Week 7 Quiz

What finding should prompt further diagnostic testing in a child presenting with diarrhea? a. Periumbilical discomfort b. Greenish, watery diarrhea c. Frequent, large-volume diarrhea d. Blood and mucus in the stools

d. Blood and mucus in the stools

What finding would rule out a diagnosis of irritable bowel syndrome in a patient with chronic diarrhea? a. Negative stool leukocytes b. Intermittent constipation c. Abdominal pain and distention d. Bloody stools

D. Bloody stools

A patient reporting vision changes, photophobia, and lid lag may be exhibiting signs of a. Addison disease. b. Cushing syndrome. c. myxedema. d. Graves disease.

D. Graves disease.

What effect would adrenocortical insufficiency have on an individual's response to surgical stress? a. More prone to hyperglycemia b. Decreased sensitivity to anesthesia c. More susceptible to hypertensive crisis d. More prone to hypotension

D. More prone to hypotension

A biliary cause of acute pancreatitis is suggested by an elevation in which serum laboratory results? a. lipase b. amylase c. glucose d. alkaline phosphatase

D. alkaline phosphatase

Aldosterone secretion is regulated by the presence of ________ in the circulation. a. progesterone b. corticoglobulin c. ACTH d. angiotensin II

D. angiotensin II

Congenital adrenal hyperplasia (adrenogenital syndrome) results from a. cortisol excess. b. testosterone-secreting tumor. c. exogenous androgens. d. blocked cortisol production.

D. blocked cortisol production.

An infusion of mannitol would be prescribed to treat a. varices. b. encephalopathy. c. peritonitis. d. cerebral edema.

D. cerebral edema.

The definitive treatment for cholecystitis is a. lithotripsy of stones. b. chemical dissolution of stones. c. antibiotics and anti-inflammatories. d. cholecystectomy.

D. cholecystectomy.

Proton pump inhibitors may be used in the management of peptic ulcer disease to a. increase gastric motility. b. inhibit secretion of pepsinogen. c. neutralize gastric acid. d. decrease hydrochloric acid (HCl) secretion.

D. decrease hydrochloric acid (HCl) secretion.

A silent abdomen 3 hours after bowel surgery most likely indicates a.peritonitis b. mechanical bowel obstruction. c. perforated bowel. d. functional bowel obstruction.

D. functional bowel obstruction.

Dumping syndrome is commonly seen after __________ procedures. a. appendectomy b. intestinal biopsy c. colonoscopy d. gastric bypass

D. gastric bypass

A patient with a history of alcoholism presents with hematemesis and profound anemia. The expected diagnosis is a. ascites b. cerebral edema c. hepatic encephalopathy d. gastroesophageal varices

D. gastroesophageal varices

An increased urine bilirubin is associated with a. an increased indirect serum bilirubin. b. hemolytic reactions. c. Gilbert syndrome. d. hepatitis.

D. hepatitis.

Hepatic encephalopathy is associated with a. hyperbilirubinemia. b. hyperuricemia. b. toxic effects of c. alcohol on brain cells. d. increased blood ammonia levels.

D. increased blood ammonia levels.

Constipation in an elderly patient can be best treated by a. maintaining a low-fiber diet. b. maintaining the current level of activity. c. fecal disimpaction. d. increasing fiber in the diet.

D. increasing fiber in the diet.

It is true that the synthesis of thyroid hormones a. is increased by thyrotropin-inhibiting factor. b. occurs in perifollicular C cells. c. is stimulated by ACTH. d. is inhibited by iodine deficiency.

D. is inhibited by iodine deficiency.

Calcitonin is produced by thyroid parafollicular cells and increases bone formation by a. homeostasis. b. osteoclasts. c. reabsorption. d. osteoblasts.

D. osteoblasts.

The most challenging aspect of treatment for chronic pancreatitis is a. pancreatectomy. b. strict dietary avoidance of fats. c. abstinence from alcohol. d. pain control.

D. pain control.

Pathophysiologically, esophageal varices can be attributed to a. elevated bilirubin. b. diminished protein metabolism. c. fluid accumulation. d. portal hypertension.

D. portal hypertension.

Clinical manifestations of hypoparathyroidism a. are similar to those occurring with hypermagnesemia. b. result from decreased neuromuscular excitability. c. are similar to those occurring with hypokalemia. d. result from decreased serum ionized calcium.

D. result from decreased serum ionized calcium.

Diabetes mellitus is the ________ leading cause of death and a major cause of disability in the United States. a. first b. second c. fourth d. seventh

D. seventh

It is true that biliary cancer a. is most often cured by surgery. b. respond well to chemotherapy. c. are identifiable and treatable when diagnosed early. d. tend to be asymptomatic and progress insidiously.

D. tend to be asymptomatic and progress insidiously.

What clinical finding would suggest an esophageal cause of a client's report of dysphagia? a. Nasal regurgitation b. Airway obstruction with swallowing c. Chest pain during meals d. Coughing when swallowing

C. Chest pain during meals

An urgent surgical consult is indicated for the patient with acute abdominal pain and a. vomiting. b. CVA tenderness. c. absent bowel sounds. d. borborygmi.

