Alterations in Digestive Function

Paralytic ileus often occurs after: gastroesophageal reflux resolves. abdominal surgery. pregnancy. vomiting.

abdominal surgery. Correct Paralytic ileus is a functional bowel obstruction caused by failure of motility and often occurs after abdominal surgery.

The most common cause of liver cirrhosis are hepatitis C and: alcoholism. cocaine abuse. overdose of antibiotic medications. liver cancer.

alcoholism. Correct High alcohol consumption causes liver injury and inflammation resulting in fibrosis and scarring of the liver.

Symptoms of hepatic encephalopathy are caused by increased serum levels of: ammonia. potassium. urea. creatinine.

ammonia. Correct When the liver is severely injured, hepatocytes are unable to convert ammonia to urea. The result is toxic accumulation of ammonia in the blood, a condition known as hepatic encephalopathy.

Which of the following nutritional disorders is characterized by lack of desire to eat, despite physiololgic stimuli that produce hunger? Obesity Anorexia nervosa Bulimia nervosa Kwashiorkor

Anorexia nervosa Correct Anorexia nervosa is a typical behavior of anorexia nervosa.

Which of the following symptoms is most specific to colon cancer? Nausea and jaundice Abdominal pain and hematochezia Epigastric pain and vomiting Heartburn and dysphagia

Abdominal pain and hematochezia Correct Abdominal pain and hematochezia, along with weight loss, changes in bowel movements, and bowel obstruction, are symptoms of colon cancer.

Individuals with chronic gastritis are at risk for developing which of the following problems? Gastric cancer Pernicious anemia Gastrointestinal bleeding All of the above

All of the above Correct Chronic damage to the stomach mucosa can cause cellular changes that lead to gastric cancer most commonly associated wth H. pylori, pernicioius anemia develops from a decreased B12 absorption from intrinsic factor loss, and gastrointestinal bleeding results from mucosal erosion

Which of the following conditions can cause dysphagia? Hiatal hernia Achalasia Gastroesophageal reflux All of the above

All of the above Correct Dysphagia, or difficulty swallowing, can be caused by hiatal hernia, achalasia, or gastroesophageal reflux

Which of the following risk factors increases a person's chance of developing esophageal cancer? Smoking Alcohol Gastroesophageal reflux All of the above

All of the above Correct Smoking, alcohol, and gastroesophageal reflux leading to Barrett esophagus all increase the risk of developing esophageal cancer, which has very poor survival rates

Which of the following factors are known causes of ulcerative colitis? Genetic predisposition Autoimmune injury Inflammation All of the above

All of the above Correct Ulcerative colitis often runs in families. Symptoms are related to autoimmune injury to the mucosal lining and the resulting inflammation.

Which of the following statements explains why portal hypertension leads to ascites? Hepatosplenomegaly develops. Backup of blood in the intra-abdominal veins occurs. Esophageal varices form in the lower esophagus. Hemorrhoids can bleed.

Backup of blood in the intra-abdominal veins occurs. Correct In portal hypertension, the backup of blood in the mesenteric veins causes an increase in capillary hydrostatic pressures and the leakage of fluid into the peritoneal cavity, which is called ascites.

Which of the following disorders is characterized by night blindness, osteopathy, and clotting disorders? Post-gastrectomy syndrome Gluten-sensitive enteropathy Bile salt deficiency Lactase deficiency

Bile salt deficiency Correct Night blindness, osteopathy, and clotting disorders are caused by bile salt deficiency and the resulting malabsorption of fat-soluble vitamins A, D, and K.

Which type of ulcer is a stress ulcer that is associated with burn injuries? Addison Cushing Curling Retroperitoneal

Curling Correct Curling ulcers are stress ulcers that occur after severe burn injuries.

Which of the following is a common cause of acute mesenteric (vascular) insufficiency? Emboli Atherosclerosis Ileus Congestive heart failure

Emboli Correct A cause of acute mesenteric insufficiency is obstruction of one of the mesenteric arteries by an embolus.

. How does a chronic infection with H. pylori lead to duodenal ulcers? Chronic inflammation inhibits the proton pumps in the gastric lining. Presence of bacteria in the stomach causes the pyloric sphincter to open prematurely, releasing acid into the duodenum. H. pylori inhibits prostaglandins, leading to decreased mucus production. H. pylori produces substances that are toxic to the duodenal mucosa.

H. pylori produces substances that are toxic to the duodenal mucosa. Correct H. pylori bacteria produce ammonia and enzymes that can damage the duodenal mucosa.

