[MCQ] Disorders of Absorption- Part 2

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Disorders of Absorption- Part 2

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Question 1

How many times bile acid pool is circulated via enterohepatic circulation ?

A	2 to 4 times / day
B	4 to 6 times / day
C	6 to 8 times / day
D	8 to 12 times / day

Question 1 Explanation:

Bile acid pool size is ~4 grams and is circulated via the enterohepatic circulation about twice during each meal, or six to eight times daily.

Question 2

Daily bile acids excretion in stool (fecal loss) equals ?

A	Half of total fat intake
B	Half of enterohepatic circulation
C	Hepatic bile acid synthesis
D	None of the above

Question 2 Explanation:

A relatively small quantity of bile acids (~500 mg) is not absorbed and is excreted in stool daily; this fecal loss is matched by hepatic bile acid synthesis.

Question 3

Small ileal dysfunction leads to ?

A	Bile acid diarrhea
B	Fatty acid diarrhea
C	Chloride diarrhea
D	Protein diarrhea

Question 3 Explanation:

Due to limited ileal disease or resection increased amount of bile acids are delivered into colon that stimulate active Cl- secretion producing diarrhoea but not steatorrhea because hepatic synthesis of bile acids increases to compensate for the rate of fecal bile acid losses upto a limit. It is called bile acid diarrhea, or cholorrheic enteropathy. It responds promptly to cholestyramine until ileal size is severely reduced.

Question 4

Large ileal dysfunction leads to ?

A	Bile acid diarrhea
B	Fatty acid diarrhea
C	Carbohydrate diarrhea
D	Protein diarrhea

Question 4 Explanation:

Patients with greater degrees of ileal disease and/or resection have diarrhea & steatorrhea that do not respond to cholestyramine. Increased quantities of bile acids enter colon. Hepatic synthesis proves insufficient resulting in impaired micelle formation and steatorrhea. This is called fatty acid diarrhea. Low-fat diet can be effective

Question 5

Reabsorption defect in enterohepatic circulation of bile acids is due to ?

A	Cirrhosis
B	Primary biliary cirrhosis
C	Jejunal diverticulosis
D	Crohn’s disease

Question 5 Explanation:

Ileal dysfunction caused by Crohn’s disease results in a decrease in bile acid reabsorption in ileum and an increase in the delivery of bile acids to large intestine leading to diarrhea with or without steatorrhea

Question 6

Which of the following is not a feature of bile acid diarrhea ?

A	Normal bile acid pool size
B	None or mild steatorrhea
C	Responds to cholestyramine
D	Responds to low-fat diet

Question 7

Which of the following is not a feature of fatty acid diarrhea ?

A	Reduced bile acid pool size
B	Steatorrhea
C	Responds to cholestyramine
D	Responds to low-fat diet

Question 7 Explanation:

Features of fatty acid diarrhea are extensive ileal disease, ileal bile acid absorption reduced, fecal bile acid excretion increased, fecal bile acid loss is not compensated by hepatic synthesis, bile acid pool size is reduced, steatorrhea (>20 grams) that does not respond to cholestyramine but responds to a low-fat diet.

Question 8

Which of the following type of fatty acids compose dietary fats ?

A	Long-chain fatty acids (LCFAs)
B	Medium-chain fatty acids (MCFAs)
C	Short-chain fatty acids (SCFAs)
D	All of the above

Question 8 Explanation:

Three types of fatty acids compose fats: long-chain fatty acids (LCFAs), medium-chain fatty acids (MCFAs), and short-chain fatty acids (SCFAs).

Question 9

Dietary fat is in the form of ?

A	Long-chain triglycerides (LCTs)
B	Medium-chain fatty acids (MCFAs)
C	Short-chain fatty acids (SCFAs)
D	All of the above

Question 9 Explanation:

Dietary fat is exclusively composed of long-chain triglycerides (LCTs), i.e., glycerol that is bound via ester-linkages to three LCFAs.

Question 10

Majority of dietary long chain fatty acids (LCFAs) have carbon chain lengths of ?

A	6 - 8
B	8 - 10
C	10 - 12
D	> 12

Question 10 Explanation:

3 types of fatty acids compose fats - long chain fatty acids (LCFAs), medium-chain fatty acids (MCFAs) & short-chain fatty acids (SCFAs). Majority of dietary LCFAs have carbon chain lengths of 16 or 18.

Question 11

Dietary MCFAs have carbon chain lengths of ?

A	6 - 8
B	8 - 12
C	12 - 16
D	16 - 20

Question 11 Explanation:

Medium-chain triglycerides (MCTs) or medium-chain fatty acids, composed of fatty acids with carbon chain lengths of 8 to 10, are present in large amounts in coconut oil

Question 12

Steatorrhea results due to defect in which phase of dietary lipid assimilation ?