C. absent bowel sounds.

The most common cause of mechanical bowel obstruction is a. volvulus. b. intussusception. c. adhesions. d. fecal impaction.

C. adhesions.

More than half of the initial cases of pancreatitis are associated with a. trauma. b. stones. c. alcoholism. d. high cholesterol.

C. alcoholism.

Epigastric pain that is relieved by food is suggestive of a. pancreatitis. b. cardiac angina. c. gastric ulcer. d. dysphagia.

C. gastric ulcer.

The signs and symptoms of adrenocortical hormone excess may occur from either a primary or secondary disorder. A symptom associated with primary Cushing syndrome is a. hyperpigmentation. b. hypotension. c. hyperglycemia. d. hyperkalemia.

C. hyperglycemia.

A laboratory finding that would help confirm the diagnosis of hyperaldosteronism is a. hypernatremia. b. hyperkalemia. c. hypokalemia. d. hyperglycemia.

C. hypokalemia.

Insulin binding to its receptor on target cells results in a. increased active transport of glucose into the cell. b. glycogen breakdown within target cells. c. increased facilitated cellular diffusion of glucose. d. gluconeogenesis.

C. increased facilitated cellular diffusion of glucose.

Radioactive iodine treatment is the therapy of choice in patients with Graves disease. The patient should be expected to a. achieve full recovery after treatment. b. need short-term thyroid replacement therapy. c. need lifelong thyroid replacement therapy. d. receive lifelong iodine treatment.

C. need lifelong thyroid replacement therapy.

Elevated serum lipase and amylase levels are indicative of a. gallbladder disease. b. appendicitis. c. pancreatitis d. peritonitis.

C. pancreatitis.

Esophageal varices represent a complication of ________ hypertension. a. primary b. pregnancy-induced c. portal d. secondary

C. portal

Narcotic administration should be administered carefully in patients with acute pancreatitis related to potential for a. respiratory depression. b. narcotic dependency. c. sphincter of Oddi dysfunction. d. allergic reaction.

C. sphincter of Oddi dysfunction.

Brain injury secondary to high serum bilirubin is called a. hepatic encephalopathy. b. hepatic meningitis. c.kernicterus. d. encephalitis.

C.kernicterus.

Which symptom suggests the presence of a hiatal hernia? a. Nausea b. Heartburn c. Diarrhea d. Abdominal cramps

B. Heartburn

What form of viral hepatitis is likely to be transmitted sexually? a. Hepatitis A b. Hepatitis B c. Hepatitis C d. Hepatitis E

B. Hepatitis B

________ is the most powerful predictor of developing type 2 diabetes mellitus. a. Aging b. Obesity c. Sedentary lifestyle d. Cardiovascular disease

B. Obesity

________ disease is a rare autosomal recessive disorder in which excessive amounts of copper accumulate in the liver. a. Kayser-Fleischer b. Wilson c. Reye d. Byler

B. Wilson

Liver transaminase elevations in which aspartate aminotransferase (AST) is markedly greater than alanine aminotransferase (ALT) is characteristic of a. viral hepatitis. b. alcohol-induced injury. c. cirrhosis. d. acetaminophen toxicity.

B. alcohol-induced injury.

It is true that Graves disease is a. a secondary endocrine disorder. b. associated with autoantibodies to TSH receptors. c. characterized by high serum TSH levels. d. untreatable.

B. associated with autoantibodies to TSH receptors.

A patient who should be routinely evaluated for peptic ulcer disease is one who is a. taking six to eight tablets of acetaminophen per day. b. being treated with high-dose oral glucocorticoids. c. experiencing chronic diarrhea. d. routinely drinking alcoholic beverages.

B. being treated with high-dose oral glucocorticoids.

An increase in ADH secretion occurs in response to a. decreased serum osmolality. b. dehydration. c. hypervolemia. d. hyponatremia.

B. dehydration

Fecal leukocyte screening would be indicated in a patient with suspected a. lactose intolerance. b. enterocolitis. c. laxative abuse. d. giardiasis.

B. enterocolitis.

A clinical finding that is consistent with a diagnosis of adrenocortical insufficiency is a. hypokalemia. b. hypoglycemia. c. hypertension. d. moon face.

B. hypoglycemia

A clinical finding consistent with a diagnosis of syndrome of inappropriate ADH secretion (SIADH) is a. hypovolemia. b. hyponatremia. c. decreased osmolality. d. dehydration.

B. hyponatremia

A patient presenting with muscle cramps, fatigue, anxiety, depression, and prolonged Q-T intervals on EKG may be showing symptoms of a. hyperparathyroidism. b. hypoparathyroidism. c. diabetes insipidus. d. SIADH.

B. hypoparathyroidism.

Surgical removal of a gland may result in a. hypersecretion. b. hyposecretion. c. hyporesponsiveness. d. tissue resistance.

