _____________.
Bladder
Which of the following diuretics targets the Na/Cl co-transporter in the distal tubule? > Amiloride > Triamterene > Chlorothiazide > Furosemide
Chlorothiazide (Thiazide). > Hydrochlorothiazide, Chlorthalidone
Describe the ionic characteristics of acidosis.
CO2 to HCO3 in the extracellular fluid is increased. The net result is that H+ ions are excreted in the urine, and the Na+ and HCO3 ions are retained (absorbed)
Which cells secrete pepsinogen? > Parietal cells > Mucous cells > D cells > Chief cells
Chief cells. > Converted to pepsin in acid > Stimulated by acid
Vasopressin is used to treat cardiogenic shock because it decreases blood pressure by: > decreasing cardiac output > increasing diuresis > causing Na+ excretion > causing systemic vasoconstriction
Causes systemic vasoconstriction. > Also used to Tx diabetes insipidus
The expanded saclike structure that joins the ileum at the ileocecal valve is the: > Appendix. > Sigmoid colon. > Rectum. > Haustra. > Cecum.
Cecum. > Appendix is attached here > Moisture is removed from chyme
Which of theses NSAIDs would be least likely to cause gastric ulcers? > Naproxen > Celecoxib > Ibuprofen > Aspirin
Celecoxib. COX 2 (not COX 1) blocker.
Following a whiplash injury, your patient finds he is constantly thirsty and urinates frequently. He is most likely suffering from _________ diabetes insipidus: > Central or cranial > Dipsogenic > Nephrogenic > Gestational
Central or cranial diabetes insipidus. > Dipsogenic: problems with hypothalamus > Nephrogenic: problems with AQP > Gestational: pregnancy
Which of the following arteries supplies the gallbladder? > Right gastric a. > Gastroduodenal a. > Cystic a.
Common hepatic a. > Proper hepatic a. >> Right hepatic a. >>> Cystic a.
What is Hirschsprung disease?
Congenital disorder caused by a section of aganglionic colon - no peristalsis, leads to obstructions > Associated with Down's Syndrome
What is the spermatic cord and what are it's contents?
Connective tissue tube that runs through the inguinal ligament. It contains: > Ductus deferens > Cremaster muscle > Testicular n., a. and v. (pampiniform plexus)
S. saprophyticus and E. coli are the most common etiologic agents of: > Cystitis > Glomerulonephritis > Urethritis > Balantitis
Cystitis
Which cells secrete somatostatin? > Parietal cells > Mucous cells > D cells > Chief cells
D cells. > Regulatory hormone > Negative feedback stimulated by acid
Compare/contrast the functions of the dartos and cremaster muscles.
DARTOS: wrinkles the scrotal skin CREMASTER: lifts and lowers the testis BOTH function to regulate the temperature of the testis
Fill in the blanks with the following options: decreases or increases. In cases of afferent arteriole vasoconstriction, glomerular capillary blood pressure ________________, net filtration pressure ________________, and GFR ________________.
DECREASE, DECREASE, DECREASE
Which of the following does not have simple cuboidal epithelium? > PCT > DCT > Descending part of the Loop of Henle > Ascending part of the Loop of Henle > Collecting ducts
DESCENDING part of the Loop of Henle. > Simple squamous epithelium
Match the 3 parts of the small intestine with the following functions: > Chemical digestion > Absorption > Mixing
DUODENUM = mixing JEJUNUM = chemical digestion ILEUM = absorption
Describe nephrosis.
Damage to the glomerular membrane resulting in enlargement of fenestrations between endothelial cells and/or slit pores of epithelial cells. > excretion of 3.5g+ of protein per day
On what day of the 28-day ovarian cycle does ovulation occur?
Day 14. > Follicular phase (days 1 - 13) > Luteal phase (days 15 - 28)
Which of the following would be best to treat nocturnal enuresis (bed-wetting): > Cortisol > Aldosterone > Desmopressin > Metformin
Desmopressin
________________ is an analog of ADH is used to Tx neurogenic diabetes insipidus, nocturia and nocturnal enuresis
Desmopressin
The internal urethral sphincter is a smooth muscle made by a thickening of the ________________ muscle: > Urogenital diaphragm > Detrusor
Detrusor muscle. > Urogenital diaphragm is associated with the external urethral sphincter
Which of the following is NOT effectively treated with diuretics? > Heart failure > Hypertension > Edema > Diabetes
Diabetes
Compare/contrast a sliding vs. a paraesophageal (rolling) hiatal hernia.
