D2 Short answer questions

1a. [1 mark]
The graph shows the relationship between gastrointestinal (GI) damage and gastric acidity in 37
healthy human volunteers.

[Source: Republished with permission of Elsevier Science and Technology Journals, from ‘Integrated
gastric acidity can predict the prevention of naproxen-induced gastroduodenal pathology in normal
subjects’, John Plachetka, Gaetano Morelli, Carolyn Hines, Julie Borland, Alison Lyke, Diane
Littlefield, Jerry D. Gardner Gastroenterology, Vol. 124, Issue 4, 2003; permission conveyed through
Copyright Clearance Center, Inc.]
State the relationship between gastric acidity and GI damage.

1b. [3 marks]
GI damage can include ulcers. Outline the treatment of stomach ulcers.

1c. [1 mark]
Other than gastric acidity, state a primary cause of stomach ulcers.

2a. [2 marks]
State two roles of hydrochloric acid in gastric juice.
Role 1:
Role 2:

2b. [3 marks]
Pancreatic juice is secreted into the pancreatic duct which carries these secretions to the small
intestine.
The hormone secretin is released by the small intestine when hydrochloric acid enters it from the
stomach. The data below show the volume of pancreatic juice released after an injection of secretin.

Pancreatic secretions contain sodium hydrogen carbonate, making them basic.
Deduce the significance of the response by the pancreas to secretin.

2c. [1 mark]
State one cause of stomach ulcers.

3a. [2 marks]
The diagram shows a cell in the lining of the stomach.

Outline the importance of the proton pumps in the digestion of foods.

3b. [3 marks]
Explain the use of proton pump inhibitors to treat patients complaining of stomach pain.

4. [1 mark]
Cells on the surface of intestinal villi have microvilli, which provide a large surface area for
absorption. State another structural characteristic of these villus cells that adapts them to the
absorption of nutrients.

5a. [2 marks]
Outline the main changes in the lungs that occur in patients with emphysema.

5b. [1 mark]
State a treatment for emphysema.


5c. [1 mark]
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The graph below shows the oxygen dissociation curve at a low CO2 concentration.

An increase in metabolic activity results in greater release of CO2 into the blood. On the graph, draw
the oxygen dissociation curve during intense exercise when the CO2 concentration of the blood is
high.

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5d. [2 marks]
Explain how the increase in CO2 concentration affects the release of oxygen to respiring cells.

6. [3 marks]
Outline how infection by Vibrio cholerae can lead to dehydration.

7a. [2 marks]
Outline the importance of acid conditions in the stomach.

7b. [1 mark]
Suggest one reason for a correlation between a low-fibre diet and a higher incidence of
gastrointestinal problems.

8a. [1 mark]
The graph shows the length of time that the content of a meal takes to pass through the gut as a
function of digestible matter content. The more digestible matter present in the meal, the lower the
dietary fibre content.

Estimate the mean residence time of a meal with 50 % digestible matter.

8b. [3 marks]
Explain the relationship between percentage of digestible matter and mean residence time.

9a. [1 mark]
State one mechanism the ileum uses to absorb digested food into the bloodstream.

9b. [1 mark]
State the role of the hepatic portal vein.

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9c. [1 mark]

Label the line that represents the ventricle.

9d. [1 mark]
Estimate the total time the atrioventricular valves are open.

9e. [1 mark]
Although some CO2 entering the blood simply dissolves in the plasma, most enters the erythrocytes
(red blood cells).
Outline how CO2 interacts with hemoglobin once it enters erythrocytes.
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10. [2 marks]
The electron micrograph shows the epithelial cells of the villus.

Identify the parts labelled I and II.
I: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
II: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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11a. [1 mark]
Elderly people lose bone mineral density (BMD) with age, and this is the source of many health
issues, including higher risk of bone fractures. Researchers measured the change in BMD amongst
elderly men considering many factors, over a period of four years. The results presented below
show the difference between bone density change due solely to vitamin C intake and bone density
loss considering a combination of the other factors represented by the baseline (zero). BMD was
measured in the spine and at two femur (thigh bone) locations (femoral neck and trochanter) using
scanner images. Daily intake of total vitamin C was categorized as high, medium or low.

Outline the effect of vitamin C intake on changes in bone density in the spine.

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11b. [2 marks]
Compare the changes in bone density of the femoral neck with those of the spine.

11c. [2 marks]
Evaluate the evidence provided by the data that the intake of vitamin C supplements may reduce
bone density loss in elderly people.

12a. [2 marks]
Distinguish between the mode of action of steroid and peptide hormones.

12b. [2 marks]
Outline the control of gastric juice secretion.

