quiz 6

how can you determine small vs large intestine obstruction based off exam findings?

nausea and vomiting are more linked to small bowel obstruction

What medical term is used to identify a functional urinary tract obstruction caused by an interruption of the nerve supply to the bladder? a. Neurogenic bladder c. Necrotic bladder b. Obstructed bladder d. Retrograde bladder

A Neurogenic bladder Neurogenic bladder is a general term for bladder dysfunction caused by neurologic disorders. The types of dysfunction are related to the sites in the nervous system that control sensory and motor bladder function (see Figure 38-3). None of the other options correctly identify the described condition.

Pyelonephritis is usually caused by which type of organism? a. Bacteria c. Viruses b. Fungi d. Parasites

A. Bacteria Pyelonephritis is usually caused by the bacteria Escherichia coli, Proteus, or Pseudomonas.

Which clinical manifestations of a urinary tract infection may be demonstrated in an 85-year-old individual? a. Confusion and poorly localized abdominal discomfort b. Dysuria, frequency, and suprapubic pain c. Hematuria and flank pain d. Pyuria, urgency, and frequency

A. Confusion and poorly localized abdominal discomfort Older adults with cystitis may demonstrate confusion or vague abdominal discomfort or otherwise be asymptomatic.

Which abnormal laboratory value is found in glomerular disorders? a. Elevated creatinine concentration c. Elevated immunoglobulin A(IgA) b. Low blood urea nitrogen (BUN) d. Low serum complement

A. Elevated creatinine concentration Elevated creatinine concentration is an abnormal laboratory value found in glomerular disorders. Reduced glomerular filtration rate during glomerular disease is evidenced by elevated plasma urea, creatinine concentration, or reduced renal creatinine clearance.Glomerular disorders are not associated with the other options.

Which statement is false concerning the pathophysiologic process of alcoholic cirrhosis? a. Inflammation and damage leading to cirrhosis begin in the bile canaliculi. b. Alcohol is transformed to acetaldehyde, which promotes liver fibrosis. c. Mitochondrial function is impaired, decreasing oxidation of fatty acids. d. Acetaldehyde inhibits export of proteins from the liver.

A. Inflammation and damage leading to cirrhosis begin in the bile canaliculi. Biliary cirrhosis differs from alcoholic cirrhosis in that the damage and inflammation leading to cirrhosis begin in bile canaliculi and bile ducts, rather than in the hepatocytes.

Hypothyroidism, edema, hyperlipidemia, and lipiduria characterize which kidney disorder? a. Nephrotic syndrome c. Chronic glomerulonephritis b. Acute glomerulonephritis d. Pyelonephritis

A. Nephrotic syndrome Symptoms of nephrotic syndrome include edema, hyperlipidemia, lipiduria, vitamin D deficiency, and hypothyroidism. These symptoms do not support the other options.

Glucose transport enhances the absorption of which electrolyte? a. Sodium b. Phosphate c. Potassium d. Chloride

A. Sodium Sodium passes through the tight junctions and is actively transported across cell membranes. Sodium and glucose share a common active transport carrier (sodium-glucose ligand transporter 1 [SGLT1]).

Exposure to which substance protects the mucosal barrier of the stomach? a. Prostaglandins b. Aspirin c. Helicobacter pylori d. Regurgitated bile

A. prostaglandins Prostaglandins and enterogastrones, such as gastric inhibitory peptide, somatostatin, and secretin, inhibit acid secretion. This selection is the only option that accurately identifies a substance that protects the mucosal barrier of the stomach.