Dilated portion of stomach protrudes above diaphgram. SLIDING: (90%) LES is above the diaphragm ROLLING: LES is at or below the diaphragm.
Define glomerulopathies.
Disorders that directly affect the glomerulus. The most common cause of kidney failure. TWO main classes: > Nephrosis > Nephritis
What portion of the nephron comes immediately after the nephron loop (i.e. Loop of Henle)? > Bowman's capsule > Glomerulus > Distal convoluted tubule > Collecting ducts > Proximal convoluted tubule
Distal convoluted tubule.
Where are the macula densa cells located? > Distal convoluted tubule > Proximal convoluted tubule > Loop of Henle > Arterioles
Distal convoluted tubules. > Juxtaglomerular cells are located in the arterioles
Which of the following compounds is used as a stool softener? > Bisacodyl > Dronabinol > Docusate > Scopolamine
Docusate > Scopolamine = antimuscarinic (anti-emesis) > Dronabinol = cannabinoid (anti-emesis) > Bisacodyl = irritant stimulant (purgative)
What are the mesenteries? What is their function?
Double layer of peritoneum that extends from the body wall to the digestive organs. Support intraperitoneal organs: > Greater omentum > Lesser omentum > Mesentery proper > Mesocolon
Where does the majority of chemical digestion occur in the small intestine?
Duodenum. > 1st part of the small intestine
Brunner glands are characteristic of the ______________________. > Stomach. > Duodenum. > Jejunum. > Ileum. > Colon.
Duodenum. Copious quantities of mucus when chyme arrives from the stomach, protects from low pH.
A condition in which the ureteric bud splits, forming two ureters is called: > Polycystic kidney disease > Horseshoe kidney > Duplex ureter and kidney > Oligohydramnios > Urachal fistula
Duplex ureter and kidney.
Which muscular layer of the uterus contains the stratum functionalis and stratum basalis?
Endometrium. > Stratum functionalis is shed during menstruation
What is an ulcer?
Erosion of mucosa into submucosa. Can result from gastritis (inflammation of the gastric mucosa) > Bleeding is a cardinal sign
The cardiac sphincter is located between the: > Stomach and duodenum > Laryngopharynx and esophagus > Esophagus and stomach > Ileum and cecum
Esophagus and stomach
What structure of the uterus contains a mucous plug during the majority of the 28-day cycle? > External os > Rugae > Dartos > Hymen > Fundus
External os
At birth, the GI tract is already infected with microorganisms. TRUE or FALSE?
FALSE.
Mechanical digestion begins in the oral cavity, whereas chemical digestion begins in the stomach. TRUE or FALSE?
FALSE. > BOTH begin in the oral cavity
Bile is produced, stored and secreted by the gallbladder. TRUE or FALSE?
FALSE. > Bile is produced by the liver > It is stored and secreted by the gallbladder
The muscularis mucosae, found in the mucosa of the digestive tract, is primarily responsible for peristalsis. TRUE or FALSE?
FALSE. > Muscularis externa is
The main microorganisms associated to Urethritis are Chlamydia trachomatis and Treponema pallidum. TRUE or FALSE?
FALSE. C. trachomatis and N. gonorrheae
Concurrent ibuprofen (NSAID) use will increase the effectiveness of diuretics in treating hypertension. TRUE or FALSE.
FALSE. It will decrease effectiveness and may result in high b.p.
The jejunum has Peyer's patches, whereas the ileum does not. TRUE or FALSE.
FALSE. The ileum has Peyer's patches (lymphatic tissue), but the jejunum does not.
Majority of the epithelium in the GI tract is ciliated. TRUE or FALSE?
FALSE. There is no ciliated epithelium in the digestive system. > Stratified squamous epithelium > Simple columnar epithelium
The mesonephric duct regresses in _______________ (males/females).
FEMALES. > Remains in males; ductus deferens > "Wolffian" duct
What are epiploic appendages?
Fat-filled pouches of visceral peritoneum
Which type of nephrosis can be caused by secondary factors including HIV, Heroin and Hypertension? > Minimal change disease > Focal segmental > Membranous
Focal segmental
Which type of nephrosis causes scarring of the glomerulus? > Minimal change disease > Focal segmental > Membranous
Focal segmental
What is the "prepuce"?