Which of the following types of hepatitis is acquired from ingesting contaminated food and manifests acutely with fever, abdominal pain, and jaundice but does not usually result in fulminant liver failure? Hepatitis A Hepatitis B Hepatitis C All of the above

Hepatitis A Correct Hepatitis A is acquired from ingesting contaminated food and manifests acutely with fever, abdominal pain, and jaundice. Individuals with hepatitis A generally make a full recovery.

Jaundice related to biliary duct obstruction is manifested by which of the following laboratory alterations? Decreased unconjugated bilirubin Increased unconjugated bilirubin Decreased conjugated bilirubin Increased conjugated bilirubin

Increased conjugated bilirubin Correct In cases of bile duct obstruction, the liver conjugates bilirubin but is unable to secrete it into the bile that is backed up. The conjugated bile seeps back into the plasma and deposits in the skin and other surface tissues, causing jaundice.

Which of the following conditions is a complication of gastrointestinal bleeding? Iron deficiency anemia Polyps Hypertension Ascites

Iron deficiency anemia Correct Blood loss in gastrointestinal bleeding can result in an iron deficiency as a result of the loss of iron in the hemoglobin.

Complications associated with GERD include which of the following? Esophageal ulcerations Esophageal cancer Esophageal strictures All of the above

Low fiber intake Correct A diet high in fiber can reduce the risk of diverticulosis. Diverticula form when there is not enough stool bulk, which is related to a diet high in refined foods.

Which of the following symptoms is associated with hepatic encephalopathy? Ascites, bleeding disorders, and immunosuppression Peripheral edema, dyspnea, and weight gain Decreased urinary output, increased serum creatinine, and elevated liver enzymes Memory loss and confusion, progressing to coma

Memory loss and confusion, progressing to coma Correct Hepatic encephalopathy results in abnormal neurotransmitter function and neuronal injury. Manifestations include altered sleep-wake cycles, mental status changes such as memory loss and confusion. As the condition develops, the patient will become comatose

Which of the following types of diarrhea can be caused by an inability to digest lactose in dairy products? Secretory Neurogenic Osmotic Motility

Osmotic Correct When an individual is unable to digest lactose, the unabsorbed molecules draw water into the lumen by osmosis, resulting in osmotic diarrhea.

Appendicitis pain manifests in which abdominal quadrant? Right upper Right lower Left upper Left lower

Right lower Correct Most individuals with appendicitis present with periumbilical pain that increases in intensity over several hours and then "moves" to the right lower quadrant.

Risk of developing cancer is increased with which of the following gastrointestinal disorders? Duodenal ulcers Diverticulosis Ulcerative colitis Dumping syndrome

Ulcerative colitis Correct Risk of developing cancer is increased only with ulcerative colitis and Crohn disease

Common characteristics of Crohn disease include which of the following? Significant blood loss in diarrhea Gastroesophageal reflux Vitamin B12 deficiency Mucosal erosions of the rectum

Vitamin B12 deficiency Correct Vitamin B12 malabsorption caused by injury to the mucosa of the ileum is a common characteristic of Crohn disease.

Hepatic failure results in decreased: levels of steroid hormones in the plasma. albumin synthesis and decreased oncotic pressure. levels of liver enzymes in the blood. nitric oxide production.

albumin synthesis and decreased oncotic pressure. Correct Hepatic failure results in decreased production of most plasma proteins including albumin, which is responsible for maintaining oncotic pressure.

The most common cause of chronic pancreatitis is: narcotic addiction. gallstones. alcohol abuse. diabetes mellitus.

alcohol abuse. Correct Chronic pancreatitis is most often associated with chronic alcohol abuse.

Reflux esophagitis is defined as: the autoimmune destruction of the esophageal lining. dysplasia of the epithelial lining of the esophagus. a congenital anomaly of the esophagus. an inflammatory response to gastroesophageal reflux.

an inflammatory response to gastroesophageal reflux. Correct Reflux esophagitis is an inflammatory response to the mucosal injury from acid and enzymes that occur with gastroesophageal reflux.

A common cause of chronic gastritis is: viral infection. bacterial infection. parasitic infection. fungal infection

bacterial infection. Correct The most common cause of chronic gastritis is chronic bacterial infection by Helicobacter pylori.

Severe trauma can result in stress ulcers that often first manifest with: abdominal pain. peritonitis. bleeding. dumping syndrome.

bleeding. Correct The first sign of stress ulcers is often acute gastrointestinal bleeding.

Vascular insufficiency of the gastrointestinal tract can occur with occlusion of all of the following aortic branches except the: brachial axis. celiac axis. superior mesenteric artery. inferior mesenteric artery

brachial axis. Correct The three branches of the abdominal aorta that are involved are the celiac axis, the superior mesenteric arteries, and the inferior mesenteric arteries.