Cirrhosis causes intrahepatic portal hypertension in children as a result of which mechanism? a. Fibrosis that increases the resistance to blood flow within the portal system b. Increased pressure from the twisting of the common bile ducts c. Development of collateral circulation within the portal system d. Shunting of fluid to the spleen or abdomen

ANS: A Fibrosis that increases the resistance to blood flow within the portal system The two basic causes of portal hypertension in children are (1) increased resistance to blood flow within the portal system and (2) increased volume of portal blood flow

What factors can contribute to the development of a cleft lip and a cleft palate? (Select all that apply.) a. Maternal deficiency of B vitamins b. Exposure to heavy metals during the second trimester of pregnancy c. Maternal use of tobacco d. Maternal diabetes mellitus e. Genetic mutation of the transforming growth factor

ANS: A, C, D In most cases, cleft lip and cleft palate are caused by multiple gene and environmental interactions, including maternal deficiency of B vitamins (B6, folic acid, and B12), maternal tobacco and alcohol use, maternal diabetes mellitus, and genetic variations of several biomolecules including transforming growth factor, interferon regulatory factor-6, fibroblast growth factor, and other growth factors. Exposure to heavy metals during the second trimester of pregnancy is not a known trigger for such development.

An intestinal obstruction at the pylorus or high in the small intestine causes metabolic alkalosis by causing which outcome? a. Gain of bicarbonate from pancreatic secretions that cannot be absorbed b. Excessive loss of hydrogen ions normally absorbed from gastric juices c. Excessive loss of potassium, promoting atony of the intestinal wall d. Loss of bile acid secretions that cannot be absorbed

ANS: B Excessive loss of hydrogen ions normally absorbed from gastric juices If the obstruction is at the pylorus or high in the small intestine, then metabolic alkalosis initially develops as a result of excessive loss of hydrogen ions that normally would be reabsorbed from the gastric juices

Which gastric hormone inhibits acid and pepsinogen secretion, as well as decrease the release of gastrin? a. Bombesin c. Somatostatin b. Histamine d. Acetylcholine

ANS: C Somatostatin Of the options available, only somatostatin inhibits the secretion of acid and pepsinogen and decreases gastrin release

What is the direct action of atrial natriuretic hormone? a. Sodium retention c. Water retention b. Sodium excretion d. Water excretion

B Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) inhibit the secretion of renin, inhibit angiotensin-induced secretion of aldosterone, vasodilate the afferent and constrict the efferent glomerular arterioles, and inhibit sodium and water absorption by kidney tubules.

The area of the kidneys that contains the glomeruli and portions of the tubules is called the: a. Medulla c. Pyramids b. Cortex d. Columns

B The cortex contains all the glomeruli and portions of the tubules of the kidneys. Althoughthe other options are also located in the kidney, they do not contain the glomeruli.

Which anomaly is often associated with Wilms tumor? a.Renal anaplasia c.Anemia b.Aniridia d.Hypothyroidism

B Aniridia Aniridia (lack of an iris in the eye) is an anomaly often associated with Wilms tumor.

When the right kidney is obstructed, how will the glomeruli and tubules in the left kidney compensate? a. Increase in number c. Develop collateral circulation b. Increase in size d. Increase speed

B Increase in size These processes cause the contralateral (unobstructed) kidney to increase the size of individual glomeruli and tubules. The changes described by the other options are not correct.

Hypercalciuria is primarily attributable to which alteration? a. Defective renal calcium reabsorption b. Intestinal hyperabsorption of dietary calcium c. Bone demineralization caused by prolonged immobilization d. Hyperparathyroidism

B Intestinal hyperabsorption of dietary calcium Hypercalciuria is usually attributable to intestinal hyperabsorption of dietary calcium and less commonly to a defect in renal calcium reabsorption. Hyperparathyroidism and bone demineralization associated with prolonged immobilization are also known to cause hypercalciuria but too a much lesser degree.

How does progressive nephrons injury affect angiotensin II activity? a. Angiotensin II activity is decreased. b. It is elevated. c. Angiotensin II activity is totally suppressed. d. It is not affected.

B It is elevated Angiotensin II activity is elevated with progressive nephron injury. This selection is the only accurate identification of the effect of progressive nephron injury on angiotensin II activity.

