Bile pigments:
- A. Are derived from globin portion of hemoglobin.
- B. Help in fat digestion and absorption.
- C. Are conjugated in the liver mainly with sulphate.
- D. Their level increases in blood in liver disease.
Correct Answer: D
Rationale: The correct answer is D because bile pigments, such as bilirubin, increase in the blood in liver disease due to impaired liver function. Bilirubin is a waste product from the breakdown of red blood cells and is normally processed by the liver. Elevated levels of bile pigments in the blood are a common indicator of liver dysfunction.
Choice A is incorrect because bile pigments are derived from heme, not the globin portion of hemoglobin.
Choice B is incorrect because bile pigments aid in the emulsification of fats but do not directly help in fat digestion and absorption.
Choice C is incorrect as bile pigments are conjugated with glucuronic acid, not sulphate, in the liver.
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Which of the following is the most plausible explanation for the protective effect of dietary fibre against cancer of the colon?
- A. Propionic acid, formed during colonic fibre fermentation inhibits liver fatty acid synthesis
- B. Butyric acid, formed during colonic fibre fermentation stimulates 'silencing' of the SLC5A8 tumour suppressor gene
- C. None of these options are correct
- D. Butyric acid, formed during colonic fibre fermentation stimulates anti-oxidant defences in the colon
Correct Answer: D
Rationale: The correct answer is D because butyric acid, a short-chain fatty acid formed during colonic fiber fermentation, has been shown to stimulate antioxidant defenses in the colon. This helps protect against oxidative damage, a key factor in the development of cancer. Choice A is incorrect because propionic acid does not inhibit liver fatty acid synthesis in relation to colon cancer. Choice B is incorrect because butyric acid does not silence the SLC5A8 tumor suppressor gene; in fact, it has been shown to have anti-tumor effects. Choice C is incorrect as there is evidence supporting the protective effect of dietary fiber through butyric acid's stimulation of antioxidant defenses.
Once chylomicrons leave the simple columnar epithelium of the small intestine, they diffuse into
- A. capillaries.
- B. lacteals.
- C. arterioles.
- D. venules.
Correct Answer: B
Rationale: The correct answer is B: lacteals. Chylomicrons are too large to enter capillaries directly, so they are absorbed into lacteals, specialized lymphatic vessels in the small intestine. Lacteals transport chylomicrons to the lymphatic system, eventually reaching the bloodstream via the thoracic duct. Arterioles and venules are part of the blood circulation system and are not directly involved in chylomicron absorption.
Trypsinogen when activated by ______ will break down proteins in the ______.
- A. enterokinase; pancreatic ducts
- B. trypsin; small intestine
- C. secretin; pancreatic ducts
- D. enterokinase; small intestine
Correct Answer: D
Rationale: The correct answer is D: enterokinase; small intestine. Enterokinase is an enzyme that activates trypsinogen into trypsin in the small intestine. Trypsin is then responsible for breaking down proteins in the small intestine. Enterokinase is not found in the pancreatic ducts, eliminating choices A and C. Trypsinogen is not activated by itself, so choice B is incorrect. In summary, enterokinase activates trypsinogen into trypsin in the small intestine, allowing for protein digestion.
What is the role of the stomach in digestion?
- A. Mechanical digestion of food
- B. Chemical digestion of proteins
- C. Absorption of nutrients
- D. Neutralization of stomach acid
Correct Answer: B
Rationale: The correct answer is B: Chemical digestion of proteins. The stomach produces hydrochloric acid and enzymes like pepsin to break down proteins into peptides and amino acids. This process is essential for protein digestion. Mechanical digestion (A) occurs mainly in the mouth and intestines. Absorption of nutrients (C) primarily takes place in the small intestine. Neutralization of stomach acid (D) is not the primary role of the stomach; rather, the stomach maintains an acidic environment for digestion.
Which of the nurse's assigned patients should be referred to the dietitian for a complete nutritional assessment? (Select all that apply.)
- A. A 35-yr-old patient who reports intermittent nausea for the past 2 days
- B. A 48-yr-old patient with rheumatoid arthritis who takes prednisone daily
- C. A 23-yr-old patient who has a history of fluctuating weight gains and losses
- D. A 64-yr-old patient who is admitted for debridement of an infected surgical wound
Correct Answer: A
Rationale: The correct answer is A. This patient reporting intermittent nausea may have altered nutritional intake, which warrants a referral to the dietitian for a complete nutritional assessment. Nausea can affect food intake and nutrient absorption, potentially leading to malnutrition. Options B, C, and D do not directly indicate a need for a dietitian referral based on the information provided. The patient with rheumatoid arthritis taking prednisone may benefit from dietary interventions, but the information provided does not specify any nutritional concerns. The patient with fluctuating weight gains and losses may have nutritional issues, but further details are needed to justify a dietitian referral. The patient admitted for debridement of an infected wound may have increased nutritional needs due to wound healing, but this alone does not warrant a dietitian referral without additional information on the patient's nutritional status.