B. hyposecretion

The finding of hypotension, rigid abdomen, and absent bowel sounds in a patient with pancreatitis a. is an expected finding and requires no specific intervention. b. indicates peritonitis with substantial risk for sepsis and shock. c. requires immediate surgical intervention. d. is an unusual finding in pancreatitis and indicates misdiagnosis.

B. indicates peritonitis with substantial risk for sepsis and shock.

The underlying pathogenic mechanism for type 2 diabetes is a. pancreatic β-cell destruction. b. insulin resistance and β-cell dysfunction. c. lack of exercise and chronic overeating. d. impaired glucose transport into cells.

B. insulin resistance and β-cell dysfunction.

The formation of active vitamin D a. occurs in the skin. b. is impaired in renal failure. c. is dependent on oral intake of vitamin D. d. is necessary for normal potassium metabolism.

B. is impaired in renal failure.

It is true that gallstones are a. a minimal risk for Native Americans. b. more common in women. c. more common in men. d. at highest risk among Asians.

B. more common in women.

Growth hormone-deficient infants would display a. low birth length and weight. b. normal birth length and weight. c. high birth length and weight. d. normal length and low weight.

B. normal birth length and weight.

A patient admitted with bleeding related to esophageal varices could be expected to receive a continuous intravenous infusion of a. glucose. b. octreotide acetate. c. anticoagulants. d. proton pump inhibitors.

B. octreotide acetate.

Barrett esophagus is a a. gastrin-secreting lesion. b. preneoplastic lesion. c. benign condition. d. gastrin-secreting tumor.

B. preneoplastic lesion

The pain associated with chronic pancreatitis is generally described as ________ in nature. a. sharp and constant b. steady and boring c. intermittent and burning d. intermittent and stabbing

B. steady and boring

A patient receiving chemotherapy may be at greater risk for development of a. gastroesophageal reflux. b. stomatitis. c. esophageal varices. d. Mallory-Weiss syndrome.

B. stomatitis.

Which response to an injection of ACTH indicates a primary adrenal insufficiency? a. No change in serum glucocorticoid level b. An increase in serum glucocorticoid level c. A decrease in serum glucose level d. An increase in serum ACTH level

A. No change in serum glucocorticoid level

Ulcerative colitis is commonly associated with a. bloody diarrhea. b. malabsorption of nutrients. c. fistula formation between loops of bowel. d. inflammation and scarring of the submucosal layer of the bowel.

A. bloody diarrhea.

Diabetic neuropathy is thought to result from a. decreased myoinositol transport. b. elevated HbA1c. c. deficient neuronal insulin receptors. d. neuronal demyelination.

A. decreased myoinositol transport.

Untreated acute cholecystitis may lead to ________ of the gallbladder wall. a. gangrene b. infection c. distention d. inflammation

A. gangrene

The most common causes of prehepatic jaundice are ________ and ineffective erythropoiesis. a. hemolysis b. metabolism c. fibrosis d. canalicular bilirubin transport

A. hemolysis

The American Diabetes Association recommends a postprandial blood glucose level of ________ mg/dL for adults with diabetes. a. less than 180 b. more than 180 c. 70 d. 130

A. less than 180

A patient being treated for hepatic encephalopathy could be expected to receive a(n) ________ diet. a. low-protein and high-fiber b. high-protein and high-carbohydrate c. high-sodium d. unrestricted

A. low-protein and high-fiber

The underlying pathogenic mechanism for type 1 diabetes is a. pancreatic β-cell destruction. b. lack of insulin receptors. c. lack of exercise and chronic overeating. d. impaired glucose transport into cells.

A. pancreatic β-cell destruction.

In type I diabetes, respiratory compensation may occur through a process of a. respiratory alkalosis. b. respiratory acidosis. c. metabolic acidosis. d. metabolic alkalosis.

A. respiratory alkalosis.

Diabetes insipidus is a condition that a. results from inadequate ADH secretion. b. is characterized by oliguria. c. is associated with anterior pituitary dysfunction. d. leads to glycosuria.

A. results from inadequate ADH secretion.

It is true that growth hormone excess in adults a. results in the condition of acromegaly. b. leads to abnormally tall stature. c. is associated with hypoglycemia. d. is usually asymptomatic.

A. results in the condition of acromegaly.

Clinical manifestations of Graves disease may include a. tremor. b. cold intolerance. c. lethargy. d. weight gain

A. tremor.

Normal bile is composed of a. water, electrolytes, and organic solutes. b. proteins. c. bile acids. d. phospholipids.

A. water, electrolytes, and organic solutes.

A patient with chronic gastritis would likely be tested for a.Helicobacter pylori. b. occult blood. c. lymphocytes. d. herpes simplex.

A.Helicobacter pylori.

What laboratory data would support a diagnosis of hemochromatosis? a. Deficient protease inhibitor b. Elevated ferritin c. Elevated urine copper d. Positive antinuclear antibody

B. Elevated ferritin

An early indicator of colon cancer is a. rectal pain. b. bloody diarrhea. c. a change in bowel habits. d. jaundice.

c. a change in bowel habits

Hepatitis B is usually transmitted by exposure to a. hepatitis vaccine. b. feces c. blood or semen d. contaminated food

c. blood or semen