Which glomerular lesion is characterized by thickening of the glomerular capillary wall with immune deposition of immunoglobulin G (IgG) and C3? a. Proliferative c. Mesangial b. Membranous d. Crescentic

B Membranous The thickening of the glomerular capillary wall characterizes only membranous lesions.

Which pancreatic enzyme is responsible for the breakdown of carbohydrates? a. Trypsin b. Amylase c. Lipase d. Chymotrypsin

B. Amylase Salivary and pancreatic amylases break down starches to oligosaccharides by splitting a-1,4-glucosidic linkages of long-chain molecules.

Congenital aganglionic megacolon (Hirschsprung disease) involves inadequate motility of the colon caused by neural malformation of which nervous system? a. Central c. Sympathetic b. Parasympathetic d. Somatic

B. Parasympathetic A malformation related only to the parasympathetic nervous system causes congenital aganglionic megacolon

How are glucose and insulin used to treat hyperkalemia associated with acute renal failure? a. Glucose has an osmotic effect, which attracts water and sodium, resulting in more dilute blood and a lower potassium concentration. b. When insulin transports glucose into the cell, it also carries potassium with it. c. Potassium attaches to receptors on the cell membrane of glucose and is carried into the cell. d. Increasing insulin causes ketoacidosis,which causes potassium to move into the cell in exchange for hydrogen.

B. When insulin transports glucose into the cell, it also carries potassium with it. This selection is the only option that accurately describes glucose metabolism, causing potassium to move to the intracellular fluid; insulin infusions therefore can be effective in shifting potassium from the extracellular to intracellular space, along with the transport of glucose.

How is Vitamin B6 absorbed? Vitamin B1? Vitamin K? Folic acid?

B6- water-soluble vitamin is absorbed by passive diffusion B1- Like all B vitamins, vitamin B1 is water-soluble and gets absorbed directly into the blood from the gastrointestinal tract Vitamin K- Like dietary lipids and other fat-soluble vitamins, ingested vitamin K is incorporated into mixed micelles via the action of bile and pancreatic enzymes, and it is absorbed by enterocytes of the small intestine Folic acid- Folates a

If glucose is positive on the UA, what is the expected minimum serum glucose

Blood glucose level is 200 mg/dl, TM glucose is reached, renal threshold for glucose is exceeded

Which statement is false regarding the pathophysiologic process of acute pancreatitis? a. Bile duct or pancreatic duct obstruction blocks the outflow of pancreatic digestive enzymes. b. Acute pancreatitis can also result from direct cellular injury from drugs or viral infection. c. Acute pancreatitis is an autoimmune disease in which immunoglobulin G (IgG) coats the pancreatic acinar cells; consequently, the pancreatic enzymes destroy the cells. d. Acute pancreatitis is usually mild and spontaneously resolves.

C. Acute pancreatitis is an autoimmune disease in which immunoglobulin G (IgG) coats the pancreatic acinar cells; consequently, the pancreatic enzymes destroy the cells. The backup of pancreatic secretions and the activation and release of enzymes (activated trypsin activates chymotrypsin, lipase, and elastase) within the pancreatic acinar cells cause acute pancreatitis, an obstructive disease. The activated enzymes cause autodigestion (e.g., proteolysis, lipolysis) of the pancreatic cells and tissues, resulting in inflammation. Acute pancreatitis is usually a mild disease and spontaneously resolves; however, approximately 20% of those with the disease develop a severe acute pancreatitis that requires hospitalization. Pancreatitis develops because of a blockage to the outflow of pancreatic digestive enzymes caused by bile duct or pancreatic duct obstruction (e.g., gallstones). Acute pancreatitis can also result from direct cellular injury from drugs or viral infection.

