The primary function of the stomach is

Question 1 of 5

The primary function of the stomach is:

A. to break down fats. B. to store food, churn, begin digestion C. to absorb major nutrients D. to package feces

Correct Answer: B

Rationale: The stomach stores food, mechanically churns it, and begins protein digestion with enzymes like pepsin, making B the correct answer.

Question 2 of 5

Which of the following statements relating to asthma is most accurate?

A. A long-acting beta2-agonist should be offered to a patient with newly-diagnosed mild intermittent asthma B. Asthma is associated with breathlessness accompanied by a chronic productive cough C. Asthma is associated with breathlessness particularly on lying flat D. Reversibility of <10% in FEV1 is consistent with a diagnosis of asthma

Correct Answer: C

Rationale: Asthma can cause breathlessness worse when lying flat due to airway obstruction, making C the most accurate statement.

Question 3 of 5

Which of the following would confirm the diagnosis of diabetes in a patient with symptoms of hyperglycaemia?

A. A fasting plasma blood glucose>=7.0 mmol/l B. A venous plasma blood glucose>=7.0 mmol/l at 2 hours after an oral glucose tolerance test C. An HbA1c >6.5% D. Two random venous plasma blood glucose levels >=6.0 mmol/l

Correct Answer: A

Rationale: Fasting plasma glucose>=7.0 mmol/l with symptoms confirms diabetes per WHO criteria, making A the correct answer.

Question 4 of 5

A 50-year-old man is admitted to A&E with severe, tearing central chest pain radiating into his back. On examination, he has a high BP with variability between both arms. An ECG shows T-wave inversions in the inferior leads. What should be the next step in the management of the patient?

A. Blood cultures should be taken and patient be started on broad spectrum antibiotics for bacterial endocarditis B. Measures need to be taken to lower the blood pressure and an urgent CT angiogram needs to be booked to look for aortic dissection C. Patient should be given anti-platelet therapy and low molecular weight heparin and treated for acute coronary syndrome D. Patient should be started on NSAIDs for pericarditis and an echocardiogram should be booked

Correct Answer: B

Rationale: Symptoms suggest aortic dissection (tearing pain, BP variability); urgent BP control and CT angiogram are critical, making B the correct answer.

Question 5 of 5

A 36-year-old woman complains of reflux symptoms and intermittent diarrhea. The diagnosis of gastrinoma is suspected so a fasting serum gastrin is obtained and found to be 280 pg/mL (normal <115 pg/mL). An abdominal CT is negative. What would you do now?

A. Refer her for an exploratory laparotomy B. Measure serum gastrin in response to secretin infusion C. Treat her for H. pylori D. Measure gastric acid secretion

Correct Answer: D

Rationale: Although the fasting serum gastrin is elevated, this finding alone is insufficient for establishing the diagnosis of gastrinoma. The serum gastrin can be elevated in other conditions, most notably recent therapy with proton-pump inhibitors or H2 antagonists and gastric achlorhydria. In fact, the serum gastrin has been reported to be elevated over 1000 pg/mL in patients with pernicious anemia. Thus, a measurement of basal acid output is required. If the gastric pH is less than 2, the diagnosis of gastrinoma is highly suspicious, and a serum secretin test should be performed. Secretin 2 IU/kg is given over 2 minutes and measurements of the serum gastrin are obtained 2.5, 5, 10, 15, and 30 minutes after infusion. A paradoxical increase in the serum gastrin of greater than 200 pg/mL is diagnostic of Z-E syndrome.

The primary function of the stomach is:

Nurselytic

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