Fold of skin that covers the head of the glans penis, removed during circumcision
What is another immunological complication that may follow streptococcal sore throat (S. pyogenes)? > Cystitis > Glomerulonephritis > Urethritis > Gonorrhea
Glomerulonephritis
Stimulation of the Vagus nerve will cause which cells to secrete gastrin? > Parietal cells > Mucous cells > G cells > Chief cells
G cells.
Which of the following GI pathologies is associated with intestinal polyposis and osteomas? > Gardner's syndrome > Plummer-Vinson syndrome > Sjogren Syndrome > Mucoepidermoid Carcinomal
Gardner's syndrome.
During deglutition, which of the following phases is not present? - Buccal - Pharyngeal - Gastric - Esophageal
Gastric phase. > Phase in gastric activity
How do high levels of ADH affect the DCT and collecting ducts? How does this alter the urine concentration?
HIGH levels = DCT and collecting ducts become more permeable to water, which is pulled into the interstitium. Urine becomes more concentrated (1200mosm/L)
The right scrotum is usually 1/2 inch _______________ (higher/lower) than the left.
HIGHER.
Compare/contrast the blood supply of the hepatic portal vein and the proper hepatic artery.
HPV: supplies 75% of the blood to the liver, containing products of digestion PHA: supplies 25% of the blood to the liver, containing oxygenated blood
Compare/contrast hyper and hyponatremia.
HYPO: too low Na+/water in excess HYPER: too high Na+/dehydration > Normal levels are 135-145
The diagnostic test for this microorganism is a urea breath test: > Salmonella spp. > Escherichia spp. > Shigella spp. > Helicobacter pylori
Helicobacter pylori.
The renal defect that involves anomalous fusion of the metanephric blastema is called: > Polycystic kidney disease > Horseshoe kidney > Duplex ureter and kidney > Oligohydramnios > Urachal fistula
Horseshoe kidney > Metanephric blastema form the kidneys
Where is vasopressin synthesized? > Hippocampus > Anterior pituitary > Posterior pituitary > Hypothalamus > Zona glomerulosa of adrenal cortex
Hypothalamus > Secreted from the posterior pituitary
The _________________ has more mesenteric fat, whereas the ___________________ has a thicker muscular wall. > Duodenum, Ileum > Ileum, Jejunum > Duodenum, Jejunum > Jejunum, Ileum
ILEUM, JEJUNUM. Ileum: more blood supply and goblet cells Jejunum: more active peristalsis
On average, the right kidney is 2cm _______________ (superior/inferior) to the left kidney.
INFERIOR. > The liver takes up space on the R.S. > Kidneys ascend to lateral abdomen to come in contact with adrenal glands
Which type of nephritis can occur 2-3 days after an upper respiratory tract or GI viral infection? - Acute post-infectious glomerulonephritis - IgA nephropathy - Chronic glomerulonephritis - Rapidly progressive glomerulonephritis
IgA nephropathy. > i.e. "Berger disease" > IgA binds glomerular mesangial cells, inducing proliferation
Retention of urinary components in the blood of an individual is called: - Uremia - Polyuria - Nocturia - Diuria - Hematuria
Uremia
What is azotemia?
Increased blood urea nitrogen and creatinine in blood as a result of damage/disease to the kidneys.
Aldosterone causes an ___________________ (increase/decrease) in _________________ (Na+/K+) and water reabsorption.
Increases Na+/water reabsorption
Which of the following does NOT supply the proximal duodenum? > Supraduodenal a. > Anterior pancreaticoduodenal a. > Superior pancreaticoduodenal a. > Inferior pancreaticoduodenal a.
Inferior pancreaticoduodenal a. > Supplies the distal portion of the duodenum (branch of the superior mesenteric a.)
Describe nephritis.
Inflammation (-itis) of the glomerulus, resulting from: - Immunologic abnormalities *most common* - Drugs or toxins - Vascular disorders - Systemic diseases - Viral causes
What is cystitis?
Inflammation of the urinary bladder
The ureteric buds are derived from: > Pronephros > Somatic mesoderm > Metanephric blastema > Intermediate mesoderm
Intermediate mesoderm (branch of metanephric duct). > Metanephric blastema are the cells surrounding it
______________ forms much of the urogenital system: > Paraxial mesoderm > Intermediate mesoderm > Lateral plate mesoderm
Intermediate mesoderm.
