Q1. Esophageal lower esophageal sphincter contraction is caused by?
a) protein b) fat
c) peppermint d) alcohol
Q2. Growth factor for adaptive response is
a) Gastrin b) Secretin
c) Neurotensin d) Peptide YY
Q3. Schilling test is not used in
a) Steatorrhoea b)Blind loop syndrome
c) Pernicious Anemia
Q4. Most important investigation for Dysphagia in 60 year old is
a) Upper GI Endoscopy b) CT Thorax
c) Barium Swallow d) MRI
Q5. Maximum potassium concentration is seen in
a) Saliva b) Gastric Secretion
c) Jejunum d) Colon
Answers
1. A
Lower esophageal sphincter tone is decreased by: - Pregnancy
- Obesity
- Smoking, Alcohol
- Fatty foods, large meals, chocolate
- Diseases such as diabetes
2. C
SHORT BOWEL SYNDROME is a clinical condition characterized by rapid intestinal transit and malabsorption in individuals who have had a congenital or, more commonly, an acquired lesion leading to intestinal resection . Surgical outcome in a given individual depends on the extent and location of resection and how well the residual intestine adapts to the reintroduction of oral nutrition. All layers of the bowel wall have been shown to participate in a hyperplastic adaptive response to intestinal resection In addition to a marked increment in the diameter and some increase in the length of the residual intestine there are structural, functional, and cytokinetic adaptations of the mucosa, with augmentation of mucosal surface area. In both animal and human studies, the adaptive increase in mucosal mass is associated with gradual functional compensation that is characterized by diminishing fecal losses and increased transit time associated with increased segmental absorption of water, electrolytes, and nutrients
The mediators of adaptive response are multifactorial, and the literature supports three categories of factors:
luminal nutrients (soluble fiber, fatty acids, triglycerides, glutamine, polyamines, and lectins),
pancreaticobiliary secretions, and
hormonal and/or systemic factors [growth hormone, epidermal growth factor, transforming growth factor-, enteroglucagon, insulin-like growth factors I and II, keratinocyte growth factor, GLP-2, peptide YY, neurotensin, bombesin, and cytokines including interleukin (IL)-3, IL-5, and IL-11]
Gastrin can also have an effect
Ref. http://ajpgi.physiology.org/cgi/content/full/275/5/G911
3. A
The Schilling test is used to determine whether the body absorbs Vitamin B12 normally
Abnormal Stage I and II Schilling tests may indicate:
biliary disease
celiac disease (sprue)
hypothyroidism
liver disease
Lower-than-normal amounts of Vitamin B12 absorption may indicate:
biliary disease, resulting in malabsorption (inadequate absorption of nutrients from the intestinal tract)
intestinal malabsorption (for example, related to sprue or celiac disease)
liver disease (causing malabsorption)
pernicious anemia
Additional conditions under which the test may be performed:
anemia of B-12 deficiency
blind loop syndrome
megaloblastic anemia
Steatorrhea is fat malabsorbtion
4. A
To rule out carcinoma is the 1st concern in this case. Endoscopy would aid in direct visualisation as well as biopsy.
although barium would provide a road map for endoscopy most important remains a.
5. A
we are checking for references