Kupffer cells are best described as: a. Natural killer cells that produce interferon-gamma (IFN-g) b. Contractile and therefore capable of regulating the sinusoid blood flow c. Bactericidal and therefore central to innate immunity d. Able to metabolize estrogen, progesterone, and androgens

C. Bactericidal and therefore central to innate immunity The sinusoids are lined with phagocytic cells, known as Kupffer cells, which are part of the mononuclear phagocyte system and are the largest population of tissue macrophages in the body. They are bactericidal and central to innate immunity.

Where in the small intestines are lymphocytes, plasma cells, and macrophages produced? a. Brush border b. Microvilli c. Lamina propria d. Crypts of Lieberkühn

C. Lamina Propria The lamina propria, which is a connective tissue layer of the mucous membrane, lies beneath the epithelial cells of the villi and contains lymphocytes, plasma cells, which produce immunoglobulins, and macrophages. None of the other options performs the described function.

Creatinine is primarily excreted by glomerular filtration after being constantly released from what type of tissue? a. Nervous system c. Muscle b. Kidneys d. Liver

C. Muscle Creatinine is constantly released from only muscle tissue to be excreted by glomerular filtration.

Bladder cancer is associated with the gene mutation of which gene? a. c-erbB2 b. Human epidermal growth factor receptor2 (HER2) c. TP53 d. myc

C. Oncogenes of the ras gene family and tumor-suppressor genes including TP53 mutations and the inactivation of the retinoblastoma gene (pRb) are implicated in bladder cancer.This process is not associated with the other options.

What process is capable of increasing both intrathoracic and intra abdominal pressure, thereby facilitating defecation? a. Relaxation of the internal anal sphincter b. Intestinal peristalsis c. Valsalva maneuver d. Ileogastric reflex

C. Valsalva maneuver Squatting or sitting facilitate defecation; these positions straighten the angle between the rectum and anal canal and increase the efficiency of straining (increasing intraabdominal pressure). Initiating the Valsalva maneuver increases intraabdominal pressure. This maneuver consists of inhaling and forcing the diaphragm and chest muscles against the closed glottis and increases both intrathoracic and intraabdominal pressure, which is transmitted to the rectum

What self-care measure is important to include when teaching women about prevention of UTI

Clean the perineal area from front to back Drink cranberry juice but avoid products with high fructose

What is the glomerular filtration rate directly related to?

DIRECTLY RELATED TO RENAL BLOOD FLOW, perfusion pressure in the glomerular capillaries

The concentration of the final urine is determined by antidiuretic hormone (ADH), which is secreted by which gland? a. Posterior pituitary c. Parathyroid b. Thyroid d. Anterior pituitary

D ADH, which is secreted from the posterior pituitary gland, controls the concentration of the final urine.

What process allows the kidney to respond to an increase in workload? a. Glomerular filtration b. Secretion of 1,25-dihydroxyvitamin D3 c. Increased heart rate d. Compensatory hypertrophy

D Compensatory hypertrophy allows the kidney to respond to an increase in workload throughout life.

What is the end-product of protein metabolism that is excreted in urine? a. Glucose c. Bile b. Ketones d. Urea

D Of the options available, only urea is an end-product of protein metabolism and is the major constituent of urine along with water.

What substance stimulates renal hydroxylation in the process of producing vitamin D? a. Erythropoietin c. Calcitonin b. Thyroid hormone d. Parathyroid hormone

D Parathyroid hormone stimulates renal hydroxylation in the process of producing vitamin D. The first step occurs in the liver with hydroxylation at the 25th carbon (calcifediol);the second step in hydroxylation occurs at the first carbon position in the kidneys.

What is the action of urodilatin? a. Urodilatin causes vasoconstriction of afferent arterioles. b. It causes vasodilation of the efferent arterioles. c. Urodilatin inhibits antidiuretic hormone secretion. d. It inhibits salt and water reabsorption.

D Urodilatin (a natriuretic peptide) inhibits sodium and water reabsorption from the medullary part of collecting duct, thereby producing diuresis.