A child injests a bottle of Tylenol. Which of the following drugs could be used as an emetic? > Methylcellulose > Ipecac syrup > Dronabinol > Scopolamine
Ipecac syrup. > Methylcellulose = laxative > Dronabinol = anti-emetic > Scopolamine = anti-emetic
Where is renin produced/secreted? What stimuli cause it's release?
Juxtaglomerular apparatus. > Decrease in blood volume or B.P. in afferent arteriole > Decrease in [NaCl] detected by macula densa
What is urolithiasis?
Kidney stone. Calculus (stone) formation in the urinary collection system. Calcium oxalate is a main component.
Which of the following is considered normal flora in the vagina? > Staphylococcus aureus > Lactobacilli > Bifidobacteria > Staphylococcus epidermidis
Lactobacilli > Bifidobacteria is found in breastmilk
Which of the following medications can help relieve constipation? > Cimetidine > Lactulose > Loperamide > Ondansetron
Lactulose. > Osmotic agent > Other laxatives: methylcellulose, Mg(OH)2
The layer of loose connective tissue that directly supports the digestive epithelium is the > Lamina propria. > Muscularis mucosae. > Submucosa. > Submucosal plexus. > Myenteric plexus.
Lamina propria
The part of the GI tract with the largest natural microbiota is the _________________.
Large intestine (i.e. colon)
Where does aldosterone act? > Late distal tubule > Blood vessels > Anterior pituitary > Glomerulus
Late distal tubule
Which arteries supply the lesser curvature of the stomach?
Left and right gastric arteries.
E. coli pathogenetic factors include all of the following, EXCEPT: > Capsular K antigens > Lipoteichoic acids > LPS O (Enterotoxin) > Frimbriae
Lipoteichoic acids
What is the body's 2nd largest organ, and largest gland?
Liver.
Helicobacter pylori is a common cause of ulcers. What is another non-microorganismal cause of ulcers?
Long-term NSAID use. > Block COX1 and COX2 (reduced mucous secretion) > Celecoxib is COX2 selective, fewer GI effects
Which class of diuretic has the highest "ceiling effect"? > Thiazides > Loop diuretics > K+ sparing diuretics > Aldosterone antagonists
Loop diuretics. > Furosemide, Bumetanide, Torsemide
Which of the following diuretic classes can cause tinnitus and hearing loss? > Thiazides > Loop diuretics > K+ sparing diuretics > Aldosterone antagonists
Loop diuretics. > Furosemide, Bumetanide, Torsemide
Which of the following medications would be the best Tx option to treat a child who has come down with diarrhea? > Docusate > Loperamide > Lactulose > Bisacodyl
Loperamide > Opioid receptor agonist > The others Tx constipation
Which type of nephrosis causes increased permeability and thickening? > Minimal change disease > Focal segmental > Membranous
Membranous > Autoimmune activation of immune complex > Deposition of Ab in the BM
Where does urine travel immediately after leaving the renal pelvis?
Ureter
What is dysuria?
Lower urinary tract infection
Which of the following is the most common? Which is the least? > Chronic fundal gastritis > Chronic antral gastritis > Chronic pyloric gastritis > Chronic cardiac gastritis
MOST COMMON: antral LESS COMMON: fundal > The other two don't exist
Which of the following is the MOST effective Tx for GERD? Which is the least? > H2 Receptor Antagonists > Antacids > Proton-Pump Inhibitors
MOST: proton pump inhibitors LEAST: antacids
Macula densa of the DCT are _______________________ (osmo/mechanoreceptors) whereas "J" cells at the wall of the afferent arteriole are __________________ (osmo/mechanoreceptors).
Macula densa = osmoreceptors Juxtaglomerular cells = mechanoreceptors
Which of the following is caused by a tear at the gastroesophageal junction? > Mallory-Weiss Syndrome > Barrett Esophagus > Plummer-Vinson syndrome > Sjogren Syndrome
Mallory-Weiss Syndrome
How do you calculate glomerular filtration rate?
Measured by the excretion and plasma concentration of inulin (a polymer of fructose that is neither secreted nor reabsorbed) > Average = 120-125ml/min
Which of the following is NOT the name of a lobe of the liver? > Quadrate > Middle > Right > Left > Caudate
Middle.
Which type of nephrosis is the most common form in children? > Minimal change disease > Focal segmental > Membranous
Minimal change disease.