Gastrectomy commonly leads to a vitamin B12 deficiency anemia because: vitamin B12 is absorbed in the stomach. decreased HCl production affects vitamin B12 absorption. pepsin is required for the conversion of vitamin B12 into its active form. decreased intrinsic factor production results in decreased vitamin B12 absorption in the ileum.

decreased intrinsic factor production results in decreased vitamin B12 absorption in the ileum. Correct The stomach secretes intrinsic factor, which is required for vitamin B12 absorption in the ileum

Which of the following disorders can result in lower gastrointestinal bleeding? Mallory-Weiss tear Peptic ulcers Cancer Hernia

female gender. Correct Men have a higher incidence of duodenal ulcers than women, and gastric ulcers affect men and women equally.

Common manifestations of gastroesophageal reflux disease (GERD) include: nausea, vomiting, and weight loss. diarrhea, abdominal cramping, and fever. heartburn, chronic cough, asthma, and laryngitis back pain, ascites, and anorexia

heartburn, chronic cough, asthma, and laryngitis Correct The clinical manifestations of reflux esophagitis include heartburn, chronic cough, asthma attacks and laryngitis. Pain ususally occurs within an hour of eating.

Intestinal obstruction can lead to all of the following complications except: hepatic failure. dehydration. peritonitis. perforation.

hepatic failure. Correct Hepatic failure is not a complication of intestinal obstruction.

Nonsteroidal anti-inflammatory agents (NSAIDs) cause peptic ulcer disease by: decreasing gastric bicarbonate production. accelerating the proton pump in parietal cells. inhibiting mucosal prostaglandin synthesis. reducing mucosal blood flow.

inhibiting mucosal prostaglandin synthesis. Correct NSAIDs are used to treat inflammatory pain and can increase the risk of peptic ulcer disease by inhibiting prostaglandin synthesis, which normally stimulates the production of gastric mucus.

Common causes of constipation include all of the following except: inadequate fluid intake. laxative use. a low-fiber diet. medications.

laxative use. Correct Laxatives are used to treat constipation.

Tissue damage in acute pancreatitis is caused by: leakage of pancreatic enzymes into pancreatic tissue. hydrochloric acid reflux into the pancreatic duct. autoimmune destruction of the pancreas. insulin toxicity.

leakage of pancreatic enzymes into pancreatic tissue. Correct Tissue damage in acute pancreatitis is caused by leakage of pancreatic enzymes into pancreatic tissue and the resulting autodigestion of the gland.

The most common cause of portal hypertension is: renal failure. liver cirrhosis. congestive heart failure. esophageal varices.

liver cirrhosis. Correct The most common cause of portal hypertension is liver cirrhosis. The obstruction of blood flow in the liver leads to increased venous pressures in the hepatic portal vein.

The presence of black, tarry stool is called: melena. hematochezia. hematemesis. occult bleeding.

melena. Correct Melena is black, tarry stool that occurs when blood components are digested in the upper gastrointestinal tract.

Diverticula are: ulcers that form in the colon. outpouchings of the colon's mucosa. perforations of the colon wall. areas where the colon wall is hypertrophied.

outpouchings of the colon's mucosa. Correct Diverticula are saclike outpouchings of the mucosa through the muscle layers of the digestive tract.

Gastric ulcers are characterized by: increased acid secretion. regurgitation of bile. pain with eating. bloody diarrhea.

pain with eating. Correct Gastric ulcers are often associated with pain upon eating because the presence of food stimulates acid and enzyme secretion, which causes further damage to the gastric mucosa and underlying tissue.

Cholelithiasis is: an infection of the gallbladder. gallbladder atrophy. hypersecretion of bile by the liver. the accumulation of gallstones in the gallbladder.

the accumulation of gallstones in the gallbladder. Correct Cholelithiasis is the accumulation of gallstones in the gallbladder.

All of the following are characteristics of ulcerative colitis except: iron deficiency anemia. the presence of "skip" lesions. diarrhea. an increased risk of colon cancer.

the presence of "skip" lesions. Correct Ulcerative colitis begins in the rectum and advances back through the colon in a continuous manner and does not "skip" parts of the mucosa.

Although the term hepatitis describes any inflammatory process affecting the liver, it is usually used to describe liver inflammation as a result of: bacterial infection. viral infection. prescription drug toxicity. street drug toxicity.

viral infection. Correct Most causes of hepatitis are viral in origin

The classic symptoms of a small bowel obstruction are: nausea, dyspnea, and mid-back pain. vomiting, severe abdominal pain, and abdominal distension. constipation, pelvic pain, and dysuria. fever, heartburn, and diaphoresis

vomiting, severe abdominal pain, and abdominal distension. Correct Symptoms of a small bowel obstruction include vomiting from vagal nerve stimulation, pain from bowel wall distention, and abdominal distension from accumulation of chyme or ascites.