Anemia of chronic renal failure can be successfully treated with which element? a. Intrinsic factor c. Vitamin D b. Vitamin B12 d. Erythropoietin

D Erythropoietin Anemia of chronic renal failure can be successfully treated with erythropoietin. Reducederythropoietin secretion and reduced red cell production are evident in anemia resultingfrom chronic renal failure. The other options are not relevant to this condition.

When renin is released, it is capable of which action? a. Inactivation of autoregulation b. Direct activation of angiotensin II c. Direct release of antidiuretic hormone(ADH) d. Formation of angiotensin I

D Formation of angiotensin I When renin is released, it cleaves an α-globulin (angiotensinogen produced by liver hepatocytes) in the plasma to form angiotensin I.

Which differentiating sign is required to make the diagnosis of pyelonephritis from that of cystitis? a. Difficulty starting the stream of urine b. Spasmodic pain that radiates to the groin c. Increased glomerular filtration rate d. Urinalysis confirmation of white blood cell casts

D Urinalysis confirmation of white blood cell casts Clinical assessment, alone, is difficult to differentiate the symptoms of cystitis from those of pyelonephritis. Urine culture, urinalysis, and clinical signs and symptoms establish a specific diagnosis. White blood cell casts indicate pyelonephritis, but they are not always present in the urine. This selection is the only option that is considered a required sign of pyelonephritis.

What is the cause of functional dysphagia? a. Intrinsic mechanical obstruction b. Extrinsic mechanical obstruction c. Tumor d. Neural or muscular disorders

D. Neural or muscular disorders Neural and muscular disorders that interfere with voluntary swallowing or peristalsis cause functional dysphagia.

What term is used to identify frank bleeding of the rectum? a. Melena b. Hematochezia c. Occult bleeding d. Hematemesis

b. Hematochezia Hematochezia is the only available option that is associated with frank bright red or burgundy blood from the rectum.

What effect do natriuretic peptides have during heart failure when the heart dilates?

Inhibits renin and aldosterone.

Innervation of the bladder and internal urethral sphincter is supplied by which nerves?

Parasympathetic fibers

What is the cause of smokey, brown colored urine resulting from acute poststreptococcal glomerulonephritis?

Presence of red blood cells

Glomerular Filtration Rate (GFR)

Provides the best estimate of functioning renal tissue. approx: 120 ml/min

dumping syndrome

Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine, causing a sudden shift of fluid from the blood vessels to the intestinal lumen Clinical manifestations include increased pulse, hypotension, weakness, pallor, sweating, dizziness followed by gastrectomy or pyloroplasty. Occurs about 20min after eating. managed well by high protein, low carb diet; frequent, small meals

What is the functional unit of the kidney called? a. Glomerulus c. Collecting duct b. Nephron d. Pyramid

The nephron is the functional unit of the kidney. Although the other options are also located in the kidney, they are not its functional units.

When is a renal biopsy indicated?

Specific reasons to do a kidney biopsy include: Blood in the urine (hematuria) or protein in the urine (proteinuria) Abnormal blood test results. Acute or chronic kidney disease with no clear cause. When deciding between a systemic or intrinsic disease

What are blood vessels of the kidneys innervated by?

Sympathetic nervous system The blood vessels of the kidney are innervated by the sympathetic noradrenergic fibers that cause arteriolar vasoconstriction and reduce renal blood flow.

How much urine does the bladder holds until it senses fullness?

The bladder normally holds 600 ml - 1000 ml of urine. May sense the urge to void with as little as 150-200ml in an adult bladder;50-100ml in a child

What is the average percent of cardiac output the kidneys receive?

The kidneys are vascular organs and receive 1000 to 1200 ml of blood per minute and 20% to 25% of cardiac output.

Why is prolonged diarrhea more severe in children than it is in adults? a. Less water is absorbed from the colon in children. b. Fluid reserves are smaller in children. c. Children have a higher fluid volume intake. d. Children have diarrhea more often than adults

b. Fluid reserves are smaller in children.