Which of the following is true of the jejunum (in comparison to the ileum)? > More mucous producing goblet cells > More mesenteric fat > More, and large plicae circulares > Presence of Peyer's patches
More, and large plicae circulares > Ileum has few at the beginning, and none at the end
What is tubular secretion?
Movement of substances from the peritubular capillaries into the lumen of the tubule for excretion in the urine. > H+, K+, penicillin
Which of the following is associated with the most common malignant salivary gland tumors: > Gardner's syndrome > Plummer-Vinson syndrome > Sjogren Syndrome > Mucoepidermoid Carcinoma
Mucoepidermoid Carcinoma > Commonly the parotid gland
What is the definition of peristalsis?
Muscular contraction that moves food through the GI tract. Does NOT break up food.
Which of the 4 layers of the digestive tract is responsible for peristalsis? > Mucosa > Submucosa > Muscularis Externa > Serosa or Adventitia
Muscularis Externa. > Inner circular smooth muscle layer > Connective tissue layer > Outer longitudinal smooth muscle layer
Rank the following from most effective Tx of GERD to least effective? > Omeprazole > Antacids > Cimetidine
Omeprazole > Cimetidine > Antacids
Which of the following is not normally sterile? > Kidney > Ureters > Urine > Urethra > Bladder
Urethra.
What is the thick muscular layer of the uterus?
Myometrium
When does oogenesis begin? When does spermatogenesis begin?
OOGENESIS: during embryonic development SPERMATOGENESIS: at puberty
The renal defect that involves inadequate amounts of urine production in utero is called: > Polycystic kidney disease > Horseshoe kidney > Duplex ureter and kidney > Oligohydramnios > Urachal fistula
Oligohydramnios. > "Potter's" syndrome
With respect to the 3 salivary glands, what type of secretion does each produce? Serous or mucous?
PAROTID = serous SUBLINGUAL = mucous SUBMANDIBULAR = both
99.5% of Na+ is reabsorbed in the nephron tubule. Where is the majority of it reabsorbed? Where is the minority of it reabsorbed?
PCT: 67% Loop of Henle: 25% DCT: 8%
What is the difference between a protease and a peptidase?
PROTEASES: break down large protein complexes PEPTIDASES: break small peptides into amino acids
The apex of each renal pyramid contains a renal: > Column > Capsule > Papilla > Pelvis > Hilum
Papilla
Sertoli cells secrete Mullerian inhibiting substance (MIS), thereby causing ___________________ ducts to degenerate.
Paramesonephric ducts in females.
The __________________ persist in females, and contribute to reproductive structures: > Mesonephric tubules > Mesonephric ducts > Metanephric blastema > Paramesonephric ducts
Paramesonephric ducts. > i.e "Mullerian" ducts
The digestive system is primarily under autonomic control. The __________________ (Symp/Parasympathetic) division increases digestive activity.
Parasympathetic
Histamine from ECL cells will most directly stimulate: > Chief cells to secrete pepsinogen > G cells to secrete gastrin > D cells to secrete somatostatin > Parietal cells to secrete H+
Parietal cells to secrete H
Gastrin will lead to acid secretion from which cells? > Parietal cells > Mucous cells > G cells > Chief cells
Parietal cells.
Which cells secrete gastric acid (HCl)? > Parietal cells > Mucous cells > D cells > Chief cells
Parietal cells. > via. H+/K+ ATPases on the apical side > 2.5 million times more H+ in lumen
All of the glands of the head are innervated by the facial nerve (CN VII). Which is the ONLY exception?
Parotid gland. > Innervated by CN IX > CN VII, however, runs through it
What is the "ampulla"?
Part of the uterine ("Fallopian") tube which is the most common site of fertilization.
Which of the following does not have transitional epithelium? > Ureter > Urethra > Urinary bladder
Urethra. > Stratified squamous epithelium
Acid in the stomach stimulates chief cells to secrete what? > Somatostatin > Gastrin > Pepsinogen > HCl
Pepsinogen. > Necessary for protein digestion > Pepsin is the active form
Which of the following is associated with GI polyps and mucosal hyperpigmentation? > Mallory-Weiss syndrome > Peutz-Jeghers syndrome > Plummer-Vinson syndrome > Sjogren Syndrome
Peutz-Jeghers syndrome.
