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.

A) The sympathetic nervous system

B) The parasympathetic nervous system

C) The enteric nervous system

D) The central nervous system

E) The gastroesophageal sphincter

F) The pyloric sphincter

G) Water reabsorption by the small intestine

H) Water reabsorption by the large intestine

I) Absorption of chyme through the stomach lining

J) 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.

A) Measure Gastrin content of chyme in the duodenum

B) Measure fat content of chyme in the duodenum

C) Measure pH of chyme in the duodenum

D) Measure protein content of chyme in the duodenum

E) Determine if the patient is experiencing abnormally high stress levels

F) Measure activity of the vagus nerve

G) Measure water content in the patient’s faeces

H) 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)?

A) High acid content in the stomach is slowing gastric motility, thus slowing the release of contents into the duodenum.

B) High acid content in the stomach is slowing protein digestion, which excites the pyloric sphincter and decreases the rate of gastric emptying.

C) High acid content in the duodenum is slowing gastric emptying by contracting the pyloric sphincter.

D) 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)?

A) Increased levels of gastrin being released from G cells.

B) Decreased levels of gastrin being released from G cells.

C) Increased levels of histamine being released from ECL cells

D) Decreased levels of histamine being released from ECL cells.

E) Increased levels of somatostatin being released from D cells.

F) Decreased levels of somatostatin being released from D cells

G) Inhibition of the H+/K+ pump in parietal cells.

H) Excess secretin release from the small intestine

I) Inhibition of cholecystokinin release from the small intestine

J) Excess cholecystokinin release from the small intestine

K) Blockage of pancreatic exocrine ducts

L) Blockage of gallblaIDer 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)

A) Increased levels of gastrin being released from G cells.

B) Decreased levels of gastrin being released from G cells.

C) Increased levels of histamine being released from ECL cells

D) Decreased levels of histamine being released from ECL cells.

E) Increased levels of somatostatin being released from D cells.

F) Decreased levels of somatostatin being released from D cells

G) Inhibition of the H+/K+ pump in parietal cells.

H) Excess secretin release from the small intestine

I) Inhibition of cholecystokinin release from the small intestine

J) Excess cholecystokinin release from the small intestine

K) Blockage of pancreatic exocrine ducts

L) Blockage of gallblaIDer exocrine ducts