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13a. [3 marks]
Outline the importance of fibre as a component of a balanced diet.

13b. [1 mark]
Distinguish between minerals and vitamins.

14a. [2 marks]
List two possible variants in the molecular structure of unsaturated fatty acids.

14b. [1 mark]
State one reason to include fibre in the diet.

14c. [3 marks]
Describe the health consequences of a diet rich in proteins.

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15a. [2 marks]
In healthy adults, there are heart sounds during the cardiac cycle. Outline the causes of two of these
sounds.

15b. [2 marks]
State two products resulting from the breakdown of erythrocytes (red blood cells) in the liver.
1. ..................................................................

2. ..................................................................
15c. [3 marks]
Compare gastric juice and pancreatic juice.

15d. [1 mark]
List one material that is egested after human digestion.

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16a. [1 mark]
State one example of a steroid hormone.

16b. [1 mark]
State one example of a hormone that is a tyrosine derivative.

16c. [2 marks]
Outline the hormonal control of digestive juice secretion in the stomach.

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16d. [3 marks]
Outline how exercise causes an increase in the ventilation rate.

17a. [2 marks]
The diagram below shows a section through the ileum.

Outline two important structural features of cell X.

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17b. [2 marks]
Explain the role of bile in lipid digestion.

17c. [3 marks]
Explain why trypsin is initially synthesized as an inactive precursor and how it is activated.

18a. [1 mark]
Helicobacter pylori infection is a cause of stomach ulcers. It affects SLC26A9, which is a membrane
protein present in the epithelial lining of the stomach. SLC26A9 takes part in the reversible
transport of chloride and hydrogen carbonate ions into and out of the epithelial cells in order to
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raise the pH at the membrane to neutral levels. Entry of chloride ions into epithelial cells and
removal of hydrogen carbonate ions both cause extracellular pH to increase.
To assess the function of SLC26A9, this process was reversed by artificially raising the external pH.
The rate of change of extracellular pH was measured with normal epithelial cells and with modified
cells with extra SLC26A9. The tests were also performed in the presence of DIDS, an inhibitor of
SLC26A9.

Calculate the difference in the rate of decrease of pH between the control cells and the modified
cells without DIDS.
.................. pH min–1


18b. [1 mark]
State the effect of DIDS on the rate of decrease of the extracellular pH.

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18c. [2 marks]
Scientists hypothesized that Helicobacter pylori alters the ability to maintain neutral pH at the
epithelial cell surface by inhibition of SLC26A9. Evaluate this hypothesis.

18d. [1 mark]
In further experiments, scientists observed that the levels of mRNA of SLC26A9 increased in
epithelial cells when infected by Helicobacter pylori. Suggest a possible explanation for this increase.

18e. [2 marks]
Predict, with a reason, the effect of DIDS on stomach pH if given to an experimental subject.

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19a. [3 marks]
Label the section of healthy liver tissue below.

I.
II.
III.
19b. [2 marks]
Outline two roles of the liver.

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19c. [1 mark]
List two materials that are not absorbed but are egested by the body.

19d. [1 mark]
State an example of a protein hormone.

20a. [1 mark]
Define hormones.

20b. [1 mark]
State one type of hormone, giving an example.

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20c. [3 marks]
Compare gastric juice and pancreatic juice.

20d. [2 marks]
Outline the reason for one named substance found in food not being digested and absorbed by
humans.

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21a. [2 marks]
Helicobacter pylori is able to live inside the stomach wall of humans. This bacterium can cause
inflammation of the stomach wall (gastritis). There may be a link between H. pylori and the
development of stomach cancer.
The graph below shows the blood levels of antibodies resulting from H. pylori infection for a control
group without stomach cancer and a group with stomach cancer. The solid lines show the median
concentrations for the control group and the group with stomach cancer. Antibody concentrations
above 10 μg ml–1 indicate that there has been infection with H. pylori.

47 % of the control group had been infected with H. pylori. Calculate the percentage of the group
with stomach cancer that had been infected. Show your working.

21b. [3 marks]
Using all of the data, evaluate the hypothesis that H. pylori causes stomach cancer.

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21c. [2 marks]
A study in gerbils indicated that infection with H. pylori leads to a decrease in the secretion of
hydrochloric acid. Discuss the consequences of this finding for the digestion of proteins in the
stomach in humans.

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22a. [2 marks]
The electron micrograph below shows cells from the intestine.

In the electron micrograph above, state the name of the
(i) structure labelled X.
(ii) type of cells labelled Y.
22b. [2 marks]
Define hormone.

22c. [3 marks]
Outline the circulation of blood through liver tissue.

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