Which of the following GI pathologies is associated with the classic triad of dysphagia, iron deficiency and esophageal webs? > Gardner's syndrome > Plummer-Vinson syndrome > Sjogren Syndrome > Mucoepidermoid Carcinoma
Plummer-Vinson syndrome
Where is ADH (vasopressin) secreted from? > Hypothalamus > Anterior pituitary > Posterior pituitary > Hippocampus > Zona glomerulosa of adrenal cortex
Posterior pituitary. > Triggers the insertion of aquaporins (AQ2)
Match the following with the stage of syphilis they are associated with: > Gummata > Chancre > "Snail tracks"
Primary = chancre Secondary = "snail tracks" Tertiary = gummata
What are the female & male gonads? What are their fxns?
Primary sex organs: produce sex cells (gametes) and sex hormones. Female --> ovaries Male --> testes
What is the function of the male scrotum?
Provides a cooler temperature (3 degrees cooler) needed for sperm production.
_____________ is the presence of pus cells (polymorphs) in urine: > Bacteriuria > Pyuria > Dysuria > Pyelonephritis
Pyuria
Which of the following is an antagonist to the aldosterone receptor? > Bumetanide > Furosemide > Chlorothiazide > Spironolactone
Spironolactone > Along with Eplerenone
The majority of renal reabsorption occurs in the _______________ (PCT/DCT), whereas the majority of renal secretion occurs in the ___________ (PCT/DCT).
REABSORPTION: Proximal convoluted tubule SECRETION: Distal convoluted tubule
During the intestinal phase of gastric regulation, small amounts of food entering the intestine leads to gastric ______________. > Release > Inhibition > No effect
RELEASE. > Larger amounts inhibit gastrin secretion
The kidney is __________________ (retro/intraperitoneal) and located between vertebral levels ______________________.
RETROPERITONEAL. T11-L3
Which renal artery is usually longer and lower? LEFT or RIGHT?
RIGHT renal artery. > Branch from abdominal aorta
Which type of nephritis, also known as "Goodpasture syndrome", results from Ab formation against the basement membrane? - Acute post-infectious glomerulonephritis - IgA nephropathy - Chronic glomerulonephritis - Rapidly progressive glomerulonephritis
Rapidly progressive glomerulonephritis.
Which of the following are not key functions of the kidneys? - Regulate plasma volume and blood pressure - Produce renin - Regulate the quantity of ions in extracellular fluid - Recycle bile salts - Activate vitamin D
Recycle bile salts. > Ileum of the small intestine reabsorbs 94%
What is Meckel's diverticulum?
Remnant of the vitelline duct, which connects the yolk sac and the primitive midgut in the embryo, forming an open omphalomesenteric fistula, cyst or ligament (connection between bowel and umbillicus)
Describe the innervation of the digestive tract.
Splanchnic nerves.
What is the most distal portion of the male urethra: > Prostatic urethra > Membranous urethra > Spongy urethra
Spongy urethra. > Bulk of the urethra
This microorganism is a common caused of uncomplicated urinary tract infections, and it is the 2nd most common etiologic agent of female cystitis after E.coli: > S. aureus > K pneumoniae > S. saprophyticus > C. albicans
Staphylococcus saprophyticus
The prominent ridges in the lining of the empty stomach are called: - Cardia. - Papillae - Rugae. - Plicae. - Villi.
Rugae.
Which of the 3 salivary glands produces the most saliva? Which produces the least?
SUBMANDIBULAR: 60-70% PAROTID: 25-30% SUBLINGUAL: 3-5%
Which anti-emetic is an antimuscarinic that is used to treat motion sickness? > Cimetidine > Dronabinol > Ondansetron > Scopolamine
Scopolamine > Cimetidine: H2 receptor antagonist (GERD, Ulcers) > Dronabinol: cannabinoid > Ondansetron: 5-HT3 receptor agonist
What is the function of secretin?
Secreted by enteroendocrine cells in the duodenum when chyme enters, increases bile synthesis by liver and bicarbonate buffers from pancreas
What is the function of vasoactive intestinal peptide (VIP)?
Secreted by enteroendocrine cells in the duodenum, stimulates intestinal glands and dilates capillaries.
Describe the pronephros stage of kidney development.
Segmentally arranged cords (nephrotomes) connected by pronephric ducts (Day 22). They are non-functional and degenerate early (by W4)
Which of the following structures produces a portion of semen? > Seminal vesicle > Prepuce > Corpus cavernosum > Cremaster muscle
Seminal vesicle.
