Patho 2: Chapter 36, 37, 38 - Quiz 4- GI Disorders, Gall Bladder and Pancreatic Disorders

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

D

Esophageal varices may develop as a complication of liver disease. Pathophysiologically, this condition can be attributed to a. elevated bilirubin. b. diminished protein metabolism. c. fluid accumulation. d. portal hypertension.

D

A deficiency of lipid digestion or absorption commonly results in a. steatorrhea. b. constipation. c. hyperlipidemia. d. cholelithiasis.

A

Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of a. appendicitis. b. peritonitis. c. cholecystitis. d. gastritis.

A

Celiac sprue is a malabsorptive disorder associated with a. inflammatory reaction to gluten-containing foods. b. megacolon at regions of autonomic denervation. c. ulceration of the distal colon and rectum. d. deficient production of pancreatic enzymes.

A

Chronic pancreatitis may lead to a. diabetes mellitus. b. Crohn disease. c. gallstones. d. celiac sprue.

A

Difficulty swallowing: a. Dysphagia b. Achalasia c. Odynophagia d. Diverticulosis e. Encopresis

A

In which of the following cases would it be inappropriate to manage dyspepsia with an empiric trial of an H2 blocker? a. Concomitant dysphagia b. Chronic use of nonsteroidal antiinflammatory drugs c. Dyspepsia occurring after meals d. Dyspepsia relieved by meals

A

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

Which of the following forms of viral hepatitis is likely to be transmitted oral-fecal? a. Hepatitis A b. Hepatitis B c. Hepatitis C d. Hepatitis E

A

Which of the following forms of viral hepatitis is likely to be transmitted sexually? a. Hepatitis A b. Hepatitis B c. Hepatitis C d. Hepatitis E

B

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

B

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

D

Herniations in the bowel wall: a. Dysphagia b. Achalasia c. Odynophagia d. Diverticulosis e. Encopresis

D

Histamine antagonists 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

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

D

Which of the following findings 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

A Barrett esophagus is a. best managed with H2 antagonists. b. a preneoplastic lesion. c. a benign condition. d. a gastrin-secreting tumor.

B

A patient who should be routinely evaluated for peptic ulcer disease is one who is a. taking 6 to 8 tablets of acetaminophen per day. b. being treated with high-dose oral glucocorticoids. c. experiencing work-related stress. d. routinely drinking alcoholic beverages.

B

Absence of peristalsis in a portion of the esophagus: a. Dysphagia b. Achalasia c. Odynophagia d. Diverticulosis e. Encopresis

B

Combined dysphagia with both solids and liquids is typical of a. esophageal stricture. b. achalasia. c. esophageal tumors. d. Mallory-Weiss syndrome.

B

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

B

Hemochromatosis is a common genetic disorder that may lead to chronic liver failure. Which of the following laboratory data would support a diagnosis of hemochromatosis? a. Deficient protease inhibitor b. Elevated ferritin c. Elevated urine copper d. Positive antinuclear antibody

B

Liver transaminase elevations in which aspartate aminotransferase (AST) is greater than alanine aminotransferase (ALT) by a 2:1 ratio is characteristic of a. viral hepatitis. b. alcohol-induced injury. c. cirrhosis. d. acetaminophen toxicity.

B

Most gallstones are composed of a. bile. b. cholesterol. c. calcium. d. uric acid salts.

B

Patients with acute pancreatitis are generally not allowed to eat and may require continuous gastric suctioning to a. prevent abdominal distention. b. remove the usual stimuli for pancreatic secretion. c. prevent hyperglycemia associated with loss of insulin secretion. d. prevent mechanical obstruction of the intestine.

B

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

Which of the following findings 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

A patient with pancreatitis may experience muscle cramps and laryngospasm secondary to a. alkalosis. b. hyperglycemia. c. hypocalcemia. d. hypermagnesemia.

C

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

C

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

C

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

C

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

C

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

C

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

C

Jaundice is a common manifestation of a. malabsorption syndromes. b. anemia. c. liver disease. d. cholecystitis.

C

Painful swallowing: a. Dysphagia b. Achalasia c. Odynophagia d. Diverticulosis e. Encopresis

C

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

C

The usual treatment for chronic pancreatitis includes a. pancreatectomy. b. strict dietary avoidance of fats. c. abstinence from alcohol. d. long-term narcotic administration for pain.

C

Which of the following clinical findings would suggest an esophageal rather than an oropharyngeal cause of dysphagia? a. Nasal regurgitation b. Airway obstruction with swallowing c. Chest pain during meals d. Coughing when swallowing

C

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

D

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

A viral hepatitis screen with positive hepatitis B surface antigen, positive anti-HB core IgM, and negative anti-HB surface IgG should be interpreted as _____ hepatitis B. a. recovered from . b. immunity to c. chronic active d. acute

D

Stasis and involuntary leakage of stool: a. Dysphagia b. Achalasia c. Odynophagia d. Diverticulosis e. Encopresis

E

A reduction in lower esophageal sphincter tone helps reduce gastroesophageal reflux. True/False

F

Bile salts enzymatically digest lipids in the small intestine. True/False

F

Crohn disease and ulcerative colitis are two types of irritable bowel syndrome. True/False

F

Diverticulitis usually is asymptomatic. True/False

F

Hepatitis A and hepatitis C are transmitted through contaminated food and water. True/False

F

Liver cancer usually is a primary cancer arising from hepatic cells. True/False

F

The pain of cholecystitis commonly radiates to the left upper quadrant and left shoulder. True/False

F

RUQ pain from cholecystitis also causes RUQ pain with associated nausea and vomiting and also classically occurs following a large, fatty meal

NOT LUQ and L shoulder pain

Alcohol abuse is the primary risk factor for chronic pancreatitis. True/False

T

Cholelithiasis is present in 90% of patients who have acute cholecystitis. True/False

T

Esophagitis pain is similar in location and pattern to myocardial chest pain. True/False

T

Hepatitis A is a self-limiting infection that does not have a chronic carrier state. True/False

T

Hepatitis C is a chronic condition in about 85% of cases. True/False

T

Liver transaminases are increased in the serum when hepatocytes are injured. True/False

T

Long-term use of nonsteroidal antiinflammatory medications and infection with Helicobacter pylori are causative factors in peptic ulcer disease. True/False

T

The exocrine pancreas is stimulated to secrete in response to secretin and cholecystokinin. True/False

T