What term is used to identify the condition that exists when the urethral meatus is located on the undersurface of the penis? a.Hypospadias c.Hyperspadias b.Epispadias d.Chordee

a. Hypospadias

Saliva contains which immunoglobulin (Ig)? a. IgA c. IgG b. IgE d. IgM

a. IgA

Which term is used to identify a condition in which the developing colon remains in the upper right quadrant instead of moving to its normal location? a. Intestinal malrotation c. Duodenal obstruction b. Ileocecal displacement d. Pyloric stenosis

a. Intestinal malrotation

What is the role of the normal intestinal bacterial flora? a. Metabolizing bile salts, estrogens, and lipids b. Breaking down proteins into amino acids c. Facilitating the motility of the colon d. Metabolizing aldosterone and insulin

a. Metabolizing bile salts, estrogens, and lipids The intestinal bacteria play a role in the metabolism of bile salts, contributing to the intestinal reabsorption of bile and the elimination of toxic bile metabolites. These bacteria also play a role in the metabolism of estrogens, androgens, and lipids, as well as in the conversion of unabsorbed carbohydrates to absorbable organic acids, the synthesis of vitamin K2, and the metabolism of various nitrogenous substances and drugs.

Which gastric cells secrete hydrochloric acid and intrinsic factor? a. Parietal b.Chief c. G d. H

a. Parietal

What is the first indication of nephrotic syndrome in children? a.Periorbital edema c.Frothy urine b.Scrotal or labial edema d.Ascites

a. Periorbital edema

Increased gastrin secretion by the mother in the last trimester of pregnancy may cause which condition in the infant? a. Pyloric stenosis c. Esophageal atresia b. Meconium ileus d. Galactosemia

a. Pyloric stenosis

What is the mechanism for developing Wilms tumor? a.The development of a Wilms tumor involves tumor-suppressor genes located on chromosome 11. b.Development involves an autosomal dominant inherited disorder involving the Y chromosome. c.Wilms tumor is an autoimmune disorder. d.The development of a Wilms tumor is a congenital anomaly.

a. The development of a Wilms tumor involves tumor-suppressor genes located on CHROMOSOME 11.

Which water-soluble vitamin is absorbed by passive diffusion? a. Vitamin B6 c. Vitamin K b. Vitamin B1 d. Folic acid

a. Vitamin B6

What factor associated with gluten-sensitive enteropathy (celiac sprue) causes an infant to bruise and bleed easily? a. Vitamin K deficiency from fat malabsorption b. Bone marrow function depression c. Iron, folate, and B12 deficiency anemias d. Prescribed daily warfarin (Coumadin)

a. Vitamin K deficiency from fat malabsorption

When does an individual have their full complement of renal nephrons? a.At birth c.At puberty b.At 6 months of age d. Between the ages 18 and 21 years

a.At birth

What causes vesicoureteral reflux to occur in children? a.Children do not ask for help in urinating in a timely manner, and urine is forced up into the ureters. b.The submucosal segment of a child's ureter is short, making the antireflux mechanism inefficient. c.The trigone lying between the opening to the ureters and the urethra is underdeveloped in children. d.As the bladder fills in infants and children, it pulls the smooth lining of the transitional epithelium away from the ureters, making the reflux valves ineffective.

b. The submucosal segment of a child's ureter is short, making the antireflux mechanism inefficient.

When does urine formation and excretion begin? a.At birth c.By 6 months' gestation b.By 3 months' gestation d.By 8 months' gestation

b. By 3 months' gestation

Which term is used to identify an intestinal obstruction caused by meconium formed in utero that is abnormally sticky and adheres firmly to the mucosa of the small intestine? a. Meconium cecum c. Meconium obstruction b. Meconium ileus d. Meconium vivax

b. Meconium ileus

The ileum and jejunum are suspended by folds of the peritoneum that contain an extensive vascular and nervous network. What are these folds called? a. Ligament of Treitz b. Mesentery c. Auerbach folds d. Lamina propria

b. Mesentery The ileum and jejunum are suspended in loose folds from the posterior abdominal wall by a peritoneal membrane called the mesentery. The mesentery facilitates intestinal motility and supports blood vessels, nerves, and lymphatics. None of the other options accurately fills this description.