A	Intraluminal or digestive phase
B	Mucosal or absorptive phase
C	Delivery or postabsorptive phase
D	Any of the above

Question 12 Explanation:

Assimilation of dietary lipid occurs in intraluminal or digestive phase, mucosal or absorptive phase and delivery or postabsorptive phase. An abnormality at any site of this process can cause steatorrhea.

Question 13

“Micellar formation” belongs to which phase of dietary lipid assimilation ?

A	Intraluminal or digestive phase
B	Mucosal or absorptive phase
C	Delivery or postabsorptive phase
D	Any of the above

Question 13 Explanation:

The digestive phase has two components, lipolysis and micellar formation.

Question 14

Lipolysis is initiated in ?

A	Stomach
B	Duodenum
C	Jejunum
D	Iliem

Question 15

In lipolysis, hydrolysis of triglycerides by lipase leads to the formation of ?

A	Free fatty acids
B	Monoglycerides
C	Glycerol
D	All of the above

Question 15 Explanation:

Lipolysis i.e. hydrolysis of Tg to free fatty acids, monoglycerides & glycerol by lipase is “initiated” in stomach by gastric lipase. ~20 - 30% of total lipolysis occurs in stomach

Question 16

Pancreatic lipolysis is greatly enhanced by ?

A	Gastric lipase
B	Pancreatic lipase
C	Colipase
D	All of the above

Question 16 Explanation:

Pancreatic lipolysis is greatly enhanced by the presence of pancreatic enzyme, colipase, which facilitates the movement of lipase to triglyceride

Question 17

Normal lipolysis can be maintained by what percentage of maximal pancreatic lipase secretion ?

A	5 %
B	15 %
C	25 %
D	35 %

Question 17 Explanation:

Normal lipolysis can be maintained by ~5% of maximal pancreatic lipase secretion.

Question 18

Pancreatic lipase is inactivated at ?

A	pH < 7
B	pH < 7.5
C	pH < 8
D	pH < 8.5

Question 18 Explanation:

Lipolysis is completed in the duodenum and jejunum by pancreatic lipase, which is inactivated by pH <7.0 leading to altered lipolysis.

Question 19

Mixed micelles are molecular aggregates composed of all except ?

A	Fatty acids
B	Triglycerides
C	Cholesterol
D	Conjugated bile acids

Question 19 Explanation:

Mixed micelles are molecular aggregates composed of fatty acids, monoglycerides, phospholipids, cholesterol, and conjugated bile acids

Question 20

Which of the following relates best with absorptive phase of lipid digestion-absorption ?

A	Micellar formation
B	Uptake and reesterification
C	Formation of chylomicrons
D	Colonic bacterial enzymes

Question 20 Explanation:

Uptake and reesterification constitute the absorptive phase of lipid digestion-absorption.

Question 21

In which form lipids exit from intestinal epithelial cell ?

A	Free fatty acids
B	Reesterified triglyceride
C	Cholesterol
D	Monoglyceride

Question 21 Explanation:

Fatty acids and monoglycerides are reesterified by a series of enzymatic steps in the endoplasmic reticulum to form triglycerides, the form in which lipid exits from the intestinal epithelial cell. Reesterified triglycerides require formation of chylomicrons for their exit from small-intestinal epithelial cell & their delivery to liver via lymphatics

Question 22

Chylomicrons are composed of ?

A	α-lipoprotein
B	β-lipoprotein
C	δ-lipoprotein
D	γ-lipoprotein

Question 23

Chylomicrons contain ?

A	Triglyceride
B	Cholesterol and Cholesterol ester
C	Phospholipid
D	All of the above

Question 24

Reesterified triglyceride exit from intestinal epithelial cell into ?

A	Lymphatics
B	Portal vein
C	Systemic vein
D	All of the above

Question 24 Explanation:

Chylomicrons are composed of beta-lipoprotein and contain triglycerides, cholesterol, cholesterol esters, and phospholipids and enter the lymphatics, not the portal vein

Question 25

In abetalipoproteinemia, the defect is in ?

