😀 EASY

Test your knowledge of some basic facts about the large intestine, plus one or two trickier questions…

Reviewed by Lena Berger and Jonathan Loomes-Vrdoljak

Physiology and Pharmacology of the Large Intestine MCQs

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Question 1
Which of the following is not a function of the large bowel?
A
Absorption of B12
B
Extraction of cations from lumen
C
Storage of faeces
D
Mass movement of faeces to the rectum
Question 2
Which ion is primarily responsible for driving the reabsorption of water from the large intestine?
A
Sodium
B
Potassium
C
Calcium
D
Magnesium
Question 3
A patient with recurrent gallstones has developed a fistula between the gallbladder fundus and jejunum. On radiography, a clear large bowel is noted with largely distended small intestine.
Peristalsis has halted, causing dilation of the small intestine lumen. Which of the below sites is the most likely point of occlusion?
A
Terminal ileum
B
Meckel’s diverticulum
C
Vermiform appendix
D
Ileocaecal valve
Question 4
T/F - a patient having four mass movements a day is more than expected?
A
True
B
False
Question 4 Explanation: 
True - one to three mass movements daily are expected. But, with all things, deviation from the mean does not necessarily warrant a pathological correlate.
Question 5
Which of the following is not a step of the defaecation reflex?
A
Rectal relaxation
B
Relaxation of the ANS innervated sphincter
C
Initial contraction of the somatically innervated sphincter
D
Increased peristaltic activity in the sigmoid colon
Question 5 Explanation: 
The rectal mural (wall) surface must contract proximal to the faeces to assist in expulsion.
Question 6
Which of the following would negatively affect the Valsalva manoeuvre?
A
Hypertrophied rectus abdominis musculature
B
Increased intra-abdominal pressure at rest (eg gravid uterus)
C
Superior laryngeal nerve lesion
D
Aortopulmonary window malignancy
Question 6 Explanation: 
The left recurrent laryngeal nerve (RLN) loops under the aortic arch. The RLN innervates most muscles of the larynx, including those responsible for closing the vocal cords. An aortopulmonary window malignancy could impinge the left RLN, meaning the vocal cords can't close, limiting the body's ability to increase the abdominal pressure.
Question 7
Which of the following is responsible for the brown colour of faeces?
A
Urobilinogen
B
Stercobilin
C
Skatole
D
Indole
Question 7 Explanation: 
Urobilinogen is colourless, but can be oxidised to urobilin. This gives urine its yellow colour, and can contribute to the brown colour in faeces although this pigmentation is mainly from stercobilin.
Question 8
T/F - a patient with bowel movements of 2 per week is deemed clinically “constipated”?
A
True
B
False
Question 8 Explanation: 
Of course it is true!!! ≤3 per week is considered clinical constipation, from the latin “constipatio”, meaning “crowd together”.
Question 9
A cylindrical, smooth and soft textured faeces sample is where on the Bristol Stool Chart (BSC)?
A
Type 3
B
Type 4
C
Type 5
D
Type 6
Question 10
Which of the following is not a recognised as a pathophysiological cause of diarrhoea?
A
Motility
B
Secretory
C
Osmotic
D
Infective
E
Inflammatory
Question 10 Explanation: 
Infectious causes of diarrhoea can exert their effects through multiple mechanisms including inflammation or, in the case of cholera, through secretion (a bacterial toxin triggers the movement of chloride ions into the gut lumen, drawing water in).
Question 11
What is the first line treatment of diarrhoea?
A
Oral rehydration therapy
B
Antibiotics
C
Loperamide
D
Senna
Question 11 Explanation: 
Oral rehydration therapy is a solution of sugar and table salt in water. The glucose in the sugar facilitates the transport of sodium into the body, which helps to draw water with it, so the patient does not become dehydrated.
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