Semen production occurs in the: > Epididymis > Ductus deferens > Seminal vesicles > Seminiferous tubules
Seminiferous tubules
What is anasarca?
Severe generalized edema
This bacteria might be in (minor) association with periodontal disease: > Shigella flexneri > Shigella dysenteriae > Shigella boydii
Shigella flexneri
Bacillary dysentery is caused by which of the following pathogens? > Salmonella spp. > Escherichia spp. > Shigella spp. > Helicobacter pylori
Shigella spp.
Where is fecal matter immediately before it is in the rectum? > Splenic flexure > Descending colon > Cecum > Ileocecal valve > Sigmoid colon
Sigmoid colon
Raynaud phenomenon is associated with which of the following GI pathologies? > Gardner's syndrome > Plummer-Vinson syndrome > Sjogren Syndrome > Mucoepidermoid Carcinoma
Sjogren syndrome.
Warthin's Tumor, "Papillary cystadenoma lymphomatosum", is associated with which of the following GI pathologies? > Gardner's syndrome > Plummer-Vinson syndrome > Sjogren Syndrome > Mucoepidermoid Carcinoma
Sjogren syndrome.
Which of the following GI pathologies is an autoimmune destruction of exocrine glands (salivary and lacrimal glands)? > Gardner's syndrome > Plummer-Vinson syndrome > Sjogren Syndrome > Mucoepidermoid Carcinoma
Sjogren syndrome. i.e. "sicca syndrome"
Where does the majority of absorption of nutrients occur?
Small intestine (~90%) Large intestine (~10%)
Where does the majority of chemical digestion occur in the GI system?
Small intestine. > Bile from liver > Enzymes from pancreas
What are haustra?
Small pocket like sacks or bulges in the large intestine
What is glomerular filtrate?
The portion of the blood plasma that enters the glomerular capsule (45 gallons; 180L/day). Does not contain large molecules such as RBCs, WBCs & plasma proteins. > High hydrostatic pressure (45 - 60mmHg) > Many pores
Describe the ionic characteristics of alkalosis.
The ratio of HCO3 increases as the pH rises (more alkaline). The net result is that H+ ions are retained and bicarbonate ions are excreted.
What is tubular reabsorption?
The transfer of fluid and solutes out of the lumen of the nephron (primarily at the PCT) into the interstitial space, and into the peritubular capillaries. > Approx. 99% of filtrate is reabsorbed
The ureters begin at vertebral level _______________ and are ______________ (retro/intraperitoneal).
The ureters begin at vertebral level L1 and are retroperitoneal.
In the large intestine, what are the teniae coli?
Three thin, longitudinal bundles of smooth muscle that assist in peristalsis.
Contraction of the dartos muscle: > Propels sperm through the urethra > Produces an erection > Tightens the scrotal sac > Moves sperm through the ductus deferens
Tightens the scrotal sac.
Which of these diuretics targets the NKCC in the loop of Henle? > Eplerenone > Chlorothalidone > Torsemide > Spironolactone
Torsemide (Loop Diuretic) > Others: Furosemide, Bumetanide > Spironolacton & Eplerenon = K+ sparing > Chlorothalidone = thiazide
Which of the following is NOT one of the 3 ligaments associated with the liver? > Falciform ligament > Transverse ligament > Triangular ligament > Coronary ligament
Transverse ligament.
Enzyme that digests proteins into peptides is _______________: > Lipase. > Amylase. > Nuclease. > Maltase. > Trypsin.
Trypsin.
The renal defect that involves a persistent allantois is called: > Polycystic kidney disease > Horseshoe kidney > Duplex ureter and kidney > Oligohydramnios > Urachal fistula
Urachal fistula
During stomach development, the liver forces the stomach to rotate _____________ degrees. Eventually, this herniation rotates another ________ degrees to re-enter the body.
W8 = 90° M3 = 180° Total Rotation = 270°
During weeks _____________, a large part of the small intestine is outside of the body, inside the umbilicus.
Weeks 8 - 10
What is glomerular filtration rate? What is considered a normal GFR?
~120 - 125 ml/min (The total amount of filtrate formed per min by the kidneys)
How many nephrons are in each kidney?
~1.2 million > Superficial cortical nephrons (85%) > Midcortical nephrons > Juxtamedullary nephrons
