Triglycerides are not miscible with water. This poses particular problems for their

digestion, which must take place in watery solutions in the small intestine. Bile salts in

bile play an important role in fat digestion.

1. Name the two major primary bile acids synthesised in the liver, and indicate what

they’re made from. (2 marks)

1. Explain the difference between a bile acid and a bile salt. Describe what is meant by

“conjugation” of bile acids and what the practical effect of this is on their action in

the gut. (2 marks)

1. Explain what co-lipase is and what its role in fat digestion is (2 marks)
2. Describe what is meant by the enterohepatic circulation (2 marks)
3. The therapeutic agent “cholestyramine” is a resin that almost irreversibly binds bile

salts in the gut lumen. This prevents them interacting with proteins including

transporters. Cholestyramine has two beneficial effects and one common

unpleasant side effect – explain how these relate to their ability to bind bile salts:

1. they reduce total body cholesterol levels
2. they reduce the itching that is associated with some types of liver disease or

damage

iii. he downside is that cholestyramine can cause constipation

(2 marks)

(10 marks)

A s a ilo r is s h ip w r e c k e d o n a d e s e r te d is la n d a fte r h is y a c h t s u n k in s tr o n g w in d s . H e has not had anything to drink for 2 days. State whether you think renin release would

increase or decrease after the 2 days without anything to drink and how this change in

renin release might act to compensate for the lack of fluids consumed by the sailor.

You will need to mention all the aspects by which a change in renin release could help the sailor survive.

(5 marks)

Describe the mechanism by which Na+ is reabsorbed from the tubular lumen into the

peritubular capillaries. In your answer you should mention (1) the location of the

Na+/K+ pump, (2) whether this pump is an energy requiring process, (3) the direction of

movement of Na+ across the basolateral membrane; whether water actively or

passively follows the movement of Na+, and whether movement of K+ across the

membrane between the tubular cell and tubular lumen is passive or active

(5 marks)

A fa m ily m e m b e r h a s c o n ta c te d y o u b e c a u s e th e y k n o w y o u a r e d o in g H u m a n

Physiology and can explain what the neonatologist has told them about the problems

their 14 day old son is experiencing. The information you are given is that the child has

a very low blood cortisol level and very high salt (Na+) concentration in their urine and will require lifelong medication for survival.

In your answer you will need to define the disorder that leads to these clinical results.

Also what is happening within the adrenal gland itself and what medication/s would be prescribed, and how they work to save the life of the child.

(10 marks)

Describe at the cellular level the process of fertilization and the cellular and DNA changes that occur in the first few days.

(10 marks)

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