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Questions 1 - 10
1

What enzyme, present in saliva, initiates the digestion of carbohydrates?

Amylase

Lipase

Pepsin

Protease

Explanation

The digestion of dietary carbohydrates is initiated by amylase, an enzyme present in saliva. This enzyme breaks down long carbohydrate molecules into shorter units such as disaccharides. Lipase breaks down fats and is not present in the saliva, rather it is secreted by the pancreas into the duodenum. Pepsin is a protease - an enzyme that breaks down proteins. This enzyme is secreted by the chief cells of the stomach in its zymogen form (pepsinogen). It is activated by the product of the parietal cells (hydrochloric acid). Note that amylase is also secreted by the pancreas to complete the chemical digestion of carbohydrates into monosaccharides so that they can be absorbed by the brush border of the small intestine.

2

Where does lipid digestion begin?

The duodenum

The ileum

The stomach

The jejunum

Explanation

While a small amount of fat digestion may occur in the mouth via the action of lingual lipase, the majority of lipid digestions begins in the duodenum. The presence of fat in the small intestine triggers release of pancreatic lipase, which enters the duodenum via the pancreatic duct. Fat digestion does not occur in the stomach.

3

What enzyme, present in saliva, initiates the digestion of carbohydrates?

Amylase

Lipase

Pepsin

Protease

Explanation

The digestion of dietary carbohydrates is initiated by amylase, an enzyme present in saliva. This enzyme breaks down long carbohydrate molecules into shorter units such as disaccharides. Lipase breaks down fats and is not present in the saliva, rather it is secreted by the pancreas into the duodenum. Pepsin is a protease - an enzyme that breaks down proteins. This enzyme is secreted by the chief cells of the stomach in its zymogen form (pepsinogen). It is activated by the product of the parietal cells (hydrochloric acid). Note that amylase is also secreted by the pancreas to complete the chemical digestion of carbohydrates into monosaccharides so that they can be absorbed by the brush border of the small intestine.

4

Where does lipid digestion begin?

The duodenum

The ileum

The stomach

The jejunum

Explanation

While a small amount of fat digestion may occur in the mouth via the action of lingual lipase, the majority of lipid digestions begins in the duodenum. The presence of fat in the small intestine triggers release of pancreatic lipase, which enters the duodenum via the pancreatic duct. Fat digestion does not occur in the stomach.

5

Which of the following foods would be unsafe to consume for a patient taking atorvastatin?

Grapefruit

Dark leafy greens

Fish

Orange juice

Explanation

Grapefruit can decrease the activity of cytochrome P450, one of the body's most important detoxification pathways, by as much as 30%. Consumption of grapefruit while on certain medications, including atorvastatin, can lead to toxic levels of the drug. All other foods listed are safe for patients to consume while taking atorvastatin.

6

Which of the following foods would be unsafe to consume for a patient taking atorvastatin?

Grapefruit

Dark leafy greens

Fish

Orange juice

Explanation

Grapefruit can decrease the activity of cytochrome P450, one of the body's most important detoxification pathways, by as much as 30%. Consumption of grapefruit while on certain medications, including atorvastatin, can lead to toxic levels of the drug. All other foods listed are safe for patients to consume while taking atorvastatin.

7

99% of glucose and amino acids are resorbed in what part of the nephron?

The proximal tubule

The distal tubule

The glomerulus

The loop of Henle

Explanation

99% of glucose and amino acids are resorbed by the proximal tubule of the nephron. The loop of Henle and the distal tubule primarily resorb electrolytes and water, while the glomerulus is strictly for filtration and does not resorb solutes.

8

99% of glucose and amino acids are resorbed in what part of the nephron?

The proximal tubule

The distal tubule

The glomerulus

The loop of Henle

Explanation

99% of glucose and amino acids are resorbed by the proximal tubule of the nephron. The loop of Henle and the distal tubule primarily resorb electrolytes and water, while the glomerulus is strictly for filtration and does not resorb solutes.

9

A nurse is performing a urine dip on a patient with edema. The dip stick shows 1+ protein. The patient is not sure if this is a normal finding or not. How should they be counseled?

No amount of protein in the urine is normal

Any urinary protein under 3+ is considered normal

Any urinary protein under 2+ is considered normal

Protein in the urine is a healthy sign of proper excretion

Explanation

No amount of protein in the urine is considered normal. The capillaries of the glomerulus are covered in a thin layer of cells called podocytes. These podocytes form a very tight filtration system that, when healthy, prevent all large molecules such as proteins from passing out of the glomerulus and into the Bowman's capsule, while allowing the passage of water, electrolytes, and smaller molecules such as glucose and amino acids.

10

A nurse is performing a urine dip on a patient with edema. The dip stick shows 1+ protein. The patient is not sure if this is a normal finding or not. How should they be counseled?

No amount of protein in the urine is normal

Any urinary protein under 3+ is considered normal

Any urinary protein under 2+ is considered normal

Protein in the urine is a healthy sign of proper excretion

Explanation

No amount of protein in the urine is considered normal. The capillaries of the glomerulus are covered in a thin layer of cells called podocytes. These podocytes form a very tight filtration system that, when healthy, prevent all large molecules such as proteins from passing out of the glomerulus and into the Bowman's capsule, while allowing the passage of water, electrolytes, and smaller molecules such as glucose and amino acids.

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