Which enzyme breaks down protein-forming polypeptides in the stomach? a. Acetylcholine b. Pepsin c. Gastrin d. Secretin

b. Pepsin only pepsin, a proteolytic enzyme, breaks down protein-forming polypeptides in the stomach.

What effect is a result of inhibiting the parasympathetic nervous system with a drug such as atropine? a. Salivation becomes thinner. b. Salivation decreases. c. The pH of saliva changes. d. Digestive enzymes are inhibited.

b. Salivation decreases.

Acute glomerulonephritis (AGN) may be accompanied by a positive throat or skin culture for which bacteria? a.Staphylococcus aureus c.Pseudomonas aeruginosa b.Streptococcus d.Haemophilus

b. Streptococcus

What is the most common manifestation of portal hypertension-induced splenomegaly? a. Leukopenia b. Thrombocytopenia c. Erythrocytopenia d. Pancytopenia

b. Thrombocytopenia Thrombocytopenia (decreased platelet count) is the most common manifestation of congestive splenomegaly and can contribute to a tendency of increased bleeding.

The movement of fluids and solute from the tubular lumen to the peritubular capillary plasma is called: a. Ultrafiltration b.Tubular reabsorption c.Tubular secretion d.Excretion

b. Tubular reabsorption Tubular reabsorption is the movement of fluids and solute from the tubular lumen to the peritubular capillary plasma.

Which vitamin facilitates the absorption of iron by the epithelial cells of the duodenum and jejunum? a. B6 b. C c. E d. B12

b. Vitamin C Of the options available, only vitamin C reduces ferric iron to ferrous iron, which is the form more easily absorbed by the epithelial cells of the duodenum and jejunum.

Bacteria gain access to the female urinary tract by which means? a.Systemic blood that is filtered through the kidney b.Bacteria traveling from the lymph adjacent to the bladder and kidneys c.Bacteria ascending the urethra into the bladder d.Colonization of the bladder when urine is static

c. Bacteria ascending the urethra into the bladder

Incomplete fusion of the nasomedial and intermaxillary process during the fourth week of embryonic development causes which condition in an infant? a. Cleft palate c. Cleft lip b. Sinus dysfunction d. Esophageal malformation

c. Cleft lip

Which renal change is found in older adults? a. Sharp decline in glomerular filtration rate b. Sharp decline in renal blood flow c. Decrease in the number of nephrons d. Decrease in urine output

c. Decrease in the number of nephrons With aging, the number of nephrons decreases.

Which hormone is synthesized and secreted by the kidneys? a. Antidiuretic hormone b. Aldosterone c. Erythropoietin d. Angiotensinogen

c. Erythropoietin Erythropoietin is produced by the fetal liver and in the adult kidney and is essential for normal erythropoiesis (the production of red blood cells).

Which disorder is characterized by damage to the mucosa of the duodenum and jejunum and impaired secretion of secretin, cholecystokinin, and pancreatic enzymes? a. Wilson disease c. Gluten-sensitive enteropathy b. Cystic fibrosis d. Galactosemia

c. Gluten-sensitive enteropathy

A peptic ulcer may occur in all of the following areas except the: a. Stomach b. Duodenum c. Jejunum d. Esophagus

c. Jejunum A peptic ulcer is a break, or ulceration, in the protective mucosal lining of the lower esophagus, stomach, or duodenum. This type of ulcer is not associated with the jejunum.