A	Lipolysis
B	Micelle formation
C	Lipid uptake
D	Reesterified triglyceride exit from epithelial cell

Question 25 Explanation:

Abetalipoproteinemia, or acanthocytosis is a disorder of impaired synthesis of beta-lipoprotein. Lipolysis, micelle formation, and lipid uptake are all normal in patients, but reesterified triglyceride cannot exit from intestinal epithelial cell because of the failure to produce chylomicrons

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See all quizzes of Peptic Ulcer Disease at here:

1,How many times bile acid pool is circulated via enterohepatic
circulation ?
A. 2 to 4 times / day
B. 4 to 6 times / day
C. 6 to 8 times / day
D. 8 to 12 times / day

2. Daily bile acids excretion in stool (fecal loss) equals ?
A. Half of total fat intake
B. Half of enterohepatic circulation
C. Hepatic bile acid synthesis
D. None of the above

3.Small ileal dysfunction leads to ?
A. Bile acid diarrhea
B. Fatty acid diarrhea
C. Chloride diarrhea
D. Protein diarrhea

4. Large ileal dysfunction leads to ?
A. Bile acid diarrhea
B. Fatty acid diarrhea
C. Carbohydrate diarrhea
D. Protein diarrhea

5.Reabsorption defect in enterohepatic circulation of bile acids
is due to ?
A. Cirrhosis
B. Primary biliary cirrhosis
C. Jejunal diverticulosis
D. Crohn’s disease

6. Which of the following is not a feature of bile acid diarrhea ?
A. Normal bile acid pool size
B. None or mild steatorrhea
C. Responds to cholestyramine
D. Responds to low-fat diet

7. Which of the following is not a feature of fatty acid diarrhea ?
A. Reduced bile acid pool size
B. Steatorrhea
C. Responds to cholestyramine
D. Responds to low-fat diet

8. Which of the following type of fatty acids compose dietary fats ?
A. Long-chain fatty acids (LCFAs)
B. Medium-chain fatty acids (MCFAs)

C. Short-chain fatty acids (SCFAs)
D. All of the above
.
9. Dietary fat is in the form of ?
A. Long-chain triglycerides (LCTs)
B. Medium-chain fatty acids (MCFAs)
C. Short-chain fatty acids (SCFAs)
D. All of the above

10. Majority of dietary long chain fatty acids (LCFAs) have carbon
chain lengths of ?
A. 6 – 8
B. 8 – 10
C. 10 – 12
D. > 12

11. Dietary MCFAs have carbon chain lengths of ?
A. 6 – 8
B. 8 – 12
C. 12 – 16
D. 16 – 20

12. Steatorrhea results due to defect in which phase of dietary
lipid assimilation ?
A. Intraluminal or digestive phase
B. Mucosal or absorptive phase
C. Delivery or postabsorptive phase
D. Any of the above

13.“Micellar formation” belongs to which phase of dietary lipid
assimilation ?
A. Intraluminal or digestive phase
B. Mucosal or absorptive phase
C. Delivery or postabsorptive phase
D. Any of the above

14.Lipolysis is initiated in ?
A. Stomach

B. Duodenum
C. Jejunum
D. Iliem
15. In lipolysis, hydrolysis of triglycerides by lipase leads to the
formation of ?
A. Free fatty acids
B. Monoglycerides
C. Glycerol
D. All of the above

16. Pancreatic lipolysis is greatly enhanced by ?
A. Gastric lipase
B. Pancreatic lipase
C. Colipase
D. All of the above

17. Normal lipolysis can be maintained by what percentage of
maximal pancreatic lipase secretion ?
A. 5 %
B. 15 %
C. 25 %
D. 35 %

18. Pancreatic lipase is inactivated at ?
A. pH < 7
B. pH < 7.5
C. pH < 8
D. pH < 8.5

19. Mixed micelles are molecular aggregates composed of all except ?
A. Fatty acids
B. Triglycerides
C. Cholesterol
D. Conjugated bile acids

20. Which of the following relates best with absorptive phase of
lipid digestion-absorption ?
A. Micellar formation
B. Uptake and reesterification
C. Formation of chylomicrons

D. Colonic bacterial enzymes

21. In which form lipids exit from intestinal epithelial cell ?
A. Free fatty acids
B. Reesterified triglyceride
C. Cholesterol
D. Monoglyceride

22. Chylomicrons are composed of ?
A. -lipoprotein
B. -lipoprotein
C. -lipoprotein
D. -lipoprotein
23. Chylomicrons contain ?
A. Triglyceride
B. Cholesterol and Cholesterol ester
C. Phospholipid
D. All of the above
24.Reesterified triglyceride exit from intestinal epithelial cell into ?
A. Lymphatics
B. Portal vein
C. Systemic vein
D. All of the above

25. In abetalipoproteinemia, the defect is in ?
A. Lipolysis
B. Micelle formation
C. Lipid uptake
D. Reesterified triglyceride exit from epithelial cell

Disorders of Absorption

[MCQ] Disorders of Absorption- Part 2

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Disorders of Absorption- Part 2

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[MCQ] Disorders of Absorption- Part 3

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