Which type of diarrhea results from lactose intolerance? a. Secretory c. Osmotic b. Motility d. Small volume

c. Osmotic The malabsorption of lactose results in osmotic diarrhea, in which fluids move by osmosis from the vascular compartment into the intestinal lumen

At 2 or 3 weeks of age, an infant who has been well fed and has gained weight begins to vomit for no apparent reason. The vomiting gradually becomes more forceful. These symptoms may be indicative of which disorder? a. Esophageal atresia c. Pyloric stenosis b. Congenital aganglionic megacolon d. Galactosemia

c. Pyloric stenosis

Considering the normal frequency of bowel evacuation, how infrequently can evacuation occur and still be considered within normal range? a. Once a day b. Once every 2 days c. Once a week d. Once every 2 weeks

c. once a week Normal bowel habits range from two or three evacuations per day to one per week

How many days does it take for the entire epithelial population of the small intestines to be replaced? a. 30 to 45 c. 7 to 15 b. 15 to 25 d. 4 to 7

d. 4 to 7

Hepatic fat accumulation is observed in which form of cirrhosis? a. Biliary c. Postnecrotic b. Metabolic d. Alcoholic

d. Alcoholic Alcoholic cirrhosis is a complex process that begins with fatty infiltration (hepatic steatosis). Fat deposition (deposition of triglycerides) within the liver hepatocytes is primarily caused by increased lipogenesis and decreased fatty acid oxidation by hepatocytes

What is the most immediate result of a small intestinal obstruction? a. Vomiting c. Electrolyte imbalances b. Dehydration d. Distention

d. Distention Distention begins almost immediately, as gases and fluids accumulate proximal to the obstruction. Within 24 hours, up to 8 L of fluid and electrolytes enters the lumen in the form of saliva, gastric juice, bile, pancreatic juice, and intestinal secretions

Which cells in the stomach secrete histamine? a. Oxyntic b. Chief c. D d. Enterochromaffin-like

d. Enterochromaffin-like

Bilirubin is a by-product of the destruction of which aged cells? a. Platelets c. Leukocytes b. Protein d. Erythrocytes

d. Erythrocytes

What is the primary source of physiologic iron? a. Transferrin from plasma b. Pepsin from pepsinogen c. Bile from bilirubin d. Heme from animal protein

d. Heme from animal protein The primary source of iron is heme from animal protein. The other options are not considered primary sources of physiologic iron.

Physiologic jaundice in a newborn is caused by: a. Reabsorption of bilirubin in the small intestine b. Impaired hepatic uptake and excretion of bilirubin c. Increased bilirubin production d. Mild conjugated (indirect-reacting) hyperbilirubinemia

d. Mild conjugated (indirect-reacting) hyperbilirubinemia

What distinguishes kwashiorkor from marasmus? a. All nutrients, proteins, fats, and carbohydrates are reduced in kwashiorkor. b. Physical growth of children is stunted in kwashiorkor but not in marasmus. c. Muscle wasting, diarrhea, low hemoglobin, and infection characterize kwashiorkor. d. Subcutaneous fat, hepatomegaly, and fatty liver are present in kwashiorkor

d. Subcutaneous fat, hepatomegaly, and fatty liver are present in kwashiorkor

Which structure synthesizes clotting factors and the vitamin K necessary for hemostasis? a. Colon c. Gallbladder b. Spleen d. Liver

d. liver The liver has hemostatic functions. It synthesizes prothrombin, fibrinogen, and factors I, II, VII, IX, and X, all of which are necessary for effective clotting. Vitamin K, a fat-soluble vitamin, is essential for the synthesis of other clotting factors. Because bile salts are needed for the absorption of fats, vitamin K absorption depends on adequate bile production in the liver. Impairment of vitamin K absorption diminishes the production of clotting factors and increases the risk of bleeding.

The telescoping of part of the intestine into another, usually causing strangulation of the blood supply.

intussusception

What normal age-related changes might one see on a UA

lower specific gravity

esophageal varices is the most common clinical manifestation of this

portal hypertension